Moderate
Budesonide × Ethinylestradiol
Inhaled corticosteroids (ICS)×Estrogens. Natural and semisynthetic estrogens, plain
Mechanism
Oestrogens raise corticosteroid-binding globulin, increasing the bound budesonide fraction, but the effective free fraction changes minimally. The interaction is clinically minor.
Symptoms
No specific clinical manifestations. On systemic long-term therapy, both drugs' side effects may appear.
Management
No dose adjustment needed. In women on combined oral contraceptives and oral budesonide, check BP and weight every 3 months. With significant systemic budesonide side effects, consider switching to inhaled glucocorticoids or mesalazine.