clear, use caution. Use Caution/Monitor.acetazolamideMinor (2)acetazolamide will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. acetazolamide will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.albuterolMonitor Closely (3)albuterol and salmeterol both decrease serum potassium. Use Caution/Monitor. albuterol and salmeterol both decrease sedation. Use Caution/Monitor. albuterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.alfentanilMonitor Closely (1)alfentanil increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfuzosinMonitor Closely (1)alfuzosin and salmeterol both increase QTc interval. Use Caution/Monitor.alprazolamMonitor Closely (1)alprazolam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amilorideMonitor Closely (1)amiloride increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.amisulprideSerious - Use Alternative (1)amisulpride and salmeterol both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylineMonitor Closely (1)amitriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline, 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.amobarbitalMonitor Closely (1)amobarbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amoxapineMonitor Closely (1)amoxapine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amoxapine, 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.anastrozoleMinor (2)anastrozole will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. anastrozole will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.apalutamideSerious - Use Alternative (2)apalutamide will decrease the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed. apalutamide will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.arformoterolMonitor Closely (3)arformoterol and salmeterol both decrease serum potassium. Use Caution/Monitor. arformoterol and salmeterol both decrease sedation. Use Caution/Monitor. arformoterol and salmeterol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.aripiprazoleMonitor Closely (1)aripiprazole increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.armodafinilMonitor Closely (1)salmeterol and armodafinil both decrease sedation. Use Caution/Monitor.aspirinMonitor Closely (1)aspirin increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.aspirin rectalMonitor Closely (1)aspirin rectal increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .aspirin/citric acid/sodium bicarbonateMonitor Closely (1)aspirin/citric acid/sodium bicarbonate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.atazanavirMonitor Closely (2)atazanavir 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 exposure atazanavir increases levels of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Increased risk of systemic effects.atenololMonitor Closely (2)atenolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. atenolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.atomoxetineMonitor Closely (1)salmeterol, atomoxetine. Other (see comment). Use Caution/Monitor. Comment: Exercise caution if beta-agonists and atomoxetine are coadministered. Interaction may be less likely with inhaled beta-agonists versus those given systemically. .azelastineMonitor Closely (1)azelastine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.belladonna and opiumMonitor Closely (1)belladonna and opium increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.bendroflumethiazideMonitor Closely (1)salmeterol and bendroflumethiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)salmeterol, bendroflumethiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.benperidolMonitor Closely (1)benperidol increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benzphetamineMonitor Closely (2)salmeterol and benzphetamine both decrease sedation. Use Caution/Monitor. salmeterol and benzphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.betaxololMonitor Closely (2)betaxolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. betaxolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.bisoprololMonitor Closely (2)bisoprolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. bisoprolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.bumetanideMonitor Closely (1)salmeterol and bumetanide both decrease serum potassium. Use Caution/Monitor.Minor (1)salmeterol, bumetanide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.buprenorphine buccalMonitor Closely (1)buprenorphine buccal increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.butabarbitalMonitor Closely (1)butabarbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.butalbitalMonitor Closely (1)butalbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.butorphanolMonitor Closely (1)butorphanol increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.caffeineMonitor Closely (1)salmeterol and caffeine both decrease sedation. Use Caution/Monitor.carbamazepineMonitor Closely (1)carbamazepine will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbenoxoloneMonitor Closely (1)salmeterol and carbenoxolone both decrease serum potassium. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.carvedilolMonitor Closely (2)carvedilol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. carvedilol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.celecoxibMonitor Closely (1)celecoxib increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.celiprololMonitor Closely (2)celiprolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. celiprolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.cenobamateMonitor Closely (2)cenobamate will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. cenobamate will decrease the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.ceritinibMonitor Closely (1)ceritinib will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)ceritinib will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chloral hydrateMonitor Closely (1)chloral hydrate increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloramphenicolSerious - Use Alternative (1)chloramphenicol will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chlordiazepoxideMonitor Closely (1)chlordiazepoxide increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloroquineSerious - Use Alternative (1)chloroquine and salmeterol both increase QTc interval. Avoid or Use Alternate Drug.chlorothiazideMonitor Closely (1)salmeterol and chlorothiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)salmeterol, chlorothiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.chlorpheniramineMonitor Closely (1)chlorpheniramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorthalidoneMonitor Closely (1)salmeterol and chlorthalidone both decrease serum potassium. Use Caution/Monitor.Minor (1)salmeterol, chlorthalidone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.choline magnesium trisalicylateMonitor Closely (1)choline magnesium trisalicylate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .cinnarizineMonitor Closely (1)cinnarizine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.citalopramMonitor Closely (1)citalopram and salmeterol both increase QTc interval. Use Caution/Monitor.clarithromycinMonitor Closely (3)clarithromycin and salmeterol both increase QTc interval. Use Caution/Monitor. clarithromycin 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 exposure clarithromycin will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.clemastineMonitor Closely (1)clemastine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clomipramineMonitor Closely (1)clomipramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine, 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.clonazepamMonitor Closely (1)clonazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clorazepateMonitor Closely (1)clorazepate increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. clozapine and salmeterol both increase QTc interval. Use Caution/Monitor.cobicistatMonitor Closely (1)cobicistat increases levels of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)cobicistat increases levels of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration not recommended; may result in increased cardiovascular effects associated with salmeterol, including QT prolongation, palpitations, and sinus tachycardia.codeineMonitor Closely (1)codeine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.conivaptanMonitor Closely (2)conivaptan will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. conivaptan 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 exposurecrizotinibMonitor Closely (1)crizotinib and salmeterol both increase QTc interval. Use Caution/Monitor.cyclizineMonitor Closely (1)cyclizine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cyclopenthiazideMonitor Closely (1)salmeterol and cyclopenthiazide both decrease serum potassium. Use Caution/Monitor.Minor (1)salmeterol, cyclopenthiazide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia.cyclophosphamideMinor (2)cyclophosphamide will increase the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. cyclophosphamide will increase the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyproheptadineMonitor Closely (1)cyproheptadine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dabrafenibMonitor Closely (1)dabrafenib will decrease the level or effect of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.darunavirContraindicated (1)darunavir increases levels of salmeterol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Potential for increased toxicity. .Monitor Closely (1)darunavir 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 exposuredasatinibMonitor Closely (1)dasatinib and salmeterol both increase QTc interval. Use Caution/Monitor.deflazacortMonitor Closely (1)salmeterol and deflazacort both decrease serum potassium. Use Caution/Monitor.degarelixMonitor Closely (1)degarelix and salmeterol both increase QTc interval. Use Caution/Monitor.desipramineMonitor Closely (1)desipramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, 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.deutetrabenazineMonitor Closely (1)deutetrabenazine and salmeterol both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexfenfluramineMonitor Closely (2)salmeterol and dexfenfluramine both decrease sedation. Use Caution/Monitor. salmeterol and dexfenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution.