Drug interactions
Budesonide + Cobicistat
Severity: Major
Budesonide and Cobicistat: 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
Cobicistat is a strong CYP3A inhibitor and substantially increases systemic budesonide exposure. This can lead to Cushing's syndrome and adrenal suppression, including with inhaled or intranasal budesonide.
What this interaction means in plain words
Budesonide and Cobicistat 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; Cobicistat belongs to Miscellaneous.
Why it happens
Strong inhibition of CYP3A4 reduces budesonide first-pass and systemic clearance.
What to do
Avoid the combination unless benefit outweighs risk; consider beclomethasone as an alternative. If used, monitor for Cushingoid effects 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 Cobicistat
- Alfuzosin + Cobicistat Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Cobicistat + Colchicine Contraindicated
- Cobicistat + Dronedarone Contraindicated
- Cobicistat + Eletriptan Contraindicated
- Cobicistat + Eplerenone Contraindicated
Frequently asked questions
Can I take Budesonide with Cobicistat?
MediHelp rates the interaction as major. Budesonide and Cobicistat 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. Cobicistat is a strong CYP3A inhibitor and substantially increases systemic budesonide exposure. This can lead to Cushing's syndrome and adrenal suppression, including with inhaled or intranasal budesonide.
How serious is the interaction between Budesonide and Cobicistat?
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 unless benefit outweighs risk; consider beclomethasone as an alternative. If used, monitor for Cushingoid effects and adrenal suppression.
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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