Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide interactions
Checked as Fluticasone + Umeclidinium in this data source.
Full monograph for Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium BromideCheck it against another medicine
Medicines
585 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Ceritinibvia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Clarithromycinvia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Desmopressin Acetatevia Fluticasone | Major | Synergy | Coadministration of desmopressin with loop diuretics or systemic or inhaled corticosteroids may increase the risk of severe hyponatremia. Loop diuretics and… | 9 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycinvia Fluticasone | Major | Metabolism · Unknown | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms | 40 sources — open the full entry |
| Itraconazolevia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Ketoconazolevia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleoveravia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycinvia Fluticasone | Major | Metabolism · Unknown | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…3 documented mechanisms | 40 sources — open the full entry |
| Lopinavir + Ritonavirvia Fluticasone | Major | Metabolism | Coadministration with ritonavir may significantly increase the systemic exposure to fluticasone following intranasal administration or oral inhalation. The… | 35 sources — open the full entry |
| Mifepristonevia Fluticasone | Major | Antagonism · Metabolism | Mifepristone is a potent antiglucocorticoid and may antagonize the effects of corticosteroids. Pharmacokinetically, mifepristone may increase the plasma… | 4 sources — open the full entry |
| Mifepristone + Misoprostolvia Fluticasone | Major | Antagonism · Metabolism · Unknown | Mifepristone is a potent antiglucocorticoid and may antagonize the effects of corticosteroids. Pharmacokinetically, mifepristone may increase the plasma…2 documented mechanisms | 4 sources — open the full entry |
| Nelfinavirvia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Nirmatrelvir + Ritonavirvia Fluticasone | Major | Metabolism | Coadministration with ritonavir may significantly increase the systemic exposure to fluticasone following intranasal administration or oral inhalation. The… | 35 sources — open the full entry |
| Posaconazolevia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Rabeprazole + Amoxicillin + Clarithromycinvia Fluticasone | Major | Metabolism · Unknown | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…3 documented mechanisms | 40 sources — open the full entry |
| Tucatinibvia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Vonoprazan + Amoxicillin + Clarithromycinvia Fluticasone | Major | Metabolism · Unknown | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms | 40 sources — open the full entry |
| Voriconazolevia Fluticasone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Abametapirvia Fluticasone | Moderate | Metabolism | Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450… | 1 sources — open the full entry |
| Aclidinium Bromide + Formoterol Fumaratevia Umeclidinium, Fluticasone | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 16 sources — open the full entry |
| Amitriptyline Hydrochloridevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Amitriptyline Hydrochloride + Chlordiazepoxidevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Apalutamidevia Fluticasone | Moderate | Absorption · Metabolism | Coadministration with apalutamide may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 3A4, 2C9, 2C19, breast… | 5 sources — open the full entry |
| Aprepitantvia Fluticasone | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral… | 7 sources — open the full entry |
| Aripiprazolevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Asciminibvia Fluticasone | Moderate | Metabolism | Coadministration with asciminib may increase the plasma concentrations of drugs that are primarily metabolized by the CYP450 3A4 isoenzyme. The mechanism is… | 1 sources — open the full entry |
| Atropine Sulfate (Injection)via Umeclidinium | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Beclometasone + Formoterol + Glycopyrroniumvia Umeclidinium, Fluticasone | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 16 sources — open the full entry |
| Beclomethasone Dipropionate + Chloramphenicol + Clotrimazole + Lidocainevia Fluticasone | Moderate | Metabolism · Unknown | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral…3 documented mechanisms | 7 sources — open the full entry |
| Bethanechol Chloridevia Umeclidinium | Moderate | Antagonism | Anticholinergic agents and other agents with significant anticholinergic activity (e.g., clozapine, class IA antiarrhythmics especially disopyramide) may… | 2 sources — open the full entry |
| Budesonide + Glycopyrronium Bromide + Formoterol Fumaratevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…3 documented mechanisms | 16 sources — open the full entry |
| Chloramphenicol (Oral)via Fluticasone | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral… | 7 sources — open the full entry |
| Chloramphenicol + Lidocaine Hydrochloridevia Fluticasone | Moderate | Metabolism · Unknown | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral…2 documented mechanisms | 7 sources — open the full entry |
| Chlorpheniramine Maleatevia Umeclidinium | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Chlorpromazine Hydrochloridevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Cinnarizine + Dimenhydrinatevia Umeclidinium | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| CiprofloxacinbaseOphthalmicvia Fluticasone | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral… | 7 sources — open the full entry |
