Drug & supplement interaction

Feverfew + Budesonide, Formoterol

Budesonide, Formoterol brand name: Symbicort.

Moderate Interaction
The bottom line Moderate

Budesonide, Formoterol falls into 3 drug categories that Feverfew can interact with; the most serious is rated moderate. Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Feverfew and Budesonide, Formoterol

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Feverfew interacts with whole categories of medication. Budesonide, Formoterol falls into 3 of those categories, so it can interact with Feverfew in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 3

Why this applies to Budesonide, Formoterol

Budesonide, Formoterol falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Feverfew interacts with.

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.
Laboratory research shows that feverfew might inhibit CYP2C19. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the bottom line with feverfew and your Symbicort inhaler (budesonide and formoterol). The concern on file is that feverfew might slow down a liver enzyme called CYP2C19, which could let certain medicines build up. Honestly, though, this is a theoretical flag based only on lab and animal research. It has never actually been reported in real people, and neither budesonide nor formoterol relies mainly on CYP2C19 to be cleared (budesonide is mostly handled by a different enzyme, CYP3A4).

If levels did rise even slightly, you might notice things like a faster heartbeat, jitteriness, or a slight tremor from the formoterol side. I wouldn't lose sleep over this combination, but it's always smart to mention any new supplement to your pharmacist or doctor first.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 3

Budesonide, Formoterol also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Laboratory research shows that feverfew might inhibit CYP2D6. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version on combining feverfew with your Symbicort (budesonide and formoterol) inhaler. The concern on file is that feverfew might slow down a liver enzyme called CYP2D6, which helps clear certain medicines. If that enzyme is blocked, a drug it handles can build up a bit and cause stronger effects. For the formoterol part, that could in theory mean more of the usual side effects like a faster or pounding heartbeat, jitteriness, shakiness, or a headache.

That said, I want to keep this in perspective. This is only a theoretical interaction seen in lab and animal testing, and it has never actually been reported in people. So it's a low-level worry, not a red alert. Still, it's worth a quick mention to your pharmacist or doctor before starting feverfew, especially if you notice your heart racing.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 3

Budesonide, Formoterol also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C9.
Laboratory research shows that feverfew might inhibit CYP2C9. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with Symbicort (budesonide and formoterol) plus feverfew. The concern is that feverfew might slow down an enzyme called CYP2C9 in your liver. If a medication leans on that enzyme to be cleared, it could build up a bit and lead to stronger effects. With Symbicort that might look like more of the usual side effects, such as a fast or pounding heartbeat, jitteriness, or a headache from the formoterol part.

That said, I want to be honest about how thin this evidence is. This comes only from lab studies, and it has never actually been reported in people. So I wouldn't lose sleep over it. Still, it's worth a quick mention to your pharmacist or doctor before you start feverfew, just so someone who knows your full list can sign off.

References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Feverfew Also Interacts With Other Medications

Feverfew has 928 moderate known drug interactions in our database — the Budesonide, Formoterol one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Feverfew

Covers the 2,830 medications we’ve checked against Feverfew. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Budesonide, Formoterol

This page covers Feverfew only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Budesonide, Formoterol page lists 120 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), 1,3-dmaa (moderate), Acacia Rigidula (moderate), Active Hexose Correlated Compound (ahcc) (moderate) and Adrafinil (moderate).

By severity: 1 major · 91 moderate · 28 minor.

Open the Budesonide, Formoterol interaction page

One more smart check

Taking Feverfew as Part of a Dietary Supplement Product? Check It for Interactions

We hold 520 real supplement products containing Feverfew, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Feverfew. Your product may carry other ingredients that interact with Budesonide, Formoterol too, on top of Feverfew — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Feverfew and Budesonide, Formoterol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Feverfew
Top 25%

#257 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Budesonide, Formoterol
Top half

#717 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Feverfew

What is Feverfew?

Feverfew
  • Migraine prevention
  • Headache
  • Fever (traditional)
  • Arthritis and joint pain
  • Menstrual discomfort

Feverfew is a daisy-family herb best known for migraine prevention, where some studies suggest it may modestly lower how often migraines occur, though the evidence is mixed. It is generally well tolerated for short-term use in most adults but should be avoided during pregnancy and breastfeeding and by people allergic to ragweed and related plants. Talk to your pharmacist or doctor before starting it.

Read the full Feverfew monograph & all interactions
Keep checking

Other Drugs & Feverfew

Browse every other medication we’ve checked against Feverfew — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
928Moderate
0Minor
1,901No known interaction
Moderate

928 interactions

Showing 60 of 928 moderate interactions — see all 928 on the Feverfew page.

No interaction 1,901 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Feverfew and Budesonide, Formoterol Together: Common Questions

Can you take Feverfew with Budesonide, Formoterol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Feverfew and Budesonide, Formoterol?
Budesonide, Formoterol belongs to more than one drug category, and Feverfew interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Feverfew and Budesonide, Formoterol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.