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Drug Interactions between budesonide / formoterol and sargramostim

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

sargramostim budesonide

Applies to: sargramostim and budesonide / formoterol

Consumer information for this interaction is not currently available.

MONITOR: Glucocorticoids may potentiate the myeloproliferative effects of colony stimulating factors. The proposed mechanism has not been established. Glucocorticoids are known to mediate their immunosuppressive effects on target cells via binding to cytosolic glucocorticoid receptors, which leads to decreased expression of proinflammatory molecules and increased expression of anti-inflammatory molecules. However, in cases of neutrophil-dominated asthma, treatment with corticosteroids have been shown to promote neutrophil survival, leading to increases in airway tissue neutrophils and hence neutrophilic inflammation. Glucocorticoids have shown anti-apoptotic effects on different cell types in vitro, including human neutrophils, with dexamethasone inhibiting spontaneous neutrophil apoptosis in a concentration-dependent manner. Various mechanisms proposed for this observed inhibition of neutrophil apoptosis have included up-regulation of anti-apoptotic Bcl-2 family members, stabilization and induction of inhibitor of apoptosis proteins (IAPs), activation of nuclear factor kappa B (NK-kB), suppression of components of the extrinsic pathway of apoptosis, and induction of signaling molecules such as mitogen activated protein kinase (MAPK) phosphatase-1 and serum and glucocorticoid activated kinase-1 (SGK-1). However, the interaction has not been reported in the product labeling for the granulocyte colony stimulating factors (G-CSFs). In addition, it is unclear whether the interaction extends to inhaled corticosteroids. The clinical significance of this interaction for the granulocyte macrophage colony stimulating factor (GM-CSF) sargramostim has also not been established.

MANAGEMENT: According to the product labeling for sargramostim, patients receiving concomitant treatment with sargramostim and glucocorticoids may require more frequent clinical and laboratory monitoring for signs of excess myeloproliferative effects.

Minor

budesonide formoterol

Applies to: budesonide / formoterol and budesonide / formoterol

Information for this minor interaction is available on the professional version.

Drug and food interactions

Moderate

budesonide food

Applies to: budesonide / formoterol

You should avoid the regular consumption of large amounts of grapefruits and grapefruit juice while taking budesonide. Grapefruit can raise the levels of budesonide in your body and lead to increased side effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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