Salmeterol : In a drug interaction trial in 20 healthy subjects, coadministration of inhaled salmeterol (50 mcg twice daily) and oral ketoconazole (400 mg once daily) for 7 days resulted in greater systemic exposure to salmeterol (AUC increased 16-fold and Cmax increased -fold). Three (3) subjects were withdrawn due to beta 2 -agonist side effects (2 with prolonged QTc and 1 with palpitations and sinus tachycardia ). Although there was no statistical effect on the mean QTc, coadministration of salmeterol and ketoconazole was associated with more frequent increases in QTc duration compared with salmeterol and placebo administration.
Although I am not a medical doctor (MD), I am a former RN/registered nurse, with many years of experience dealing holistically with various ailments, including conquering my husband's and my previous VCD attacks (and helping many, many others to conquer their VCD). The advice I can give you, is not medical advice--it is practical advice. The practical advice can help you to make a plan, about what you can try doing (and not doing), and also includes seeing various VCD-knowledgable specialist doctors, to be safe, and to get fully and accurately diagnosed, and correctly treated for your specific situation.