Drug interactions
Budesonide + Mitotane
Severity: Moderate
Budesonide and Mitotane: moderate 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
Mitotane is a potent inducer of CYP3A4 and can markedly lower systemic budesonide exposure. This may lead to loss of anti-inflammatory efficacy, for example in Crohn's disease or asthma. Mitotane also causes adrenal insufficiency, so steroid needs must be judged carefully.
What this interaction means in plain words
Budesonide and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Budesonide belongs to Respiratory; Mitotane belongs to Oncology.
Why it happens
Induction of hepatic and intestinal CYP3A4 by mitotane accelerates the first-pass and systemic metabolism of budesonide.
What to do
Monitor for reduced budesonide response and consider a higher dose or an alternative corticosteroid if efficacy is lost. Review overall glucocorticoid replacement in patients on mitotane.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Budesonide
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Budesonide with Mitotane?
MediHelp rates the interaction as moderate. Budesonide and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane is a potent inducer of CYP3A4 and can markedly lower systemic budesonide exposure. This may lead to loss of anti-inflammatory efficacy, for example in Crohn's disease or asthma. Mitotane also causes adrenal insufficiency, so steroid needs must be judged carefully.
How serious is the interaction between Budesonide and Mitotane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced budesonide response and consider a higher dose or an alternative corticosteroid if efficacy is lost. Review overall glucocorticoid replacement in patients on mitotane.
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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