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Drug Interactions between budesonide and physostigmine

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

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Interactions between your drugs

Moderate

PHYSostigmine budesonide

Applies to: physostigmine and budesonide

Using budesonide together with PHYSostigmine may result in severe muscle weakness in patients with myasthenia gravis. If you have been receiving treatment with PHYSostigmine, you may experience increased muscle weakness when budesonide is first initiated. Improvement in muscular function may occur gradually. Talk to your doctor if you have any questions or concerns. Your doctor may discontinue PHYSostigmine at least one day before you start taking budesonide. 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.

Drug and food/lifestyle interactions

Moderate

budesonide food/lifestyle

Applies to: budesonide

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.

Disease interactions

Major

PHYSostigmine Arrhythmias

Applies to: Arrhythmias

Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.

Major

PHYSostigmine Asthma

Applies to: Asthma

Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma, or obstructive pulmonary disease. Respiratory function should be closely monitored for the occurrence of respiratory adverse reactions. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress.

Major

PHYSostigmine Asthma

Applies to: Asthma

Physostigmine is a cholinesterase inhibitor that inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Physostigmine salicylate injection is contraindicated in patients with asthma.

Major

PHYSostigmine Cardiovascular Disease

Applies to: Cardiovascular Disease

Physostigmine salicylate injection is contraindicated in patients with cardiovascular disease.

Major

PHYSostigmine Chronic Obstructive Pulmonary Disease

Applies to: Chronic Obstructive Pulmonary Disease

Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma, or obstructive pulmonary disease. Respiratory function should be closely monitored for the occurrence of respiratory adverse reactions. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress.

Major

PHYSostigmine Diabetes Mellitus

Applies to: Diabetes Mellitus

Physostigmine salicylate injection is contraindicated in patients with diabetes, and in patients with gangrene.

Major

PHYSostigmine Gastrointestinal Obstruction

Applies to: Gastrointestinal Obstruction

Physostigmine is a cholinesterase inhibitor that inhibit the hydrolysis of acetylcholine. Physostigmine salicylate injection is contraindicated in patients with mechanical obstruction of the intestine or urogenital tract or any vagotonic state.

Major

PHYSostigmine Ischemic Heart Disease

Applies to: Ischemic Heart Disease

The use of cholinesterase inhibitors has been associated with a constriction of coronary arteries. Therapy with cholinesterase inhibitors should be administered cautiously in patients with coronary artery disease.

Major

PHYSostigmine Parkinsonism

Applies to: Parkinsonism

Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.

Major

PHYSostigmine Urinary Tract Obstruction

Applies to: Urinary Tract Obstruction

Physostigmine is a cholinesterase inhibitor that inhibit the hydrolysis of acetylcholine. Physostigmine salicylate injection is contraindicated in patients with mechanical obstruction of the intestine or urogenital tract or any vagotonic state.

Moderate

budesonide Cataracts

Applies to: Cataracts

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.

Moderate

budesonide Glaucoma/Intraocular Hypertension

Applies to: Glaucoma / Intraocular Hypertension

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.

Moderate

budesonide Hyperadrenocorticism

Applies to: Hyperadrenocorticism

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.

Moderate

PHYSostigmine Hyperthyroidism

Applies to: Hyperthyroidism

Many of the manifestations of hyperthyroidism may be exacerbated by increased levels of acetylcholine produced by cholinesterase inhibitors. Therapy with cholinesterase inhibitors should be administered cautiously to patients with hyperthyroidism. Monitoring of thyroid levels is recommended.

Moderate

budesonide Infection - Bacterial/Fungal/Protozoal/Viral

Applies to: Infection - Bacterial / Fungal / Protozoal / Viral

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.

Moderate

budesonide Lactose Intolerance

Applies to: Lactose Intolerance

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.

Moderate

budesonide Liver Disease

Applies to: Liver Disease

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.

Moderate

budesonide Ocular Herpes Simplex

Applies to: Ocular Herpes Simplex

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.

Moderate

budesonide Osteoporosis

Applies to: Osteoporosis

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.

Moderate

budesonide Tuberculosis -- Latent

Applies to: Tuberculosis -- Latent

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.

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.


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.