Amiodarone and Budesonide: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amiodarone
Budesonide
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased budesonide exposure and an increased risk of budesonide-related adverse effects
Interaction Deep Dive
Avoid concomitant use of budesonide (a CYP3A4 substrate) with CYP3A4 inhibitors, as it may result in increased systemic budesonide concentrations1. Cushing's syndrome as a result of oral budesonide treatment in a patient receiving amiodarone has been reported. It has been suggested that the development of Cushing's syndrome is due to a decrease or inhibition of CYP3A-mediated metabolism of budesonide by amiodarone 2.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of budesonide
Literature reports
1 report — tap to read
a) An 81-year-old male known to have paroxysmal atrial fibrillation and chronic renal insufficiency developed Cushing's syndrome while being treated with concomitant amiodarone and budesonide. The patient presented with diarrhea. PredniSONE was used after treatment with 5-ASA failed. After six months of predniSONE therapy, budesonide (9 mg/day) was initiated and the diarrhea subsequently disappeared within six weeks. Diarrhea recurred when attempts were made to reduce the dose of budesonide. Eleven months later the patient presented with arterial hypertension, mooning, abdominal obesity, fragile skin with multiple hematoma, furunculosis, and thrombophlebitis. Budesonide was reduced to 3 mg/day. Diarrhea recurred and Cushingoid symptoms remained. ACTH and plasma cortisol were within normal limits. The patient was reexposed to 6 mg/day of budesonide for two weeks. One month later, ACTH, plasma cortisol, and free urine cortisol were normal while all signs of Cushing's syndrome persisted. Amiodarone treatment was discontinued and budesonide treatment was continued at 3 mg/day. The clinical signs of Cushing's syndrome disappeared after 4 weeks 2.
Common questions
Can I take Amiodarone and Budesonide together?
Increased budesonide exposure and an increased risk of budesonide-related adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amiodarone and Budesonide interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amiodarone or Budesonide need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: EOHILIA(TM) oral suspension, budesonide oral suspension. Takeda Pharmaceuticals America, Inc.(per FDA), Lexington, MA, 2024. DailyMed
- Ahle G, Blum A, Martinek J, et al: Cushing's syndrome in an 81-year-old patient treated with budesonide and amiodarone. Eur J Gastroenterol Hepatol 2000; 12(9):1041-1042. PubMed
Keep reading about Amiodarone
Keep reading about Budesonide
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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