Drug interactions
Budesonide + Ritonavir
Severity: Major
Budesonide and Ritonavir: 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
Ritonavir strongly inhibits CYP3A4 and markedly increases systemic budesonide exposure. Cushing syndrome and adrenal suppression have been reported with inhaled, intranasal and oral budesonide combined with ritonavir.
What this interaction means in plain words
Budesonide and Ritonavir 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; Ritonavir belongs to Anti Virals.
Why it happens
Potent CYP3A4 and P-glycoprotein inhibition by ritonavir reduces budesonide clearance.
What to do
Avoid long-term coadministration and use an alternative such as beclomethasone or prednisolone; if unavoidable, 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 Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Budesonide with Ritonavir?
MediHelp rates the interaction as major. Budesonide and Ritonavir 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. Ritonavir strongly inhibits CYP3A4 and markedly increases systemic budesonide exposure. Cushing syndrome and adrenal suppression have been reported with inhaled, intranasal and oral budesonide combined with ritonavir.
How serious is the interaction between Budesonide and Ritonavir?
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 long-term coadministration and use an alternative such as beclomethasone or prednisolone; if unavoidable, 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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