Editor’s Note: Each month, Drug Topics will be bringing you a new case to review, along with commentary to help you hone your clinical acumen.
DT is a 46-year-old African American woman with HIV, COPD, hypertension, and hyperlipidemia who presents to clinic for routine follow up. Her current medications are listed in the Table. You note that budesonide/formoterol is no longer on the preferred formulary and that fluticasone/salmeterol (Advair) is now preferred. You run a drug interaction check and find that fluticasone/salmeterol is not recommended with darunavir/cobicistat with an “X: avoid combination” warning because of the potential for increased fluticasone concentrations and adrenal suppression.
What change in therapy would you recommend to avoid the risk that DT could develop adrenal insufficiency and Cushing’s syndrome? Voice your opinion in the comments below, or let us know on our Facebook or on Twitter @Drug_Topics.
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