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Drug interactions

Budesonide + St john's wort

Severity: Moderate

Budesonide and St john's wort: 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

St John's wort induces CYP3A4 and P-gp and may reduce budesonide exposure. This may lead to reduced anti-inflammatory effect.

What this interaction means in plain words

Budesonide and St john's wort 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.

Evidence level: Moderate

Why it happens

Induction of CYP3A4 and P-glycoprotein by hyperforin increases budesonide clearance.

What to do

Advise patients to avoid St John's wort and monitor disease control. If it is stopped, reassess the budesonide dose.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Budesonide with St john's wort?

MediHelp rates the interaction as moderate. Budesonide and St john's wort 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. St John's wort induces CYP3A4 and P-gp and may reduce budesonide exposure. This may lead to reduced anti-inflammatory effect.

How serious is the interaction between Budesonide and St john's wort?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid St John's wort and monitor disease control. If it is stopped, reassess the budesonide dose.

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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