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Interaction with beta-blockers: Beta-adrenergic blockers may weaken or antagonise the effect of beta2-agonists, such as vilanterol. Concurrent use of either non-selective or selective beta-adrenergic blockers should be avoided unless there are compelling reasons for their use.
Interaction with CYP3A4 inhibitors: Vilanterol, a component of Umeclidinium + Vilanterol (Anoro Ellipta), is cleared by CYP3A4 mediated extensive first-pass metabolism in the gastrointestinal tract and in the liver.
Care is advised when co-administering with strong CYP3A4 inhibitors (e.g. ketoconazole) as there is potential for an increased systemic exposure to vilanterol, which could lead to an increase in the potential for adverse reactions (see Pharmacology: Pharmacokinetics under Actions).
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