Drug Interaction Report

Indinavir and Budesonide Nasal Spray: Interaction Details

A pharmacist-reviewed analysis of the Indinavir and Budesonide Nasal Spray interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Budesonide Nasal Spray

Rhinocort Rhinocort® Allergy Spray Rhinocort® Aqua Nasal Spray
+

Indinavir

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 123 documented Indinavir interactions, 85 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Increased budesonide exposure and an increased risk of budesonide-related adverse effects

Interaction Deep Dive

Avoid use of budesonide oral delayed-release capsules1 and use caution with budesonide inhalation 23 in combination with strong CYP3A4 inhibitors, as the exposure of budesonide may be increased 1423 and it may result in budesonide-related adverse effects 3.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism of budesonide

Literature reports

1 report — tap to read

a) Ketoconazole and itraconazole, strong inhibitors of CYP3A4, the main metabolic enzyme for corticosteroids, increased plasma levels of orally ingested budesonide and orally inhaled budesonide, respectively 3.

Common questions

Can I take Indinavir and Budesonide Nasal Spray 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 Indinavir and Budesonide Nasal Spray interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Indinavir or Budesonide Nasal Spray 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 (4)

  1. Product Information: TARPEYO(TM) oral delayed-release capsules, budesonide oral delayed-release capsules. Calliditas Therapeutics AB (per FDA), Stockholm, Sweden, 2021. DailyMed
  2. Product Information: AIRSUPRA(TM) oral inhalation aerosol, albuterol budesonide oral inhalation aerosol. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2023. DailyMed
  3. Product Information: SYMBICORT AEROSPHERE® oral inhalation aerosol, budesonide formoterol fumarate oral inhalation aerosol. AstraZeneca Pharmaceuticals LP, Wilmington, DE, 2026.
  4. Product Information: BREZTRI AEROSPHERE® inhalation aerosol, budesonide, glycopyrrolate, formoterol fumarate inhalation aerosol. AstraZeneca Pharmaceuticals LP, Wilmington, DE, 2026. DailyMed
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Budesonide Nasal Spray

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Beyond drug–drug

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:

Indinavir + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 142 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.