Drug & supplement interaction

Goji + Budesonide, Formoterol

Budesonide, Formoterol brand name: Symbicort.

Moderate Interaction
The bottom line Moderate

Budesonide, Formoterol falls into 3 drug categories that Goji can interact with; the most serious is rated moderate. Theoretically, goji berry might inhibit CYP2D6 and reduce metabolism of CYP2D6 substrates.

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

Goji and Budesonide, Formoterol

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

Why Are There 3 Interactions?

Goji interacts with whole categories of medication. Budesonide, Formoterol falls into 3 of those categories, so it can interact with Goji 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 2D6 (CYP2D6) SUBSTRATES

1 of 3

Why this applies to Budesonide, Formoterol

Budesonide, Formoterol falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Goji interacts with.

Theoretically, goji berry might inhibit CYP2D6 and reduce metabolism of CYP2D6 substrates.
In vitro research shows that goji berry juice inhibits CYP2D6 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP2D6 substrates. However, this 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 honest picture with your Symbicort inhaler. The concern on file is that goji might slow down a liver enzyme called CYP2D6, which could let certain medications build up. The catch is that neither budesonide nor formoterol relies much on CYP2D6. Budesonide is mainly cleared by a different enzyme (CYP3A4), and an inhaler also delivers a fairly small, targeted dose to your lungs.

On top of that, this signal comes only from lab studies, not from real people, so it's very theoretical. If anything ever did pool up, you might notice more shakiness, a fast or pounding heartbeat, or jitteriness from the formoterol side. Eating goji berries as food is unlikely to matter. Before starting a concentrated goji supplement, just run it by your pharmacist or doctor.

References
  1. Liu R, Tam TW, Mao J, et al. In vitro activity of Lycium barbarum (Goji) against major human phase I metabolism enzymes. Complement Integr Med. 2016;13(3):257-265.
Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

2 of 3

Budesonide, Formoterol also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

Theoretically, goji berry might inhibit CYP2C19 and reduce metabolism of CYP2C19 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C19 enzymes. Concomitant use with goji may decrease metabolism and increase levels of CYP2C19 substrates. However, this 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 honest picture with Symbicort (budesonide and formoterol) and goji. The concern on file is that goji might slow down a liver enzyme called CYP2C19. In theory, slowing an enzyme that helps clear a medicine could let more of it linger in your body. So the worry would be slightly higher exposure, which could mean more of budesonide's effects (like throat irritation or oral thrush) or formoterol's stimulating effects (a faster heartbeat, jitteriness, or shakiness).

That said, I'd keep this in perspective. Budesonide is mainly handled by a different enzyme (CYP3A4), not 2C19, so this link is a weak fit, and the evidence is only lab-based, never shown in people. Eating goji berries as food is very unlikely to matter. If you use concentrated goji supplements, just mention it to your pharmacist.

References
  1. Liu R, Tam TW, Mao J, et al. In vitro activity of Lycium barbarum (Goji) against major human phase I metabolism enzymes. Complement Integr Med. 2016;13(3):257-265.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 3

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

Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.
In vitro research shows that goji berry tincture and juice inhibit CYP2C9 enzymes. Additionally, multiple case reports suggest that goji berry concentrated tea and juice inhibit the metabolism of warfarin, a CYP2C9 substrate. Concomitant use with goji may decrease metabolism and increase levels of CYP2C9 substrates.
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 honest picture with Symbicort and goji. The concern on file is that goji might block a liver enzyme called CYP2C9, which could let certain drugs build up. The catch is that budesonide and formoterol aren't really cleared by CYP2C9 in any meaningful way. Budesonide is handled mostly by a different enzyme (CYP3A4), and an inhaled steroid plus a long-acting breathing medicine just don't fit this particular pathway well.

On top of that, the evidence here is very thin, based on lab dishes and a few warfarin case reports, not on Symbicort. So I wouldn't lose sleep over eating goji berries. Still, if you're using concentrated goji supplements or juice daily, mention it to your pharmacist so they can double-check everything you take.

References
  1. Lam AY, Elmer GW, Mohutsky MA. Possible interaction between warfarin and Lycium Barbarum. Ann Pharmacother 2001;35:1199-201.
  2. Guzmán CE, Guzmán-Moreno CG, Assad-Morell JL, Edgar Francisco Carrizales-Sepúlveda EF. Flecainide toxicity associated with the use of goji berries: a case report. Eur Heart J Case Rep. 2021;5(6):ytab204. PubMed
  3. Liu R, Tam TW, Mao J, et al. In vitro activity of Lycium barbarum (Goji) against major human phase I metabolism enzymes. Complement Integr Med. 2016;13(3):257-265.

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

Goji Also Interacts With Other Medications

Goji has 2 major, 929 moderate, 68 minor 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 Goji

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

Everything else you take

See Every Supplement That Interacts With Budesonide, Formoterol

This page covers Goji 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 Goji as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,738 real supplement products containing Goji, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Goji. Your product may carry other ingredients that interact with Budesonide, Formoterol too, on top of Goji — 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 Goji 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 Goji
Top 10%

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

29 days ago today
Medication Budesonide, Formoterol
Steady interest

#2,317 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 Goji

What is Goji?

Goji
  • General antioxidant support
  • Eye health
  • Immune support
  • Anti-aging and well-being
  • Blood sugar support

Goji berries are a nutritious fruit rich in antioxidants, vitamins, and plant polysaccharides, and they are safe for most people as a food. While they are popular for eye health, immune support, and general wellness, strong human evidence for most health claims is limited. Talk with your pharmacist or doctor before using concentrated goji supplements, especially if you take medications or are pregnant.

Read the full Goji monograph & all interactions
Keep checking

Other Drugs & Goji

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

2Major
929Moderate
68Minor
1,830No known interaction
Major

2 interactions

Moderate

929 interactions

Showing 60 of 929 moderate interactions — see all 929 on the Goji page.

Minor

68 interactions

Showing 60 of 68 minor interactions — see all 68 on the Goji page.

No interaction 1,830 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 Goji and Budesonide, Formoterol Together: Common Questions

Can you take Goji 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 Goji and Budesonide, Formoterol?
Budesonide, Formoterol belongs to more than one drug category, and Goji 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 Goji 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.