Drug Interactions between budesonide and capivasertib

Consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit should be avoided during treatment with capivasertib as they may increase the blood levels of capivasertib. This may increase the risk of side effects such as high blood sugar levels, diarrhea, skin reactions, nausea, vomiting, tiredness, and changes in certain blood tests. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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.

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with corticosteroids should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Severe hyperglycemia, including diabetic ketoacidosis and fatal outcomes, has occurred in patients treated with capivasertib. The safety of capivasertib in patients with Type 1 diabetes or with diabetes requiring insulin has not been established; these patients were excluded from clinical studies. Fasting blood glucose and hemoglobin A1C should be evaluated and optimized before starting treatment. Regular monitoring of fasting blood glucose as recommended by the manufacturer should be performed during treatment with capivasertib. Consider consultation with a specialist in the treatment of hyperglycemia and initiation of fasting glucose monitoring at home for patients who have risk factors for or who experience hyperglycemia. If hyperglycemia occurs during treatment, the dose of capivasertib may need to be withheld or reduced, or treatment permanently discontinued based on severity or if ketoacidosis is confirmed.

Severe hyperglycemia, including diabetic ketoacidosis and fatal outcomes, has occurred in patients treated with capivasertib. The safety of capivasertib in patients with Type 1 diabetes or with diabetes requiring insulin has not been established; these patients were excluded from clinical studies. Fasting blood glucose and hemoglobin A1C should be evaluated and optimized before starting treatment. Regular monitoring of fasting blood glucose as recommended by the manufacturer should be performed during treatment with capivasertib. Consider consultation with a specialist in the treatment of hyperglycemia and initiation of fasting glucose monitoring at home for patients who have risk factors for or who experience hyperglycemia. If hyperglycemia occurs during treatment, the dose of capivasertib may need to be withheld or reduced, or treatment permanently discontinued based on severity or if ketoacidosis is confirmed.

Severe hyperglycemia, including diabetic ketoacidosis and fatal outcomes, has occurred in patients treated with capivasertib. The safety of capivasertib in patients with Type 1 diabetes or with diabetes requiring insulin has not been established; these patients were excluded from clinical studies. Fasting blood glucose and hemoglobin A1C should be evaluated and optimized before starting treatment. Regular monitoring of fasting blood glucose as recommended by the manufacturer should be performed during treatment with capivasertib. Consider consultation with a specialist in the treatment of hyperglycemia and initiation of fasting glucose monitoring at home for patients who have risk factors for or who experience hyperglycemia. If hyperglycemia occurs during treatment, the dose of capivasertib may need to be withheld or reduced, or treatment permanently discontinued based on severity or if ketoacidosis is confirmed.

Severe hyperglycemia, including diabetic ketoacidosis and fatal outcomes, has occurred in patients treated with capivasertib. The safety of capivasertib in patients with Type 1 diabetes or with diabetes requiring insulin has not been established; these patients were excluded from clinical studies. Fasting blood glucose and hemoglobin A1C should be evaluated and optimized before starting treatment. Regular monitoring of fasting blood glucose as recommended by the manufacturer should be performed during treatment with capivasertib. Consider consultation with a specialist in the treatment of hyperglycemia and initiation of fasting glucose monitoring at home for patients who have risk factors for or who experience hyperglycemia. If hyperglycemia occurs during treatment, the dose of capivasertib may need to be withheld or reduced, or treatment permanently discontinued based on severity or if ketoacidosis is confirmed.

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with corticosteroids should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

The use of corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis or in hepatitis B carriers. Monitor patients for any new or worsening infection and use with caution in these patients. A serious or even fatal course of chickenpox and measles can occur in susceptible patients. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Some inhaled corticosteroid formulations contain lactose and may cause adverse reactions including cough, wheezing and bronchospasm in patients with severe milk protein allergy or intolerance. Caution is advised.

Corticosteroids are predominantly cleared by hepatic metabolism and impairment of the liver function may lead to their accumulation. Patients with hepatic disease should be closely monitored.

Capivasertib has not been studied in patients with severe hepatic impairment (bilirubin greater than 3 times ULN and any AST). In patients with moderate hepatic impairment (bilirubin greater than 1.5 to 3 times ULN and any AST), additional monitoring for adverse side effects is recommended due to the potential for increased exposure. No dose adjustment is recommended in patients with mild hepatic impairment.

Pharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.

Prolonged use of inhaled corticosteroids may be associated with a reduction in bone density. This effect appears to be dose-related and has been reported primarily with high dosages (800 mcg/day or more of beclomethasone or equivalent for 1 year or greater). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages. Long-term therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with osteoporosis. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Capivasertib has not been studied in patients with severe renal dysfunction (CrCl 15 to 29 mL/min). No dose adjustment is recommended in patients with mild to moderate renal dysfunction (CrCl 30 to 89 mL/min).

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis or in hepatitis B carriers. Monitor patients for any new or worsening infection and use with caution in these patients. A serious or even fatal course of chickenpox and measles can occur in susceptible patients. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.