Drug interactions
Budesonide + Clarithromycin
Severity: Major
Budesonide and Clarithromycin: 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
Clarithromycin strongly inhibits CYP3A4 and can markedly raise budesonide exposure, increasing the risk of systemic corticosteroid effects such as adrenal suppression and Cushingoid features. The risk is greatest with prolonged use.
What this interaction means in plain words
Budesonide and Clarithromycin 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.
Budesonide belongs to Respiratory; Clarithromycin belongs to Anti Bacterial.
Why it happens
Strong CYP3A4 inhibition reduces budesonide first-pass and systemic clearance.
What to do
Avoid the combination with oral budesonide where possible, or use a short antibiotic course with monitoring for hypercortisolism. Consider an alternative macrolide such as azithromycin.
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
- Aldesleukin + Budesonide Major
- Atazanavir + Budesonide Major
- Bcg vaccine live + Budesonide Major
- Budesonide + Ceritinib Major
- Budesonide + Cobicistat Major
- Budesonide + Darunavir Major
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Budesonide with Clarithromycin?
MediHelp rates the interaction as major. Budesonide and Clarithromycin 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. Clarithromycin strongly inhibits CYP3A4 and can markedly raise budesonide exposure, increasing the risk of systemic corticosteroid effects such as adrenal suppression and Cushingoid features. The risk is greatest with prolonged use.
How serious is the interaction between Budesonide and Clarithromycin?
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 the combination with oral budesonide where possible, or use a short antibiotic course with monitoring for hypercortisolism. Consider an alternative macrolide such as azithromycin.
What other medicines interact with Budesonide?
MediHelp also lists interactions of Budesonide with, for example, Aldesleukin, Atazanavir, Bcg vaccine live. The full list is on the Budesonide page.
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