Compatibility «Budesonide» and «Dexamethasone»
Between «Budesonide» and «Dexamethasone» found 22 dangerous and 81 negative interaction, joint admission is not recommended without consulting a doctor.
Interaction tableCompare |
Dexamethasone |
✘Budesonide Analogs | |
✘Dexamethasone Analogs |
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Interactions Budesonide with Dexamethasone
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Dangerous interactions
Since systemic GCS, when administered in high doses and/ or for an extended period of time, have an immunosuppressive effect, additive effects may be observed when using other immunosuppressants or antitumor agents. With simultaneous administration of GCS and antidiabetic drugs, it is necessary to monitor the condition of patients for deterioration of glycemic control, and with the abolition of GCS - for the development of signs of hypoglycemia. The simultaneous use of purine analogues with other drugs that cause suppression of the bone marrow or the immune system, such as other antitumor drugs or immunosuppressants, in pm GCS, can lead to additive effects. Since systemic GCS, when administered in high doses and/or for an extended period of time, have an immunosuppressive effect, additive effects may be observed when using other immunosuppressants. Since the use of bupropion is associated with a dose-dependent risk of seizures, it is recommended to take special care when using other drugs at the same time that can lower the threshold of convulsive readiness, such as systemic GCS. High doses of GCS seem to pose a greater risk of enhancing the anticoagulant effect. In addition, the use of GCS is associated with the risk of peptic ulcer disease and gastrointestinal bleeding. Vigabatrin should not be used in conjunction with GCS, which are associated with serious ophthalmic side effects (for example, retinopathy or glaucoma), unless the benefits of treatment clearly outweigh the risks. Since stomach ulcers and gastrointestinal bleeding have been reported in patients taking deferasirox, caution should be exercised when prescribing it with other drugs that are known to increase the risk of peptic ulcer or gastric bleeding, including GCS. Caution should be exercised when using droperidol in combination with GCS, which can cause electrolyte disturbances, especially hypokalemia or hypomagnesemia, and thus increase the risk of prolongation of the QT interval or the development of cardiac arrhythmias. Patients receiving GCS for 2 weeks or more may be vaccinated after discontinuation of steroid therapy for at least 3 months in accordance with the general recommendations for the use of live vaccines. With the simultaneous use of indapamide with other drugs associated with an increased risk of hypokalemia, such as systemic GCS, additive hypokalemia may occur. Cases of cortical blindness, stroke, spinal cord infarction, paralysis, seizures, nerve damage, cerebral edema and death were time-related (td; ranging from a few minutes to 48 hours after injection) associated with epidural injection of GCS. Joint intrathecal administration of GCS with radiopaque substances is contraindicated due to the increased risk of seizures. Mifepristone for termination of pregnancy is contraindicated in patients receiving long-term corticosteroid therapy, and in Cushing's disease or other chronic conditions - in patients who require simultaneous treatment with systemic corticosteroids in vital situations, for example, with serious diseases or immunosuppression after organ transplantation. In other situations, when GCS is used to treat non-life-threatening conditions, mifepristone may lead to a decrease in the effectiveness of GCS and exacerbation or deterioration of such conditions. With the simultaneous use of nilotinib (a CYP3A4 inhibitor) and dexamethasone (a CYP3A4 substrate), metabolism may decrease and the risk of side effects associated with GCS may increase. Prolonged simultaneous use of NSAIDs and GCS should be avoided due to an increased risk of adverse events from the gastrointestinal tract and impaired water-electrolyte balance. Pimozide, the use of which is associated with a known risk of prolongation of the QT interval and the development of torsade de pointes, is contraindicated in patients with known hypokalemia or hypomagnesemia, it should not be prescribed simultaneously with drugs that are known to cause electrolyte imbalance, such as systemic GCS in high doses. Patients receiving GCS during propranolol therapy may be at increased risk of hypoglycemia due to the loss of the cortisol counterregulatory response. Prolonged simultaneous use of salicylates and GCS should be avoided due to an increased risk of adverse events from the gastrointestinal tract. The use of quinolones is associated with an increased risk of tendon rupture requiring surgery or leading to long-term disability; this risk is further increased in patients receiving GCS at the same time. -
Negative interactions
