Drug interactions
Budesonide + Itraconazole
Severity: Major
Budesonide and Itraconazole: 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
Itraconazole strongly inhibits CYP3A4 and can greatly increase budesonide exposure, leading to Cushing syndrome and adrenal suppression, including with inhaled budesonide. Cases have been reported.
What this interaction means in plain words
Budesonide and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces budesonide first-pass and systemic clearance.
What to do
Avoid the combination where possible; if needed, use the lowest budesonide dose and monitor for hypercortisolism and adrenal suppression. Consider switching to a corticosteroid less dependent on CYP3A4, such as beclomethasone.
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
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Budesonide with Itraconazole?
MediHelp rates the interaction as major. Budesonide and Itraconazole 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. Itraconazole strongly inhibits CYP3A4 and can greatly increase budesonide exposure, leading to Cushing syndrome and adrenal suppression, including with inhaled budesonide. Cases have been reported.
How serious is the interaction between Budesonide and Itraconazole?
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 where possible; if needed, use the lowest budesonide dose and monitor for hypercortisolism and adrenal suppression. Consider switching to a corticosteroid less dependent on CYP3A4, such as beclomethasone.
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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