Ritonavir : Fluticasone Propionate: A drug interaction trial with fluticasone propionate aqueous nasal spray in healthy subjects has shown that ritonavir (a strong CYP3A4 inhibitor) can significantly increase plasma fluticasone propionate exposure, resulting in significantly reduced serum cortisol concentrations [see CLINICAL PHARMACOLOGY ]. During postmarketing use, there have been reports of clinically significant drug interactions in patients receiving fluticasone propionate and ritonavir, resulting in systemic corticosteroid effects including Cushing's syndrome and adrenal suppression.
Fluticasone propionate is a synthetic (man-made) corticosteroid that is used on the skin (topically). The naturally-occurring corticosteroid is cortisol or hydrocortisone produced by the adrenal gland. Corticosteroids have potent anti-inflammatory actions and also suppress the immune response. Similar drugs include betamethasone dipropionate (Diprolene), clobetasol propionate (Temovate), halobetasol propionate (Ultravate), betamethasone dipropionate (Diprosone), desoximetasone (Topicort), halcinonide (Halog), amcinonide (Cyclocort), triamcinolone acetonide (Kenalog), fluocinolone acetonide (Synalar), hydrocortisone butyrate (Locoid), hydrocortisone valerate (Westcort), and mometasone furoate (Elocon). The FDA approved topical fluticasone propionate in December, 1990.
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