Drug interactions
Budesonide + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Budesonide and Elvitegravir / cobicistat / emtricitabine / tenofovir df: major interaction.
Last updated Sources: US FDA label
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 strongly inhibits CYP3A4, markedly raising systemic budesonide exposure. This can cause Cushing's syndrome and adrenal suppression, especially with long-term use.
What this interaction means in plain words
Budesonide and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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.
Why it happens
Cobicistat inhibits CYP3A4-mediated first-pass and hepatic metabolism of budesonide.
What to do
Avoid the combination for long-term therapy; consider an alternative corticosteroid with less CYP3A4 dependence such as beclomethasone. If unavoidable, 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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References
Other interactions of Budesonide
Frequently asked questions
Can I take Budesonide with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Budesonide and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 strongly inhibits CYP3A4, markedly raising systemic budesonide exposure. This can cause Cushing's syndrome and adrenal suppression, especially with long-term use.
How serious is the interaction between Budesonide and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
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 for long-term therapy; consider an alternative corticosteroid with less CYP3A4 dependence such as beclomethasone. If unavoidable, monitor for Cushingoid features 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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