| Ciprofloxacin + Dexamethasonevia Fluticasone | Moderate | Metabolism · Unknown | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral…2 documented mechanisms | 7 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetatevia Fluticasone | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral… | 7 sources — open the full entry |
| Clomipramine Hydrochloridevia Umeclidinium | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Clozapinevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Crizotinibvia Fluticasone | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral… | 7 sources — open the full entry |
| Cyclizine Hydrochloridevia Umeclidinium | Moderate | Synergy | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary… | 12 sources — open the full entry |
| Cyclobenzaprine Hydrochloridevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Darifenacinvia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Dexamethasone + Chloramphenicolvia Fluticasone | Moderate | Metabolism · Unknown | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral…2 documented mechanisms | 7 sources — open the full entry |
| Dextromethorphan + Phenylephrine + Triprolidinevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Dextromethorphan + Pseudoephedrine + Triprolidinevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Dicycloverine Hydrochloridevia Umeclidinium, Fluticasone | Moderate | Synergy · Unknown | The potential exists for additive anticholinergic effects such as mydriasis, blurred vision, heat intolerance, fever, dry mouth, tachycardia, urinary…2 documented mechanisms | 12 sources — open the full entry |
| Diltiazem Hydrochloridevia Fluticasone | Moderate | Metabolism | Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral… | 7 sources — open the full entry |
Conditions
Conditions in which Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide needs care, as documented in this source.
Milk Hypersensitivity
MajorSome inhaled anticholinergic bronchodilators such as aclidinium and umeclidinium are contraindicated in patients with severe hypersensitivity to milk proteins. There have been reports of anaphylactic reactions on these patients after inhalation of other powder products containing lactose, therefore patients with severe milk protein allergy should not use these products.
2 sources
- "Product Information. Tudorza Pressair (aclidinium)." Forest Pharmaceuticals (2012):
- "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
Adrenocortical Hyperfunction
ModerateThe use of inhaled and nasal corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.
30 sources
- Kimmerle R, Rolla AR "Iatrogenic Cushing's syndrome due to dexamethasone nasal drops." Am J Med 79 (1985): 535-7
- Monk B, Cunliffe WJ, Layton AM, Rhodes DJ "Acne induced by inhaled corticosteroids." Clin Exp Dermatol 18 (1993): 148-50
- Brogden RN, Heel RC, Speight TM, Avery GS "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126
- Clark TJ "Safety of inhaled corticosteroids." Eur J Respir Dis Suppl 122 (1982): 235-42
- Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
- "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
Show all 30 sourcesShow fewer sources
- "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
- van As A, Bronsky E, Grossman J, Meltzer E, Ratner P, Reed C "Dose tolerance study of fluticasone propionate aqueous nasal spray in patients with seasonal allergic rhinitis." Ann Allergy 67 (1991): 156-62
- Stevens DJ "Cushing's syndrome due to the abuse of betamethasone nasal drops." J Laryngol Otol 102 (1988): 219-21
- Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
- Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
- "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
- Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
- "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- Robinson DS, Geddes DM "Inhaled corticosteroids: benefits and risks." J Asthma 33 (1996): 5-16
- Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
- "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
- Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
- McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
- Wiseman LR, Benfield P "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs 53 (1997): 885-907
- "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
- "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
- "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
- Wales D, Makker H, Kane J, McDowell P, ODriscoll BR "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
- Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
- "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
- "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
Anticholinergic Syndrome
ModerateAclidinium, ipratropium, umeclidinium, and tiotropium are anticholinergic agents. Although systemic effects are uncommon due to the poor absorption of quaternary ammonium compounds from gastrointestinal and nasal mucosa, worsening of urinary retention or angle-closure glaucoma has been reported. Increased intraocular pressure and precipitation or exacerbation of angle-closure glaucoma may also occur due to inadvertent contact of the eye with aerosolized or nebulized drug. Accordingly, therapy with quaternary ammonium compounds should be administered cautiously in patients with urinary retention/obstruction or angle-closure glaucoma. Measures should be taken whenever possible to minimize ocular exposure to these drugs, such as keeping eyes closed during oral inhalation or use of a mouthpiece rather than face mask during nebulization. Patients should be advised to contact their physician if they experience urinary difficulty (especially in patients with prostatic hyperplasia or bladder neck obstruction); or signs and symptoms of angle-closure glaucoma (e.g., eye pain or discomfort; blurred vision; visual halos; colored images in association with red eyes from conjunctival congestion or corneal edema).
