Is Budesonide Safe To Take With Azithromycin?

In our latest question and answer, our pharmacist discusses the safety of combining budesonide and azithromycin.

Question

Is it ok to take inhaled budesonide with oral azithromycin?

Asked by Cindy On Dec 26, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Dec 27, 2022
Last updated Apr 14, 2024

Key points

  • There is no known drug interaction between azithromycin and budesonide. They are considered safe to take together.
  • Budesonide can be found in combination with other drugs (e.g., Symbicort). Sometimes, these additional drugs can interact with azithromycin, so always be sure to discuss your medication therapy with a healthcare professional if you are concerned about interactions.

Answer

There is no known drug interaction between budesonide and azithromycin. They are considered safe to use together. This applies to both oral budesonide and inhaled budesonide.

In fact, there are several studies (such as this one) that have evaluated the use of both drugs together to help treat inflammatory conditions, such as bronchitis and COPD. These studies have generally found the combination has positive results with few safety concerns regarding their combined use.

What For Drug Combinations

I will say, however, that there are several drug products that contain budesonide as a component that do interact with azithromycin. One such example is Symbicort.

Symbicort is an inhaler that contains two drugs:

  • Budesonide
  • Formoterol

Budesonide is a corticosteroid while formoterol is known as a LABA, or long-acting beta agonist.

Long-acting beta-agonists have been reported to increase the risk of certain types of arrhythmia, like QT-prolongation. This has been reported with azithromycin as well and it is recommended, if possible, to avoid combining drugs that both increase the risk of arrhythmia.

Azithromycin has been particularly noted as being risky for causing QT-prolongation, so much so that the FDA (food and drug administration) has released safety warnings regarding it.

In your question, you only asked about budesonide, and, as mentioned, that is safe. I just wanted to point out that budesonide can be found in combination with other drugs, and you need to be careful with some of those.

Final Words

I hope you found this answer helpful.

Please reach back out anytime!


References

  • FDA Drug Safety Communication: Azithromycin (Zithromax or Zmax) and the risk of potentially fatal heart rhythms, FDA
  • Clinical observation of aerosol inhalation of azithromycin combined with budesonide suspension in the treatment of mycoplasma pneumoniae pneumonia in children, PubMed
  • Azithromycin modulates release of steroid-insensitive cytokines from peripheral blood mononuclear cells of patients with chronic obstructive pulmonary disease, PubMed
  • Therapeutic effect of budesonide, montelukast and azithromycin on post-infectious bronchiolitis obliterans in children, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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