Budesonide and Dexamethasone belong to the same pharmaceutical group: Glucocorticosteroids. It is necessary to closely monitor the development of signs and symptoms of infection if simultaneous administration of GCS and adalimumab is necessary. With the simultaneous use of non-potassium-sparing diuretics, in pm thiazide, with other drugs that increase the risk of hypokalemia, such as GCS, additive hypokalemia may occur. GCS stimulate the production of glucose in the liver and inhibit the peripheral absorption of glucose by muscles and adipose tissues, causing insulin resistance. The combined use of altretamine with other drugs that cause suppression of the bone marrow or the immune system, such as GCS, may lead to the development of additional effects. GCS can interact with cholinesterase inhibitors, including ambenonium, neostigmine and pyridostigmine, sometimes causing severe muscle weakness in patients with myasthenia gravis. If necessary, the combined use of these drugs is recommended to begin therapy with GCS in low doses and under close clinical supervision. Caution should be exercised when concomitantly using amiodarone with drugs that can cause hypokalemia and/ or hypomagnesemia, including GCS. The effects of potassium loss in GCS therapy may be enhanced with the simultaneous use of other drugs that cause potassium loss, including amphotericin B. L-asparaginase temporarily suppresses insulin production, contributing to the development of hyperglycemia observed with concomitant therapy of GCS. There are reports that the use of L-asparaginase after GCS, rather than before them, causes fewer hypersensitivity reactions. Concomitant use may lead to a decrease in antiretroviral efficacy and the potential development of viral resistance to atazanavir, the possibility of using an alternative GCS should be considered. The possibility of using other GCS, such as beclomethasone and prednisone, the concentration of which is less affected by strong CYP3A4 inhibitors, especially with prolonged use, should be considered. With the simultaneous use of GCS and neuromuscular transmission blockers, especially for a long time, caution and careful monitoring are recommended due to increased neuromuscular blockade. It may take weeks or years for clinical improvement or recovery after discontinuation of GCS. Caution should be exercised when concomitantly using GCS and acetylsalicylic acid in patients with hypoprothrombinemia. With the simultaneous use of GCS and neuromuscular transmission blockers, especially for a long time, caution and careful monitoring are recommended due to the increased effect of neuromuscular blockade. Induction of the CYP3A4 isoenzyme by dexamethasone may lead to a decrease in the concentration of budesonide in plasma and a decrease in its clinical effect. There are reports of both an increase and a decrease in the effects of anticoagulants when used concomitantly with GCS, however, there is a limited amount of published data, and the mechanism of interaction is not well described. Therefore, GCS should be used with caution and under proper clinical supervision in patients receiving oral anticoagulants. Daily laboratory monitoring is desirable while taking high doses of GCS. Salicylates should be used with caution in patients receiving GCS. Simultaneous use of GCS may increase the risk of adverse events from the gastrointestinal tract. Caution should be exercised when using vorinostat and GCS, etc. together; if electrolyte disturbances occur, the risk of prolongation of the QT interval and the development of arrhythmia increases. GCS can cause electrolyte imbalance, hypomagnesemia, hypokalemia or hypocalcemia and increase the risk of prolongation of the QT interval associated with the use of vorinostat. Caution is recommended when using haloperidol and GCS at the same time, since electrolyte imbalance caused by GCS may increase the risk of prolongation of the QT interval when using haloperidol. GCS increase the activity of this enzyme, and they should not be used in conjunction with gemin. The metabolism of GCS increases with hyperthyroidism and decreases with hypothyroidism. Concomitant use of darunavir with dexamethasone should be avoided, which may lead to a decrease in antiretroviral efficacy and the potential development of viral resistance to darunavir, and the possibility of using an alternative GCS should be considered. The possibility of using GCS such as beclomethasone and prednisone, the concentration of which is less affected by strong CYP3A4 inhibitors, especially with prolonged use, should be considered. Desmopressin, when used to treat nocturia, is contraindicated with GCS due to the risk of severe hyponatremia. Desmopressin can be started or resumed after 3 days or 5 1/2'>T1/2 after discontinuation of GCS, whichever is longer. GCS can cause increased side effects of digoxin due to its effect on the electrolyte balance. Zafirlukast inhibits CYP3A4 isoenzymes and should be used with caution in patients receiving drugs metabolized by CYP3A4, such as GCS. Isotretinoin and GCS can cause osteoporosis with prolonged