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Entocort EC oral

Budesonide/Grapefruit Juice

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug, changing your diet or commencing any course of treatment.

Medical warning:

Very important. A change in your diet, medicine, or dosage may be necessary. Promptly consult your doctor or pharmacist.

How the interaction occurs:

Grapefruit juice decreases the ability of your gut to process budesonide.

What might happen:

The level of this drug can increase in your blood and cause more side effects than usual.

What you should do about this interaction:

While you are taking this medicine, you should avoid eating grapefruit or drinking grapefruit juice. You may choose an alternative citrus beverage (such as orange juice).Let your doctor know right away if you notice any swelling of your face, neck, or trunk; pain in the abdomen or back, prolonged sore throat or fever, or mood changes.In the event that you are instructed by a healthcare professional (e.g., doctor, pharmacist, or dietitian) to eat grapefruit or drink grapefruit juice, you should immediately discuss with doctor the effects of grapefruit on the blood levels of this medicine. If you notice an increase in any side effect from your medicine, contact your doctor. Your healthcare professionals may be aware of this interaction and may be monitoring you for it. Do not start, stop, or change your medicine or diet before checking with them first.

References:

1.Entocort HC (budesonide) US prescribing information. AstraZeneca AB June, 2009.
2.Seidegard J, Randvall G, Nyberg L, Borga O. Grapefruit juice interaction with oral budesonide: equal effect on immediate-release and delayed-release formulations. Pharmazie 2009 Jul;64(7):461-5.
3.Lown KS, Bailey DG, Fontana RJ, Janardan SK, Adair CH, Fortlage LA, Brown MB, Guo W, Watkins PB. Grapefruit juice increases felodipine oral availability in humans by decreasing intestinal CYP3A protein expression. J Clin Invest 1997 May 15;99(10):2545-53.
4.Kolars JC, Lown KS, Schmiedlin-Ren P, Ghosh M, Fang C, Wrighton SA, Merion RM, Watkins PB. CYP3A gene expression in human gut epithelium. Pharmacogenetics 1994 Oct;4(5):247-59.
5.Kivisto KT, Bookjans G, Fromm MF, Griese EU, Munzel P, Kroemer HK. Expression of CYP3A4, CYP3A5 and CYP3A7 in human duodenal tissue. Br J Clin Pharmacol 1996 Sep;42(3):387-9.

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