Pulmicort (budesonide) is a prescription drug that’s used to help manage and prevent asthma symptoms in adults and some children. Like other drugs, Pulmicort may have interactions.

One substance can cause another substance to have a different effect than expected. Alcohol, another drug, or a supplement can affect how a drug works in your body. If you have certain health conditions, interactions can occur.

Pulmicort Flexhaler vs. Pulmicort Respules

Pulmicort comes in two different forms.

  • Pulmicort Flexhaler is a dry powder inhaler.
  • Pulmicort Respules, a liquid suspension that’s used with a nebulizer

In this article, we use the namePulmicort to describe the two forms of the drug.

Keep reading to learn about Pulmicort’s possible interactions. And for more information about Pulmicort, see this article.

Pulmicort Flexhaler is a new form of the drug in the United States. The Turbuhaler is available in other countries, but not in the United States.

“If you have a health condition, Pulmicort could raise your risk of harm. Your doctor may not prescribe Pulmicort for you if that’s the case. This is acontraindication. Thecontraindications of Pulmicort are listed below.”

If you have a severe asthma attack. If you have a severe asthma attack, your doctor likely won’t prescribe Pulmicort to treat your condition. Instead, they’ll prescribe you other medications or breathing treatments. If you have questions about what to do during a severe asthma attack, talk with your doctor.

If you’ve had an allergic reaction to Pulmicort or any of its ingredients, your doctor likely won’t prescribe Pulmicort. And if you’ve had an allergic reaction to milk proteins, your doctor likely won’t prescribe Pulmicort Flexhaler. (This form of Pulmicort contains a small amount of lactose, which is a type of milk protein. But Pulmicort Respules does not contain milk proteins.) Ask your doctor about other treatments that may be better options for you.

If any of the factors above apply to you, talk with your doctor before using Pulmicort. Pulmicort can be determined by your doctor if it is safe for you to take.

It is safe to drink alcohol during your Pulmicort treatment. The drug is not used to interact with alcohol.

If you have questions about drinking alcohol, talk to your doctor.

Inform your doctor and pharmacist about any drugs you take before you start using Pulmicort. Sharing this information with them may help prevent future interactions.

If you have questions about drug interactions, talk to your doctor or pharmacist.

The drugs that may interact with Pulmicort are listed in the chart. All drugs that may interact with Pulmicort are not included in this chart. The “Drug interactions explained” section gives more information about some of the interactions.

Drug group or drug name Drug examples What can happen
certain antiviral drugs • ritonavir (Norvir)
• atazanavir
• nelfinavir (Viracept)		 can increase the risk of side effects of Pulmicort
certain antibiotic drugs • clarithromycin
• erythromycin (E.E.S., Ery-Tab, EryPed, others)		 can increase the risk of side effects of Pulmicort
certain antifungal drugs • itraconazole (Sporanox, Tolsura)
• ketoconazole
• voriconazole (Vfend)		 can increase the risk of side effects of Pulmicort
nefazodone — can increase the risk of side effects of Pulmicort

There are drug interactions that can occur with Pulmicort.

Interaction with certain antiviral drugs

Pulmicort can have side effects if it is used with certain drugs. Antivirals are drugs used to fight infections.

The table below describes this interaction.

What could happen Examples of antiviral medications What you can do
Certain antivirals may keep the body from breaking down Pulmicort as it should. This can increase the amount of Pulmicort in your body. As a result, your risk of side effects with Pulmicort may be higher. • ritonavir (Norvir)
• atazanavir
• nelfinavir (Viracept)		 Before you use Pulmicort, tell your doctor about any antivirals you take. They’ll tell you whether it’s safe to take Pulmicort with these drugs. If they tell you it’s safe, your doctor may monitor you closely for side effects from Pulmicort.

Interaction with certain antibiotic drugs

Using Pulmicort with certain antibiotic drugs can increase the risk of side effects from Pulmicort. (Antibiotics are a group of drugs used to fight infections caused by bacteria.)

The table below contains details about this interaction.

What could happen Examples of antibiotic medications What you can do
Certain antibiotics may keep the body from breaking down Pulmicort as it should. This can increase Pulmicort levels in your body and raise your risk of side effects from the drug. • clarithromycin
• erythromycin (E.E.S., Ery-Tab, EryPed, others)		 Before using Pulmicort, tell your doctor about any antibiotics you take. They’ll tell you whether it’s safe to take Pulmicort with these medications. If they tell you it’s safe, they may monitor you closely for side effects from Pulmicort.

Interaction with certain antifungal drugs

Taking Pulmicort with certain antifungal drugs can increase the risk of side effects from Pulmicort. (Antifungals are a group of drugs used to fight infections caused by fungi.)

The table below describes this interaction.

What could happen Examples of antifungal medications What you can do
Certain antifungals may keep the body from breaking down Pulmicort as it should. This can increase the amount of Pulmicort in your body, which could raise your risk of side effects from the drug. • itraconazole (Sporanox, Tolsura)
• ketoconazole
• voriconazole (Vfend)		 Before starting Pulmicort treatment, tell your doctor about any antifungals you take. They’ll tell you whether it’s safe to take Pulmicort with these drugs. If they tell you it’s safe, your doctor may monitor you closely for side effects from Pulmicort.

Pulmicort may have other interactions. They could happen with supplements, foods, vaccines, or even lab tests. See below for more.

Does Pulmicort interact with supplements?

Before you start using Pulmicort, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions, talk to your doctor or pharmacist.

Pulmicort and herbs

There are currently no reports of Pulmicort Flexhaler or Pulmicort Respules interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

It is still important to check with your doctor or pharmacist before taking any of these products.

Pulmicort and vitamins

There are currently no reports of Pulmicort Flexhaler or Pulmicort Respules interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

It is still important to check with your doctor or pharmacist before taking any of these products.

Does Pulmicort interact with food?

There are currently no reports of Pulmicort Flexhaler or Pulmicort Respules interacting with food. If you have questions about eating certain foods during your treatment with Pulmicort, talk with your doctor.

Does Pulmicort interact with vaccines?

There are currently no reports of Pulmicort Flexhaler or Pulmicort Respules interacting with vaccines. If you have questions about getting specific vaccines during your treatment with Pulmicort, talk with your doctor.

Does Pulmicort interact with lab tests?

There are currently no reports of Pulmicort Flexhaler or Pulmicort Respules interacting with lab tests. If you have questions about getting specific lab tests during your treatment with Pulmicort, talk with your doctor.

Does Pulmicort interact with cannabis or CBD?

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Pulmicort. These products may increase Pulmicort levels in your body. As a result, your risk of side effects from Pulmicort may be higher.

If you take cannabis, tell your doctor and pharmacy about it. You may help prevent interactions by sharing this information with them.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

There is a risk of interactions with Pulmicort if you have certain medical conditions. Talk to your doctor about your health history before using Pulmicort. They will determine if Pulmicort is right for you.

Other factors that might interact with Pulmicort include:

  • Liver problems. If you have liver problems, such as liver failure, tell your doctor before using Pulmicort. Your liver helps remove Pulmicort from your body. If you have liver problems, your body may not be able to clear the drug like usual. This could lead to a buildup of Pulmicort in your body and increase your risk of side effects. Your doctor will tell you whether it’s safe to use Pulmicort with your condition.
  • Infection, including tuberculosis (TB) or herpes in the eye. Before using Pulmicort, tell your doctor if you have an infection. Also tell them if you have TB or herpes infection in the eye, or if you’ve had these in the past. Pulmicort may raise your risk of infection or worsen a current infection. In some cases, it’s possible for TB or herpes infections in the eye to come back after they’ve already been treated. Due to these risks, your doctor will recommend treating any infection you have before you start using Pulmicort. And they’ll determine if it’s safe to use Pulmicort if you have or have had TB or herpes in the eye.
  • Weakened bones. Tell your doctor if you have a condition that causes weakened bones, such as osteoporosis. Pulmicort may cause weakened bones, which could worsen your condition. The drug could also increase your risk of fractures. Your doctor may recommend treatments to strengthen your bones while you’re using Pulmicort.
  • Eye problems, such as cataracts or glaucoma. Pulmicort may raise your risk of eye problems, such as glaucoma or cataracts. As a result, the drug could worsen an eye condition you already have. Your doctor will tell you if it’s safe to use Pulmicort. And they may watch for changes in your vision during your Pulmicort treatment.
  • Not being vaccinated against chickenpox or measles. If you’ve never been vaccinated against chickenpox or measles, tell your doctor before using Pulmicort. This drug could increase your risk of severe chickenpox or measles. Due to this risk, your doctor may suggest you receive these vaccines before using the drug. They may also suggest you avoid contact with people who have chickenpox or measles during your Pulmicort treatment.
  • Surgery or other types of stress on the body. Long-term use of Pulmicort can affect your body’s response to episodes of stress. This includes events such as surgery. If you have an upcoming surgery or other activity that could cause stress on the body, talk with your doctor. This is especially important if your Pulmicort dosage is being lowered. Your doctor may need to temporarily increase your Pulmicort dosage or give you a different steroid during times of stress. (Pulmicort is a steroid drug.) This will help your body to better cope with the stress episode. If you have questions about Pulmicort and stress, talk with your doctor.
  • Pregnancy. Pulmicort is generally considered safe to use while pregnant. The drug isn’t known to cause any problems with fetal development (commonly known as birth defects). To learn more about using Pulmicort during pregnancy, talk with your doctor.
  • Breastfeeding. Pulmicort is thought to be safe to use while breastfeeding. Small amounts of the drug may pass into breastmilk, but this isn’t known to cause side effects in a breastfed child. To learn more about using Pulmicort while breastfeeding, talk with your doctor.
  • Allergic reaction. If you’ve had an allergic reaction to Pulmicort or any of its ingredients, your doctor will likely not prescribe Pulmicort. And if you have had an allergic reaction to milk proteins, your doctor likely won’t prescribe Pulmicort Flexhaler. (This form of Pulmicort contains a small amount of lactose, which is a type of milk protein. But Pulmicort Respules does not contain milk proteins.) Ask your doctor about other treatments that may be better choices for you.

Find answers to questions about Pulmicort.

How long is Pulmicort safe to use?

Pulmicort is safe to use as a long-term treatment. The drug can be used long term to help manage and prevent asthma symptoms in adults and some children. Your doctor will tell you how long you can expect to use Pulmicort.

Can I use Pulmicort with nasal sprays or other inhalers, such as Nasonex, Symbicort, or Atrovent?

Pulmicort can be used with sprays or inhalers in certain circumstances.

If your doctor tells you it is safe, you can use Pulmicort. Nasonex is a spray that is used for sneezing. Pulmicort and Atrovent are both prescribed by your doctor along with other inhalers.

Pulmicort is not likely to be prescribed by your doctor. Budesonide is an active drug in Pulmicort and Symbicort. Your doctor will probably not prescribe the same drug for two different reasons.

Symbicort contains both budesonide and formoterol. Symbicort is likely to be prescribed by your doctor alone if they want to prescribe budesonide with formoterol. They will do this instead of Symbicort.

If you have questions about using Pulmicort, talk to your doctor.

Is it safe to use Pulmicort with over-the-counter pain relievers, such as acetaminophen?

Pulmicort and OTC pain killers are safe to combine.

There is no known interaction between Pulmicort and acetaminophen. It should be safe to use these drugs together.

But other OTC pain relievers may interact with Pulmicort. This includes aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen (Advil) and naproxen (Aleve) are examples of NSAIDs.

Long-term use of Pulmicort with aspirin or NSAIDs could increase your risk of a stomach ulcer (painful sore). This side effect can occur when aspirin or NSAIDs are taken on their own. Taking these drugs with Pulmicort increases your risk of a stomach ulcer even more.

If you want to use OTC pain relief with Pulmicort, you should talk to your doctor or pharmacist. They may recommend you use a different drug.

But if you’d prefer to use aspirin or an NSAID, your doctor or pharmacist can tell you how long it’s safe to take these drugs with Pulmicort. They’ll likely suggest you use aspirin or an NSAID for the shortest amount of time needed to treat your condition. Doing so will reduce your risk of a stomach ulcer.

Taking certain steps can help you avoid getting into arguments with Pulmicort. Talk to your doctor and pharmacist before treatment begins. Things to discuss with them.

  • You can use alcohol or cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • If you start taking a new drug, what should you do?

It’s also important to read Pulmicort’s label and other paperwork that comes with the drug. You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the prescribing information) may have other details about interactions. If you need help understanding this information, your doctor or pharmacist can help.

Pulmicort can help prevent interactions.

If you still have questions, talk to your doctor.

You may want to ask your doctor some questions.

  • Do other drugs interact with my condition?
  • Is Pulmicort still a good option if I have a health condition?
  • What should I do if I start taking a new medication?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.