11 sources
- Gross NJ "Ipratropium bromide." N Engl J Med 319 (1988): 486-94
- Milford CA, Mugliston TA, Lund VJ, Mackay IS "Long-term safety and efficacy study of intranasal ipratropium bromide." J Laryngol Otol 104 (1990): 123-5
- Lozewicz S "Bladder outflow obstruction induced by ipratropium bromide." Postgrad Med J 65 (1989): 260-1
- Pras E, Stienlauf S, Pinkhas J, Sidi Y "Urinary retention associated with ipratropium bromide." DICP 25 (1991): 939-40
- Massey KL, Gotz VP "Ipratropium bromide." Drug Intell Clin Pharm 19 (1985): 5-12
- Pakes GE, Brogden RN, Heel RC, Speight TM, Avery GS "Ipratropium bromide: a review of its pharmacological properties and therapeutic efficacy in asthma and chronic bronchitis." Drugs 20 (1980): 237-66
- "Product Information. Atrovent (ipratropium)." Boehringer-Ingelheim (2002):
- "Product Information. Atrovent Nasal (ipratropium nasal)." Boehringer-Ingelheim
Show all 11 sourcesShow fewer sources
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
- "Product Information. Tudorza Pressair (aclidinium)." Forest Pharmaceuticals (2012):
- "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
Hepatic Insufficiency
ModerateCorticosteroids are predominantly cleared by hepatic metabolism and impairment of the liver function may lead to their accumulation. Patients with hepatic disease should be closely monitored.
4 sources
- "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
- "Product Information. Asmanex Twisthaler (mometasone)." Schering-Plough Corporation (2005):
- "Product Information. Beconase AQ (beclomethasone nasal)." GlaxoSmithKline (2015):
- "Product Information. Pulmicort Flexhaler (budesonide)." A-S Medication Solutions (2016):
Infections
ModerateThe immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis infection of the respiratory tract or any untreated systemic fungal, bacterial, parasitic, or viral infection. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.
31 sources
- Horton DJ, Spector SL "Clinical pulmonary tuberculosis in an asthmatic patient using a steroid aerosol." Chest 71 (1977): 540-2
- Carrel TP, Schaffner A, Schmid ER, Schneider J, Bauer EP, Laske A, von Segesser LK, Turina MI "Fatal fungal pericarditis after cardiac surgery and immunosuppression." J Thorac Cardiovasc Surg 101 (1991): 161-4
- Vogt FC "The incidence of oral candidiasis with use of inhaled corticosteroids." Ann Allergy 43 (1979): 205-10
- Milne LJ, Crompton GK "Beclomethasone dipropionate and oropharyngeal candidiasis." Br Med J 3 (1974): 797-8
- Toogood JH, Jennings B, Greenway RW, Chuang L "Candidiasis and dysphonia complicating beclomethasone treatment of asthma." J Allergy Clin Immunol 65 (1980): 145-53
- Webb EL "Nasal candidiasis in a patient on long-term topical intranasal corticosteroid therapy." J Allergy Clin Immunol 91 (1993): 680-1
- Shaikh WA "Pulmonary tuberculosis in patients treated with inhaled beclomethasone." Allergy 47 (1992): 327-30
- Kesten S, Hyland RH, Pruzanski WR, Kortan PP "Esophageal candidiasis associated with beclomethasone dipropionate aerosol therapy." Drug Intell Clin Pharm 22 (1988): 568-9
Show all 31 sourcesShow fewer sources
- Brogden RN, Heel RC, Speight TM, Avery GS "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126
- Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
- Executive Committee American Academy of Allergy and Immunology "Inhaled corticosteroids and severe viral infections." J Allergy Clin Immunol 92 (1993): 223-8
- "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
- "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
- Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
- Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
- "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
- "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
- "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
- Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
- McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
- "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
- "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
- "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
- Wales D, Makker H, Kane J, McDowell P, ODriscoll BR "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
- Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
- "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
- "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
Keratitis, Herpetic
ModeratePharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.