use. Patients receiving systemic corticosteroids should be prescribed isotretinoin therapy with caution. If necessary, the combined use of itraconazole (a strong inhibitor and substrate of CYP3A4) and dexamethasone (a moderate inducer and substrate of CYP3A4) should be monitored for side effects associated with the use of GCS (decreased metabolism) and changes in the reaction to itraconazole (increased clearance). With the simultaneous appointment of GCS and potassium-sparing diuretics, careful monitoring of the condition of patients for the development of hypokalemia is necessary. Drugs that cause potassium loss, such as GCS, can counteract the hyperkalemic effect of potassium-sparing diuretics. Calcium absorption decreases with simultaneous intake of calcium carbonate with systemic GCS, which inhibit the absorption of calcium in the intestine. Caution should be exercised when quetiapine is co-administered with GCS, etc.; the QT interval may be prolonged due to the electrolyte imbalance caused by GCS. In addition, ketoconazole itself can inhibit the synthesis of GCS by the adrenal glands and cause adrenal insufficiency during the withdrawal of GCS. In addition, clarithromycin inhibits CYP3A4, which may lead to an increase in the concentration of dexamethasone in blood plasma and require a reduction in the dosage of GCS. With the simultaneous use of GCS and coumarin anticoagulants, it is necessary to frequently check PV, etc; GCS may change the response to the use of these anticoagulants. Studies have shown that the usual effect caused by the addition of GCS is to inhibit the reaction to coumarins, however, there are reports of potentiation that have not been confirmed by studies. GCS may increase the loss of electrolytes associated with diuretic therapy, which leads to hypokalemia. Patients who are simultaneously receiving immunosuppressants, such as GCS, together with micafungin, may be at additional risk of developing infection or other side effects. This is due to the fact that mifepristone exhibits antiglucocorticoid activity, which can counteract the therapy of GCS and stabilize the underlying disease. Mifepristone can also cause adrenal insufficiency, so patients receiving GCS for a non-life-threatening disease should be closely monitored for signs and symptoms of adrenal insufficiency. If adrenal insufficiency occurs, treatment with mifepristone should be stopped immediately and systemic GCS should be prescribed, high doses may be required to treat these phenomena. In the presence of serious infections, continued use of corticosteroids or immunosuppressants in combination with appropriate antimicrobial therapy may be required. Recommendations for the combined use of GCS depend on the main indications for therapy with natalizumab. In patients with Crohn's disease receiving corticosteroids, at the beginning of therapy with natalizumab, the dose of corticosteroids should be reduced as soon as the therapeutic effect occurs. If the patient cannot cancel the use of systemic corticosteroids for 6 months, natalizumab should be discontinued. Concomitant use of natalizumab and GCS may increase the risk of serious infections, including progressive multifocal leukoencephalopathy, compared with the risk observed with the use of natalizumab alone. Simultaneous use of systemic sodium chloride, especially in high doses, and GCS can lead to sodium and fluid retention in the body. Concomitant use of ocrelizumab and GCS may increase the risk of immunosuppression, and careful monitoring of patients for signs and symptoms of infection is necessary. GCS may increase the loss of electrolytes associated with diuretic therapy, leading to hypokalemia and/or hypomagnesemia. GCS with mineralocorticoid activity (e.g. cortisone, hydrocortisone) can cause sodium and fluid retention. GCS can interact with cholinesterase inhibitors, including ambenonium, neostigmine and pyridostigmine, causing severe muscle weakness in patients with myasthenia gravis. Ritodrine can cause pulmonary edema in a pregnant woman, which is more common in patients receiving GCS at the same time. Rituximab and GCS are usually used together, but during combined long-term therapy, the patient's condition should be monitored for immunosuppression, as well as signs and symptoms of infection. If joint therapy with GCS is required, their dose should be carefully adjusted. With the simultaneous use of GCS and telbivudine, the risk of developing myopathy increases. The combined use of GCS and testosterone may increase the risk of edema, especially in patients with underlying heart or liver disease. Most patients treated with tocilizumab who developed serious infections also received concomitant immunosuppressants such as systemic corticosteroids. Caution is recommended when using arsenic trioxide and GCS at the same time, since the electrolyte imbalance caused by GCS may increase the risk of prolongation of the QT interval when using arsenic trioxide. Phenytoin, phenobarbital, ephedrine and rifampicin can increase the metabolic