<unk>  may have drug–drug interactions (DDIs) that are both pharmacokinetic (related to metabolism) and pharmacodynamic (related to the effect of medications) in nature. FF/UMEC/VI is susceptible to DDIs that would normally effect any of the individual components of the medication. Pharmacokinetic interactions All three components are substrates of the efflux transporter p-glycoprotein (p-gp), a protein that causes drugs to be transported out of cells. The presence of p-gp inhibiting drugs did not appear to effect the pharmacokinetics of<unk> , though the area under the curve (a measure of systemic absorption) of umeclidinium increased 1.4-fold. The effect of p-gp inhibitors on<unk>  pharmacokinetics are unknown.<unk><unk> <unk><unk>  is metabolized by cytochrome P450 3A4 (CYP3A4). Medications that are inhibitors of CYP3A4 (e.g. ketoconazole) may decrease<unk> 's metabolism in the body, causing levels to accumulate. The bioavailability (the amount of a medication that reaches the blood after administration) of<unk>  in the FF/UMEC/VI product is low (15.2%), decreasing the risk of acute toxicity in overdose/accumulation situations. However, if a person is exposed to high doses of<unk>  over time, it may increase their risk of experiencing Cushing's syndrome (a syndrome that occurs due to high levels of glucocorticoids, like<unk> , and includes muscular weakness, weight gain, and excessive hairiness). In drug interaction studies of FF/UMEC/VI in the presence of the CYP3A4 inhibitor ketoconazole, adrenal insufficiency (as measured by serum cortisol levels was noted at 24 hours (27% decrease in cortisol). Umeclidinium bromide Umeclidinium is primarily metabolized by CYP2D6, in addition to a few secondary metabolism pathways (e.g. glucuronidation). At doses of umeclidinium that are above the recommended doses, no clinically significant differences in blood levels of umeclidinium was found after repeated dosing in people with impaired CYP2D6 function (compared to people with normal CYP2D6 function).<unk> <unk>  is also a CYP3A4 substrate. Like<unk> , CYP3A4 inhibitors may increase the levels of<unk>  in the body. In drug interaction studies of FF/UMEC/VI in the presence of the CYP3A4 inhibitor ketoconazole, side effects that are characteristic of<unk>  overdose were not observed (i.e. elevated heart rate). Pharmacodynamic interactions<unk><unk> <unk><unk>  is a corticosteroid, a type of hormone that can suppress the function of the immune system (which fights off infections). This can increase the risk of infection, especially oral fungal infections when people do not rinse out their mouths with water after using<unk> . Combining<unk>  with other steroids (e.g. oral prednisone) may theoretically increase the risk of infections. Umeclidinium bromide Umeclidinium is a medication with anticholinergic properties. When combined with other medication that also antagonize cholinergic receptors, this may lead to a duplicate anticholinergic effect, increasing the risk for anticholinergic spectrum side effects (e.g. dry mouth, constipation).<unk> <unk>  is a beta2-adrenergic receptor agonist. When combined with medications that have the opposite effect (i.e. beta blockers, like carvedilol), this may theoretically prevent<unk>  from working as intended.
Fluticasone furoate/umeclidinium bromide/vilanterol
Beclometasone/formoterol/glycopyrronium bromide
Budesonide/glycopyrronium bromide/formoterol
Budesonide/formoterol
Aclidinium bromide/formoterol
Umeclidinium bromide/vilanterol
Glycopyrronium bromide/formoterol
Olopatadine/mometasone