Pulmicort Interactions: Alcohol, Medications, and Others

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.

Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions.

Pulmicort Flexhaler vs. Pulmicort Respules

Pulmicort comes in two forms:

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

In this article, we use “Pulmicort” to describe both forms of the drug.

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

* In the United States, Pulmicort Flexhaler replaced an earlier form of the drug called Pulmicort Turbuhaler. The Turbuhaler is no longer available in the United States but is available in other countries.

Certain health conditions or other factors could raise your risk of harm if you take Pulmicort. In that case, your doctor may not prescribe Pulmicort for you. This is known as a contraindication. The list below includes contraindications of Pulmicort.

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.

Before you start using Pulmicort, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Pulmicort is safe for you to take.

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

If you have questions about consuming alcohol with Pulmicort, talk with your doctor.

Before you start using Pulmicort, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The chart below lists drugs that may interact with Pulmicort. Keep in mind that this chart does not include all drugs that may interact with Pulmicort. For more information about some of these interactions, see the “Drug interactions explained” section below.

Learn more about certain drug interactions that can occur with Pulmicort.

Interaction with certain antiviral drugs

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

This interaction is described in the table below.

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.)

For details about this interaction, see the table below.

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.)

This interaction is described in the table below.

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

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 that may affect you, talk with 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.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Pulmicort.

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.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Pulmicort.

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.

Before you start treatment with Pulmicort, tell your doctor and pharmacist if you take cannabis. By sharing this information with them, you may help prevent possible interactions.

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

Certain medical conditions or other health factors may raise the risk of interactions with Pulmicort. Before using Pulmicort, talk with your doctor about your health history. They’ll determine whether Pulmicort is right for you.

Health conditions or 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 some frequently asked questions about Pulmicort and possible interactions.

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?

In certain situations, you may be able to use Pulmicort with nasal sprays or other inhalers.

For example, if your doctor tells you it’s safe, you may use Pulmicort with a nasal spray. An example of a nasal spray is Nasonex (mometasone). In addition, your doctor may prescribe Pulmicort along with certain other inhalers, including Atrovent (ipratropium).

But your doctor isn’t likely to prescribe Pulmicort with Symbicort (budesonide/formoterol). This is because Pulmicort and Symbicort both contain the active drug budesonide. Your doctor will likely avoid prescribing two forms of the same active drug.

In addition to budesonide, Symbicort contains the active drug formoterol. If your doctor would like to prescribe budesonide with formoterol, they’re likely to prescribe Symbicort on its own. They’ll do this instead of prescribing Pulmicort along with Symbicort.

If you have other questions about using nasal sprays or other inhalers with Pulmicort, talk with your doctor.

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

Yes, it’s safe to combine Pulmicort with certain over-the-counter (OTC) pain relievers.

For example, there isn’t a known interaction between Pulmicort and acetaminophen (Tylenol). 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’d like to use an OTC pain reliever with Pulmicort, talk with your doctor or pharmacist. They may recommend you use Tylenol instead of aspirin, ibuprofen, or naproxen.

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 interactions with Pulmicort. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use 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.
• What to do if you start taking a new drug during your Pulmicort treatment.

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.

Using Pulmicort exactly as prescribed can also help prevent interactions.

If you still have questions about Pulmicort and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Do other drugs that treat my condition have similar interactions?
• Could I still use Pulmicort even if it interacts with a health condition I have?
• What should I do if I start taking a new medication while I’m using Pulmicort?

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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.