Drug interactions
Budesonide + Ketoconazole
Severity: Major
Budesonide and Ketoconazole: 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
Ketoconazole strongly inhibits CYP3A4 and markedly increases budesonide exposure, raising the risk of systemic corticosteroid effects including adrenal suppression. Oral budesonide labeling advises avoiding this combination.
What this interaction means in plain words
Budesonide and Ketoconazole 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; Ketoconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces budesonide first-pass and systemic clearance.
What to do
Avoid concurrent use with oral budesonide; if unavoidable, monitor for hypercortisolism and reduce the budesonide dose. Consider an alternative antifungal or corticosteroid.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Budesonide and Ketoconazole, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Budesonide
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Budesonide with Ketoconazole?
MediHelp rates the interaction as major. Budesonide and Ketoconazole 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. Ketoconazole strongly inhibits CYP3A4 and markedly increases budesonide exposure, raising the risk of systemic corticosteroid effects including adrenal suppression. Oral budesonide labeling advises avoiding this combination.
How serious is the interaction between Budesonide and Ketoconazole?
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 concurrent use with oral budesonide; if unavoidable, monitor for hypercortisolism and reduce the budesonide dose. Consider an alternative antifungal or corticosteroid.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
