Matters of the HAART: Ritonavir Induced CYP3A4 Inhibition of Intranasal Fluticasone Leading to Cushing's Syndrome
October 2023
in “
Journal of the Endocrine Society
”
Studysummary In this case report, researchers highlight a 57-year-old HIV patient on ritonavir who developed Cushing’s syndrome from over-the-counter intranasal fluticasone, underscoring the risks of drug interactions and the importance of counseling patients about potential steroid ingredients in OTC products.
Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
The article discusses a case where a 57-year-old man with HIV on HAART developed Cushing’s syndrome due to the interaction between ritonavir, a potent CYP3A4 inhibitor, and over-the-counter intranasal fluticasone propionate (FP). Despite not using oral or topical steroids, the patient experienced symptoms like fatigue, weight gain, and easy bruising. Physical examination and lab results confirmed exogenous steroid-induced Cushing’s syndrome. The condition resolved after discontinuing FP. The study highlights the importance of educating patients on ritonavir about the risks of using OTC steroids and the need for thorough medication reviews to prevent such adverse effects.
