Drug interactions
Budesonide + Levoketoconazole
Severity: Major
Budesonide and Levoketoconazole: 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
Levoketoconazole is a strong CYP3A4 inhibitor and can markedly increase systemic budesonide exposure. This may cause Cushingoid effects and adrenal suppression, and is of particular concern with oral budesonide.
What this interaction means in plain words
Budesonide and Levoketoconazole 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; Levoketoconazole belongs to Endocrine.
Why it happens
Strong inhibition of CYP3A4 reduces first-pass and systemic clearance of budesonide.
What to do
Avoid the combination where possible and use a less CYP3A4-dependent corticosteroid. If unavoidable, use the lowest effective budesonide dose and monitor for hypercortisolism 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
Other interactions of Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Budesonide with Levoketoconazole?
MediHelp rates the interaction as major. Budesonide and Levoketoconazole 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. Levoketoconazole is a strong CYP3A4 inhibitor and can markedly increase systemic budesonide exposure. This may cause Cushingoid effects and adrenal suppression, and is of particular concern with oral budesonide.
How serious is the interaction between Budesonide and Levoketoconazole?
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 and use a less CYP3A4-dependent corticosteroid. If unavoidable, use the lowest effective budesonide dose and monitor for hypercortisolism 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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