Drug interactions between Diflucan and Flonase
|Flonase (fluticasone nasal)|
Interactions between your drugs
fluconazole ↔ fluticasone
Applies to:Diflucan (fluconazole) and Flonase (fluticasone nasal)
Consumer information for this interaction is not currently available.
MONITOR: Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation. Fluticasone undergoes extensive first-pass and systemic metabolism via CYP450 3A4, thus inhibition of the isoenzyme may significantly increase systemic bioavailability of the drug. However, the extent of interaction may depend on the route of fluticasone administration and the specific formulation. Multiple case reports describe instances of adrenal insufficiency and Cushing's syndrome associated with concomitant use of inhaled fluticasone and the azole antifungal fluconazole, a moderate CYP450 3A4 inhibitor.
MANAGEMENT: Monitor for signs and symptoms of hypercorticism if intranasal or orally inhaled fluticasone is coadministered with a moderate inhibitor of CYP450 3A4. Signs and symptoms of hypercorticism include acne, striae, thinning of the skin, easy bruising, moon facies, dorsocervical "buffalo" hump, truncal obesity, increased appetite, acute weight gain, edema, hypertension, hirsutism, hyperhidrosis, proximal muscle wasting and weakness, glucose intolerance, exacerbation of preexisting diabetes, depression, and menstrual disorders. Other systemic glucocorticoid effects may include adrenal suppression, immunosuppression, posterior subcapsular cataracts, glaucoma, bone loss, and growth retardation in children and adolescents. Signs and symptoms of adrenal insufficiency include anorexia, hypoglycemia, nausea, vomiting, weight loss, muscle wasting, fatigue, weakness, dizziness, postural hypotension, depression, and adrenal crisis manifested as inability to respond to stress (e.g., illness, infection, surgery, trauma). Systemic glucocorticoids may be necessary until adrenal function recovers.
- "Product Information. Prezista (darunavir)." Ortho Biotech Inc, Bridgewater, NJ.
- St Clair K, Maguire JD "Role of fluconazole in a case of rapid onset ritonavir and inhaled fluticasone-associated secondary adrenal insufficiency." Int J STD AIDS 23 (2012): 371-2
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- Hoover WC, Britton LJ, Gardner J, Jackson T, Gutierrez H "Rapid onset of iatrogenic adrenal insufficiency in a patient with cystic fibrosis-related liver disease treated with inhaled corticosteroids and a moderate CYP3A4 inhibitor." Ann Pharmacother 45 (2011): e38
- "Product Information. Bosulif (bosutinib)." Pfizer U.S. Pharmaceuticals Group, New York, NY.
- "Product Information. Imbruvica (ibrutinib)." Pharmacyclics Inc, Sunnyvale, CA.
Drug and food interactions
Therapeutic duplication warnings
No therapeutic duplications were found for your selected drugs.
Drug Interaction Classification
|No information available.|
Do not stop taking any medications without consulting your healthcare provider.