fluticasone inhaled by unspecified interaction mechanism. Avoid or Use Alternate Drug. Coadministration may reduce serum cortisol concentrations; alternative corticosteroids should be considered, particularly for long term use ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of salmeterol by decreasing metabolism. Avoid or Use Alternate Drug. Concurrent administration of Viekira Pak and salmeterol is not recommended; coadministration may result in increased risk of cardiovascular adverse events associated with salmeterol, including QT prolongation, palpitations and sinus tachycardiaopium tinctureMonitor Closely (1)opium tincture increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.osilodrostatMonitor Closely (1)osilodrostat and salmeterol both increase QTc interval. Use Caution/Monitor.oxaprozinMonitor Closely (1)oxaprozin increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.paliperidoneMonitor Closely (1)paliperidone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.panobinostatSerious - Use Alternative (1)salmeterol and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.papaveretumMonitor Closely (1)papaveretum increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.parecoxibMonitor Closely (1)parecoxib increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.penbutololMonitor Closely (2)penbutolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. penbutolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentazocineMonitor Closely (1)pentazocine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazineMonitor Closely (1)perphenazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phendimetrazineMonitor Closely (2)salmeterol and phendimetrazine both decrease sedation. Use Caution/Monitor. salmeterol and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenelzineSerious - Use Alternative (1)phenelzine increases effects of salmeterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.phenobarbitalMonitor Closely (2)phenobarbital will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. phenobarbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenoxybenzamineMonitor Closely (1)phenoxybenzamine, salmeterol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Hypotension, tachycardia.phentermineMonitor Closely (2)salmeterol and phentermine both decrease sedation. Use Caution/Monitor. salmeterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenylephrineMonitor Closely (2)salmeterol and phenylephrine both decrease sedation. Use Caution/Monitor. salmeterol and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenylephrine POMonitor Closely (2)salmeterol and phenylephrine PO both decrease sedation. Use Caution/Monitor. salmeterol and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodineMonitor Closely (1)pholcodine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (1)pimozide increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pindololMonitor Closely (2)pindolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. pindolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.pirbuterolMonitor Closely (3)pirbuterol and salmeterol both decrease serum potassium. Use Caution/Monitor. pirbuterol and salmeterol both decrease sedation. Use Caution/Monitor. pirbuterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.piroxicamMonitor Closely (1)piroxicam increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.posaconazoleMonitor Closely (2)posaconazole will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. posaconazole will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposurepotassium acid phosphateMonitor Closely (1)potassium acid phosphate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.potassium chlorideMonitor Closely (1)potassium chloride increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.potassium citrateMonitor Closely (1)potassium citrate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.primidoneMonitor Closely (1)primidone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)primidone will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.procarbazineMonitor Closely (1)procarbazine increases effects of salmeterol by pharmacodynamic synergism. Use Caution/Monitor.prochlorperazineMonitor Closely (1)prochlorperazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propranololMonitor Closely (2)propranolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. propranolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.propylhexedrineMonitor Closely (2)salmeterol and propylhexedrine both decrease sedation. Use Caution/Monitor. salmeterol and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.protriptylineMonitor Closely (1)protriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)protriptyline, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.pseudoephedrineMonitor Closely (1)salmeterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (1)quetiapine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quinidineMonitor Closely (1)quinidine will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposureribociclibMonitor Closely (1)ribociclib will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)ribociclib will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.rifabutinMonitor Closely (1)rifabutin will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.risperidoneMonitor Closely (1)risperidone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ritonavirContraindicated (1)ritonavir increases levels of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Potential for increased toxicity.Monitor Closely (1)ritonavir will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposurerucaparibMonitor Closely (2)rucaparib will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated. rucaparib will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.sacubitril/valsartanMonitor Closely (1)sacubitril/valsartan increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.sageMinor (1)sage increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.salicylates (non-asa)Monitor Closely (1)salicylates (non-asa) increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.salsalateMonitor Closely (1)salsalate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.saquinavirMonitor Closely (2)saquinavir increases levels of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias. saquinavir will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposurescullcapMonitor Closely (1)scullcap increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidateMonitor Closely (1)salmeterol and serdexmethylphenidate/dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.shepherd's purseMonitor Closely (1)shepherd's purse increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycolMonitor Closely (1)salmeterol and sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.solriamfetolMonitor Closely (1)salmeterol and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sotalolMonitor Closely (2)sotalol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. sotalol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.spironolactoneMonitor Closely (1)spironolactone increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.stiripentolMonitor Closely (2)stiripentol, salmeterol. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment. stiripentol, fluticasone inhaled. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.succinylcholineMonitor Closely (1)succinylcholine increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.sufentanilMonitor Closely (1)sufentanil increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sulfasalazineMonitor Closely (1)sulfasalazine increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.sulindacMonitor Closely (1)sulindac increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tazemetostatMonitor Closely (2)tazemetostat will decrease the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. tazemetostat will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will decrease the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.temazepamMonitor Closely (1)temazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.terbutalineMonitor Closely (3)salmeterol and terbutaline both decrease serum potassium. Use Caution/Monitor. salmeterol and terbutaline both decrease sedation. Use Caution/Monitor. salmeterol and terbutaline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.thioridazineMonitor Closely (1)thioridazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.timololMonitor Closely (2)timolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. timolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tipranavirMonitor Closely (1)tipranavir will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong CYP3A4 inhibitors may increase fluticasone systemic exposureSerious - Use Alternative (1)tipranavir will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tolfenamic acidMonitor Closely (1)tolfenamic acid increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tolmetinMonitor Closely (1)tolmetin increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tolvaptanMonitor Closely (1)tolvaptan increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.topiramateMonitor Closely (1)topiramate increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.torsemideMonitor Closely (1)salmeterol and torsemide both decrease serum potassium. Use Caution/Monitor.Minor (1)salmeterol, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.tramadolMonitor Closely (1)tramadol increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineSerious - Use Alternative (1)tranylcypromine increases effects of salmeterol by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trastuzumabMonitor Closely (1)trastuzumab, fluticasone inhaled. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .trastuzumab deruxtecanMonitor Closely (1)trastuzumab deruxtecan, fluticasone inhaled. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile