Moderate
Budesonide × Estradiol
Inhaled corticosteroids (ICS)×Estrogens — natural and semisynthetic
Mechanism
Oestradiol raises corticosteroid-binding globulin, increasing the bound budesonide fraction. The free fraction changes minimally. The interaction is clinically minor.
Symptoms
No specific clinical manifestations. On long-term systemic therapy, both drugs' side effects may appear.
Management
No dose adjustment needed. In women on menopausal hormone therapy and oral budesonide, check BP, weight, and lipid profile every 6 months. With systemic budesonide over 3 months, consider switching to inhaled glucocorticoids.