Drug interactions
Budesonide + Voriconazole
Severity: Major
Budesonide and Voriconazole: 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
Voriconazole strongly inhibits CYP3A4 and can substantially increase systemic budesonide exposure. This may cause Cushingoid features and adrenal suppression, even with inhaled or oral low-bioavailability forms.
What this interaction means in plain words
Budesonide and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4-mediated first-pass and systemic metabolism of budesonide by voriconazole.
What to do
Avoid the combination where possible, or use the lowest budesonide dose and monitor for hypercortisolism and adrenal suppression. Consider an alternative corticosteroid less dependent on CYP3A4, such as beclometasone.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Budesonide with Voriconazole?
MediHelp rates the interaction as major. Budesonide and Voriconazole 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. Voriconazole strongly inhibits CYP3A4 and can substantially increase systemic budesonide exposure. This may cause Cushingoid features and adrenal suppression, even with inhaled or oral low-bioavailability forms.
How serious is the interaction between Budesonide and Voriconazole?
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 monitor for hypercortisolism and adrenal suppression. Consider an alternative corticosteroid less dependent on CYP3A4, such as beclometasone.
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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