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No clinically relevant interactions with other agents for asthma are known.
Ketoconazole 200 mg once daily increased the plasma concentrations of budesonide (3 mg in a single dose) on average six-fold when administered concomitantly. When ketoconazole was administered 12 hours after budesonide, the concentration was increased on average three-fold. Information about this interaction is lacking for inhaled budesonide, but markedly increased plasma levels are also expected in such cases. The combination should be avoided since data to support dose recommendations are lacking.
If this is not possible, the time interval between administration of ketoconazole and budesonide should be as long as possible. A reduction of budesonide dose must also be considered.
Other potent inhibitors of CYP3A4, i.e. itraconazole are also cause a marked increase in the plasma levels of budesonide.
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