13 sources
- "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
- "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
- "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
- "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
- "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
Show all 13 sourcesShow fewer sources
- "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
- "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
- "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
- "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
Liver Failure
ModeratePatients with moderate hepatic impairment showed no relevant increases in Cmax or AUC when using umeclidinium, when compared with healthy subjects. However, studies have not been performed in patients with severe hepatic impairment.
1 source
- "Product Information. Incruse Ellipta (umeclidinium)." GlaxoSmithKline (2014):
Osteoporosis
ModerateProlonged use of inhaled corticosteroids may be associated with a reduction in bone density. This effect appears to be dose-related and has been reported primarily with high dosages (>= 800 mcg/day of beclomethasone or equivalent for >= 1 year). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages. Long-term therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with osteoporosis. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.
24 sources
- Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
- Toogood JH, Crilly RG, Jones G, Nadeau J, Wells GA "Effect of high-dose inhaled budesonide on calcium and phosphate metabolism and the risk of osteoporosis." Am Rev Respir Dis 138 (1988): 57-61
- Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
- Konig P, Hillman L, Cervantes C, Levine C, Maloney C, Douglass B, Johnson L, Allen S "Bone metabolism in children with asthma treated with inhaled beclomethasone dipropionate." J Pediatr 122 (1993): 219-26
- Kinberg KA, Hopp RJ, Biven RE, Gallagher JC "Bone mineral density in normal and asthmatic children." J Allergy Clin Immunol 94 (1994): 490-7
- Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
- Toogood JH, Baskerville JC, Markov AE, Hodsman AB, Fraher LJ, Jennings B, Haddad RG, Drost D "Bone mineral density and the risk of fracture in patients receiving long-term inhaled steroid therapy for asthma." J Allergy Clin Immunol 96 (1995): 157-66
- Hanania NA, Chapman KR, Sturtridge WC, Szalai JP, Kesten S "Dose-related decrease in bone density among asthmatic patients treated with inhaled corticosteroids." J Allergy Clin Immunol 96 (1995): 571-9
Show all 24 sourcesShow fewer sources
- Martinati LC, Bertoldo F, Gasperi E, Micelli S, Boner AL "Effect on cortical and trabecular bone mass of different anti-inflammatory treatments in preadolescent children with chronic asthma." Am J Respir Crit Care Med 153 (1996): 232-6
- Packe GE, Douglas JG, McDonald AF, Robins SP, Reid DM "Bone density in asthmatic patients taking high dose inhaled beclomethasone diproprionate and intermittent systemic corticosteroids." Thorax 47 (1992): 414-7
- Reid DM, Nicoll JJ, Smith MA, Higgins B, Tothill P, Nuki G "Corticosteroids and bone mass in asthma: comparisons with rheumatoid arthritis and polymyalgia rheumatica." BMJ 293 (1986): 1463-6
- Ali NJ, Capewell S, Ward MJ "Bone turnover during high dose inhaled corticosteroid treatment." Thorax 46 (1991): 160-4
- Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
- Packe GE, Robb O, Robins SP, Reid DM, Douglas JG "Bone density in asthmatic patients taking inhaled corticosteroids: comparison of budesonide and beclomethasone dipropionate." J R Coll Physicians Lond 30 (1996): 128-32
- Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
- McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
- Wiseman LR, Benfield P "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs 53 (1997): 885-907
- Luengo M, delRio L, Pons F, Picado C "Bone mineral density in asthmatic patients treated with inhaled corticosteroids: a case-control study." Eur Respir J 10 (1997): 2110-3
- Wisniewski AF, Lewis SA, Green DJ, Maslanka W, Burrell H, Tattersfield AE "Cross sectional investigation of the effects of inhaled corticosteroids on bone density and bone metabolism in patients with asthma." Thorax 52 (1997): 853-60
- Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
- Wong CA, Walsh LJ, Smith CJP, Wisniewski AF, Lewis SA, Hubbard R, Cawte S, Green DJ, Pringle M, Tattersfield AE "Inhaled corticosteroid use and bone-mineral density in patients with asthma." Lancet 355 (2000): 1399-403
- Israel E, Banerjee TR, Fitzmaurice GM, Kotlov TV, LaHive K, LeBoff MS "Effects of inhaled glucocorticoids on bone density in premenopausal women." N Engl J Med 345 (2001): 941-7
- Sharma PK, Malhotra S, Pandhi P, Kumar N "Effect of inhaled steroids on bone mineral density: a meta-analysis." J Clin Pharmacol 43 (2003): 193-7
