Drug interactions
Budesonide + Posaconazole
Severity: Major
Budesonide and Posaconazole: 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
Posaconazole is a strong CYP3A4 inhibitor and can markedly raise budesonide exposure, leading to systemic corticosteroid effects such as Cushing syndrome and adrenal suppression. This has been described with other strong CYP3A4 inhibitors, including with inhaled budesonide.
What this interaction means in plain words
Budesonide and Posaconazole 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; Posaconazole belongs to Anti Fungals.
Why it happens
Posaconazole strongly inhibits CYP3A4, reducing the first-pass and systemic metabolism of budesonide.
What to do
Avoid the combination where possible, or use the lowest budesonide dose and consider an alternative corticosteroid such as beclomethasone. 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
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Budesonide with Posaconazole?
MediHelp rates the interaction as major. Budesonide and Posaconazole 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. Posaconazole is a strong CYP3A4 inhibitor and can markedly raise budesonide exposure, leading to systemic corticosteroid effects such as Cushing syndrome and adrenal suppression. This has been described with other strong CYP3A4 inhibitors, including with inhaled budesonide.
How serious is the interaction between Budesonide and Posaconazole?
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, or use the lowest budesonide dose and consider an alternative corticosteroid such as beclomethasone. 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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