NutriStack
Fluticasone Nasal and Schisandra, a caution.
Nasal fluticasone usually has low systemic exposure, but CYP3A inhibition can still increase steroid exposure in susceptible patients. Schisandra extract inhibits CYP3A in humans, so concentrated products may increase the risk of systemic steroid effects during chronic nasal fluticasone use.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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From the interaction database
What the row says.
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At a glance
- Substances
- Fluticasone Nasal and Schisandra
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Nasal fluticasone usually has low systemic exposure, but CYP3A inhibition can still increase steroid exposure in susceptible patients. Schisandra extract inhibits CYP3A in humans, so concentrated products may increase the risk of systemic steroid effects during chronic nasal fluticasone use.
Mechanism. Fluticasone is cleared primarily by CYP3A4, limiting systemic exposure after swallowed or absorbed drug. Schisandra-mediated CYP3A inhibition could reduce this clearance and increase systemic glucocorticoid activity.
Recommendation. Use Schisandra cautiously if you use nasal fluticasone daily or at high doses. Watch for steroid excess symptoms such as easy bruising, facial swelling, weight gain, or unusual fatigue, and tell your clinician about the supplement.
Sources (2)
- Xin HW, Wu XC, Li Q, Yu AR, Xiong L. Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers. Br J Clin Pharmacol. 2009;67(5):541-546. PMID 19552749
- Foisy MM, Yakiwchuk EM, Chiu I, Singh AE. Adrenal suppression and Cushing's syndrome secondary to an interaction between ritonavir and fluticasone: a review of the literature. HIV Med. 2008;9(6):389-396. PMID 18459946
Stack Score
How this pair moves the number.
Effect on the composite score
If both Fluticasone Nasal and Schisandra are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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