Drug interactions
Budesonide + Rifampin
Severity: Major
Budesonide and Rifampin: major interaction.
Last updated Sources: UK SmPC
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
Rifampin is a potent CYP3A4 inducer and can substantially lower budesonide concentrations. This may cause loss of efficacy in inflammatory bowel disease, asthma or other conditions.
What this interaction means in plain words
Budesonide and Rifampin 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.
Why it happens
Rifampin induces CYP3A4 (and P-gp), accelerating budesonide metabolism.
What to do
Monitor for loss of disease control and consider a higher budesonide dose or an alternative corticosteroid. Reassess the dose after rifampin is stopped.
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
Frequently asked questions
Can I take Budesonide with Rifampin?
MediHelp rates the interaction as major. Budesonide and Rifampin 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. Rifampin is a potent CYP3A4 inducer and can substantially lower budesonide concentrations. This may cause loss of efficacy in inflammatory bowel disease, asthma or other conditions.
How serious is the interaction between Budesonide and Rifampin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of disease control and consider a higher budesonide dose or an alternative corticosteroid. Reassess the dose after rifampin is stopped.
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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