- Boulet LP, Milot J, Gagnon L, Poubelle PE, Brown J "Long-term influence of inhaled corticosteroids on bone metabolism and density. Are biological markers predictors of bone loss?" Am J Respir Crit Care Med 159 (1999): 838-44
Toxic Optic Neuropathy
ModerateProlonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with inhaled and nasal corticosteroids has only rarely produced these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.
32 sources
- Fraunfelder FT, Meyer SM "Posterior subcapsular cataracts associated with nasal or inhalation corticosteroids." Am J Ophthalmol 109 (1990): 489-90
- Karim AK, Thompson GM, Jacob TJ "Steroid aerosols and cataract formation." BMJ 299 (1989): 918
- Allen MB, Ray SG, Leitch AG, Dhillon B, Cullen B "Steroid aerosols and cataract formation." BMJ 299 (1989): 432-3
- Kewley GD "Possible association between beclomethasone diproprionate aerosol and cataracts." Aust Paediatr J 16 (1980): 117-8
- Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
- Ghanchi F "Young patients on inhaled steroids and cataract." Lancet 342 (1993): 1306-7
- Dreyer EB "Inhaled steroid use and glaucoma." N Engl J Med 329 (1993): 1822
- "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
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- "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
- "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
- "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
- Spaeth GL, Rodrigues MM, Weinreb S "Steroid-induced glaucoma: A. Persistent elevation of intraocular pressure B. Histopathological aspects." Trans Am Ophthalmol Soc 75 (1977): 353-81
- Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
- Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
- "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
- Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
- "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
- Garbe E, LeLorier J, Boivin JF, Suissa S "Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." JAMA 277 (1997): 722-7
- "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
- Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
- McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
- Cumming RG, Mitchell P, Leeder SR "Use of inhaled corticosteroids and the risk of cataracts." N Engl J Med 337 (1997): 8-14
- "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
- "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
- Agertoft L, Larsen FE, Pedersen S "Posterior subcapsular cataracts, bruises and hoarseness in children with asthma receiving long-term treatment with inhaled budesonide." Eur Resp J 12 (1998): 130-5
- "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
- "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
- Wales D, Makker H, Kane J, McDowell P, ODriscoll BR "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
- Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
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Therapeutic duplication
Drug classes that overlap with Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Formoterol/glycopyrrolate
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Phenohytro
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Olodaterol/tiotropium
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Urolet mb
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Chlorpheniramine/methscopolamine/phenylephrine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Phosphasal
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Glycopyrrolate/indacaterol
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Motofen
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Sympak ii
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Librax
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): B & o supprettes
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Butabarbital/hyoscyamine/phenazopyridine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Hyoscyamine/phenyltoloxamine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Duodote
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Duaklir pressair
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Tussigon
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Budesonide/formoterol/glycopyrrolate
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Albuterol/ipratropium
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Vi-atro
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Glycopyrrolate/neostigmine
anticholinergics/antispasmodics
The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category.
Example product in the source data (US market): Prosed ds
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Formoterol/mometasone
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Symbicort
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Budesonide/formoterol/glycopyrrolate
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Albuterol/budesonide