Drug interactions
Atazanavir + Budesonide
Severity: Major
Atazanavir and Budesonide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir, a potent CYP3A4 inhibitor boosted or not, can markedly raise systemic budesonide concentrations. This can cause iatrogenic Cushing's syndrome and adrenal suppression, even with inhaled or intranasal budesonide.
What this interaction means in plain words
Atazanavir and Budesonide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Budesonide belongs to Respiratory.
Why it happens
Inhibition of CYP3A4-mediated first-pass and systemic metabolism of budesonide.
What to do
Avoid long-term combination where possible and consider an alternative corticosteroid such as beclomethasone. If combined, monitor for Cushingoid features and adrenal suppression.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Budesonide
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Budesonide?
MediHelp rates the interaction as major. Atazanavir and Budesonide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir, a potent CYP3A4 inhibitor boosted or not, can markedly raise systemic budesonide concentrations. This can cause iatrogenic Cushing's syndrome and adrenal suppression, even with inhaled or intranasal budesonide.
How serious is the interaction between Atazanavir and Budesonide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid long-term combination where possible and consider an alternative corticosteroid such as beclomethasone. If combined, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Budesonide?
MediHelp also lists interactions of Budesonide with, for example, Aldesleukin, Bcg vaccine live, Ceritinib. The full list is on the Budesonide page.
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