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Respiratory Medications

Symbicort with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Symbicort (Budesonide / Formoterol). Most antibiotics do not interfere meaningfully with Budesonide, Formoterol at 80/4.5 mcg, 160/4.5 mcg, 200/6 mcg, 400/12 mcg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Respiratory Medications agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Budesonide, Formoterol at 80/4.5 mcg, 160/4.5 mcg, 200/6 mcg, 400/12 mcg.

Practical guidance

According to the prescribing information for Budesonide, Formoterol, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Symbicort is co-administered. Adjusted 80/4.5 mcg, 160/4.5 mcg, 200/6 mcg, 400/12 mcg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Symbicort during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Budesonide, Formoterol is metabolised and may need a temporary 80/4.5 mcg, 160/4.5 mcg, 200/6 mcg, 400/12 mcg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Symbicort regimen.

Will antibiotics make Symbicort stop working?

Most antibiotics do not affect Symbicort efficacy. Rifampicin and a few others can lower Budesonide, Formoterol levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Symbicort

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