Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- Multitest CMI (skin test antigens, multiple)
- Symbicort (budesonide / formoterol)
Interactions between your drugs
skin test antigens, multiple budesonide
Applies to: Multitest CMI (skin test antigens, multiple), Symbicort (budesonide / formoterol)
MONITOR: Immunosuppressed patients may have diminished response to diagnostic skin test antigens due to suppression of cell-mediated, delayed-type hypersensitivity. Falsely insignificant or false-negative results may occur in such patients, which may include those who have recently received or are receiving immunosuppressive agents, antilymphocyte globulins, alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (e.g., greater than or equal to 2 mg/kg/day or 20 mg/day of prednisone or equivalent for 14 consecutive days or more), or long-term topical or inhaled corticosteroids.
MANAGEMENT: Clinicians should be aware of the potential for falsely insignificant or false-negative results when administering diagnostic skin test antigens to patients treated with immunosuppressive agents.
References
- (2001) "Product Information. Candin (candida albicans extract)." Nielsen Biosciences Inc
- (2001) "Product Information. Histolyn-Cyl (histoplasmin)." ALK Laboratories Inc
- (2001) "Product Information. Spherulin (coccidioidin skin test)." ALK Laboratories Inc
- (2001) "Product Information. MSTA Mumps Skin Test Antigen (mumps skin test antigen)." Aventis Pharmaceuticals
- (2001) "Product Information. Multitest CMI (skin test antigens, multiple)." Aventis Pharmaceuticals
- "Product Information. Tuberculin Tine Test (tuberculin purified protein derivative)." Connaught Laboratories Inc
budesonide formoterol
Applies to: Symbicort (budesonide / formoterol), Symbicort (budesonide / formoterol)
Although they are often combined in clinical practice, the concomitant use of beta-2 adrenergic agonists and corticosteroids may result in additive hypokalemic effects. Since beta-2 agonists can sometimes cause QT interval prolongation, the development of hypokalemia may potentiate the risk of ventricular arrhythmias including torsade de pointes. However, clinical data are limited, and the potential significance is unknown. Patients who are receiving systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or systemic corticosteroid therapy may be at a greater risk of developing hypokalemia.
References
- (2001) "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- Agencia EspaƱola de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de informaciĆ³n online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
Drug and food interactions
budesonide food
Applies to: Symbicort (budesonide / formoterol)
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations and systemic effects of orally administered budesonide. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. According to the manufacturer, the systemic exposure of oral budesonide approximately doubles after extensive intake of grapefruit juice.
MANAGEMENT: Patients receiving budesonide should avoid the regular consumption of grapefruits and grapefruit juice to prevent undue increases in plasma budesonide levels and systemic effects.
References
- (2001) "Product Information. Entocort (budesonide)." AstraZeneca Pharma Inc
Therapeutic duplication warnings
No duplication 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
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
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