clearance of GCS, which leads to a decrease in blood levels and pharmacological activity and requires an adjustment in the dosage of GCS. The therapeutic effect of phenylephrine may be enhanced in patients receiving GCS, it is necessary to monitor the condition of patients for increased pressor effect with simultaneous use of these drugs. GCS can interact with cholinesterase inhibitors, sometimes causing severe muscle weakness in patients with myasthenia gravis. With the simultaneous use of ceritinib (a strong CYP3A4 inhibitor), due to a decrease in the metabolism of GCS, adverse reactions associated with their use should be monitored; Cushing's syndrome may develop and adrenal function suppression with prolonged use. The possibility of using GCS such as beclomethasone and prednisone, the concentration of which is less affected by strong CYP3A4 inhibitors, should be considered. Caution is recommended when using citalopram and GCS at the same time, since the electrolyte imbalance caused by GCS may increase the risk of prolongation of the QT interval when using citalopram. In vitro studies show that GCS inhibit the antifungal activity of econazole against C. It is necessary to monitor the condition of patients for the development of side effects associated with the use of GCS, if necessary, consider reducing the dose of dexamethasone and titrating it until a clinical effect is achieved. Caution should be exercised when using dexamethasone and erythromycin (a CYP3A4 inhibitor), etc.; This may lead to increased plasma concentrations of GCS, such as dexamethasone. The use of estrogens is associated with an increase in serum concentrations of corticosteroid-binding globulin, which leads to an increase in the total number of circulating GCS, although the free concentrations of these hormones may be lower, the clinical significance of this phenomenon is unknown. These drugs should be used together with caution or consider prescribing alternative GCS, especially with prolonged use. A decrease in blood concentration and activity may require an increase in the dose of GCS. Echinacea has immunostimulating activity and theoretically can reduce the response to immunosuppressants such as GCS. In patients receiving GCS for the treatment of serious diseases such as cancer, or after organ transplantation, this potential interaction may lead to a preferred withdrawal from the use of echinacea. -
No interactions
GCS administered before or simultaneously with photosensitizing drugs used in photodynamic therapy may reduce the effectiveness of treatment. -
Positive interactions
Concomitant use of L-asparaginase with GCS can lead to additive hyperglycemia. In addition, since systemic GCS exhibit immunosuppressive effects when administered in high doses and/or over an extended period of time, additive effects may be observed with concomitant use of antitumor drugs. In addition, since systemic GCS have an immunosuppressive effect when administered in high doses and/or over an extended period of time, additive effects may be observed when using antitumor agents. Simultaneous use of pegaspargase with GCS can lead to additive hyperglycemia. Ephedrine may enhance the metabolic clearance of GCS. -
Unclear interactions
Budesonides. The effect of GCS on oral anticoagulants (e.g. warfarin) varies. Colestyramine may increase the clearance of GCS. In patients with multiple sclerosis, short courses of GCS may be used during treatment with natalizumab. GCS can slow down bone growth and, consequently, inhibit the growth-stimulating effects of somatropin. When the concentration of GCS was equal to or higher than the concentration of econazole in terms of unit body weight, the antifungal activity of econazole was significantly suppressed. When the concentration of GCS was one tenth of the concentration of econazole, no inhibition of antifungal activity was observed.
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Dangerous interactions
Decoding the colors of interactions and contraindications
Dangerous | — | a pronounced negative interaction or contraindication. |
Negative | — | negative interaction or side effect that may reduce effectiveness. |
Positive | — | the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug. |
No | — | the drugs do NOT interact, which is separately indicated in the instructions. |
Unclear | — | the system failed to pre-assess the danger. |
Video instruction
Additional information
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- Why do I need to
- Avoid dangerous prescriptions for your patients.
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- The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
- The article is written: artificial intelligence Kiberis
- Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
- Total analyzed: 169,972,605 possible combinations of drugs and their components were found 412,508 interacting combinations.
- Medicine section: Standard evidence-based medicine
- The date of the last update of the interaction database: 2024-04-11
Category - medicine