Drug interactions
Budesonide-formoterol + Ketoconazole
Severity: Major
Budesonide-formoterol and Ketoconazole: major 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
Ketoconazole prolongs the QT interval and formoterol may add to this effect. Ketoconazole is also a strong CYP3A4 inhibitor that can markedly raise budesonide exposure, leading to systemic corticosteroid effects such as adrenal suppression.
What this interaction means in plain words
Budesonide-formoterol and Ketoconazole 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-formoterol belongs to Respiratory; Ketoconazole belongs to Anti Fungals.
Why it happens
Additive QT prolongation, plus strong CYP3A4 inhibition reducing budesonide clearance.
What to do
Avoid the combination where possible, or use an alternative antifungal or inhaled corticosteroid. If unavoidable, monitor ECG and electrolytes and watch for signs of corticosteroid excess.
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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Other interactions of Budesonide-formoterol
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Budesonide-formoterol with Ketoconazole?
MediHelp rates the interaction as major. Budesonide-formoterol and Ketoconazole 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. Ketoconazole prolongs the QT interval and formoterol may add to this effect. Ketoconazole is also a strong CYP3A4 inhibitor that can markedly raise budesonide exposure, leading to systemic corticosteroid effects such as adrenal suppression.
How serious is the interaction between Budesonide-formoterol and Ketoconazole?
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 an alternative antifungal or inhaled corticosteroid. If unavoidable, monitor ECG and electrolytes and watch for signs of corticosteroid excess.
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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