Drug interactions
Budesonide-formoterol + Erythromycin lactobionate
Severity: Moderate
Budesonide-formoterol and Erythromycin lactobionate: 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
Intravenous erythromycin produces high concentrations and can prolong the QT interval, and formoterol can add to this effect, particularly with hypokalemia. Erythromycin also inhibits CYP3A4 and may raise systemic budesonide exposure. The combination raises the risk of torsades de pointes in susceptible patients.
What this interaction means in plain words
Budesonide-formoterol and Erythromycin lactobionate 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.
Budesonide-formoterol belongs to Respiratory; Erythromycin lactobionate belongs to Anti Bacterial.
Why it happens
Additive QTc prolongation (macrolide potassium channel blockade plus beta-agonist induced hypokalemia and sympathetic stimulation), with CYP3A4 inhibition raising budesonide levels.
What to do
Obtain an ECG and correct potassium and magnesium before and during intravenous erythromycin. Choose a non-macrolide antibiotic if the patient has significant cardiac risk.
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?
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Other interactions of Budesonide-formoterol
Other interactions of Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Budesonide-formoterol with Erythromycin lactobionate?
MediHelp rates the interaction as moderate. Budesonide-formoterol and Erythromycin lactobionate 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. Intravenous erythromycin produces high concentrations and can prolong the QT interval, and formoterol can add to this effect, particularly with hypokalemia. Erythromycin also inhibits CYP3A4 and may raise systemic budesonide exposure. The combination raises the risk of torsades de pointes in susceptible patients.
How serious is the interaction between Budesonide-formoterol and Erythromycin lactobionate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain an ECG and correct potassium and magnesium before and during intravenous erythromycin. Choose a non-macrolide antibiotic if the patient has significant cardiac risk.
What other medicines interact with Budesonide-formoterol?
MediHelp also lists interactions of Budesonide-formoterol with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Budesonide-formoterol page.
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