Symbicort (budesonide/formoterol) is a brand-name prescription drug. It’s used to treat asthma and chronic obstructive pulmonary disorder (COPD) in certain people.

As with other medications, Symbicort can interact with some other drugs. It can also interact with certain supplements and foods. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Symbicort’s interactions, keep reading. For additional information about Symbicort, including details about its uses, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Symbicort due to the risk of harm. These are known as contraindications. The contraindications of Symbicort include the ones mentioned below.

Note: Before you start treatment with Symbicort, it’s important to tell your doctor if either of these contraindications applies to you. They can determine whether to prescribe Symbicort.

Current asthma attacks or COPD that requires intense treatment

Your doctor typically will not prescribe Symbicort to treat sudden breathing problems. These can include an asthma attack and difficulty breathing due to chronic obstructive pulmonary disorder (COPD). Symbicort is not approved for these uses.

Instead, you’ll likely be prescribed a rescue inhaler, such as albuterol (ProAir, Ventolin HFA), to ease your symptoms. Your doctor may advise you to seek emergency care in some situations. This is because sudden breathing problems can be life threatening if not treated correctly.

Having had an allergic reaction to Symbicort or any of its ingredients

If you have had an allergic reaction to Symbicort or any of its ingredients, your doctor will likely not prescribe Symbicort. This is because using the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

If you have additional questions or concerns about who should not take Symbicort, talk with your doctor or pharmacist.

There aren’t any known interactions between Symbicort and alcohol. However, drinking alcohol can increase your risk of side effects from Symbicort.*

For example, Symbicort may cause headache, nausea, or vomiting. Alcohol can also cause these side effects. So you may be at a higher risk of side effects if you consume alcohol while using Symbicort.

If you’re interested in drinking alcohol while using Symbicort, talk with your doctor to see whether it’s safe for you.

* For details about Symbicort’s side effects, see this article.

Before you start treatment with Symbicort, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Symbicort interacts with supplements, herbs, or vitamins, see “Symbicort and other interactions” below.)

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

Here’s a table of drugs that can interact with Symbicort. Keep in mind that this table doesn’t include all drugs that may interact with Symbicort. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Symbicort
beta-blockers• metoprolol (Lopressor, Toprol XL)
• atenolol (Tenormin)
nebivolol (Bystolic)
can make Symbicort less effective than usual
other long-acting beta-agonists (LABAs)• fluticasone/salmeterol (Advair, Wixela)
salmeterol (Serevent Diskus)
• formoterol (Perforomist)
can increase the risk of side effects from Symbicort* and other LABAs
other corticosteroids• beclomethasone (Qvar)
fluticasone (Flonase)
prednisone (Rayos)
can increase the risk of side effects from Symbicort* and other corticosteroids
drugs that weaken your immune system• abatacept (Orencia)
• ofatumumab (Kesimpta)
cyclosporine (Neoral)
can increase the risk of side effects from Symbicort* and drugs that weaken your immune system
drugs that increase your blood pressure• pseudoephedrine (Sudafed)
• phenylephrine (Biophren)
• amphetamine salts (Adderall)
epinephrine (EpiPen)
can increase the risk of side effects from drugs that increase your blood pressure
monoamine oxidase inhibitors (MAOIs)• isocarboxazid (Marplan)
• tranylcypromine (Parnate)
• selegiline (Emsam)
can increase the risk of side effects from Symbicort*†
tricyclic antidepressantsnortriptyline (Pamelor)
doxepin (Silenor)
amitriptyline
can increase the risk of side effects from Symbicort*
certain HIV medications• ritonavir (Norvir)
• atazanavir (Reyataz)
• nelfinavir (Viracept)
can increase the risk of side effects from Symbicort*
certain antibioticsclarithromycin
levofloxacin
can increase the risk of side effects from Symbicort* and certain antibiotics
certain diureticschlorthalidone (Thalitone)
torsemide (Soaanz)
furosemide (Lasix)
can increase the risk of side effects from certain diuretics
certain antifungal drugs• itraconazole (Sporanox)
ketoconazole (Nizoral)
fluconazole (Diflucan)
can increase the risk of side effects from Symbicort*
nefazodonecan increase the risk of side effects from Symbicort*
vigabatrin (Sabril)can increase the risk of side effects from Symbicort*
desmopressin (Nocdurna)can increase the risk of side effects from desmopressin
dabrafenib (Tafinlar)can make Symbicort less effective than usual

* For details about Symbicort’s side effects, see this article.
† This interaction may take place while both medications are being taken together and for 14 days after. Your doctor or pharmacist can tell you more.

Here’s a closer look at certain drug interactions of Symbicort.

Corticosteroids

Corticosteroids may be used to treat many conditions, including inflammation, breathing problems, and allergic reactions.

Interaction result. Using Symbicort in combination with another corticosteroid may increase your risk of side effects from both drugs. (For details about Symbicort’s side effects, see this article.)

Interaction explained. Symbicort contains a corticosteroid called budesonide. If you use Symbicort with another corticosteroid, you’re essentially taking two corticosteroids. This may increase your risk of certain side effects from both drugs. The side effects can include infection, raised blood sugar level, and weakened bones.

Examples of corticosteroid drugs. Here are some corticosteroids that may interact with Symbicort:

Steps you or your doctor may take. Before starting Symbicort treatment, tell your doctor about any corticosteroid drugs that you take. They can help determine whether it’s safe to take the medications together.

In some situations, your doctor may prescribe another corticosteroid while you’re using Symbicort. They can adjust your dosages and monitor you for any side effects as needed.

Beta-blockers

Beta-blockers are typically used to treat high blood pressure and angina (a type of chest pain).

Interaction result. Using Symbicort with a beta-blocker can make Symbicort less effective than usual.

Interaction explained. Symbicort contains formoterol, which is a type of drug called a long-acting beta-agonist (LABA). Beta-blockers can stop LABAs from working.

If you use Symbicort with a beta-blocker, the beta-blocker will prevent formoterol from working as effectively to treat your condition. This means Symbicort won’t be as effective as it should be.

Examples of beta-blocker drugs. Here are some beta-blockers that may interact with Symbicort:

Steps you or your doctor may take. If you’re taking a beta-blocker, tell your doctor before starting Symbicort treatment. They may switch you to a different medication that doesn’t interact with Symbicort.

In some situations, your doctor may prescribe a beta-blocker with Symbicort. They’ll recommend one that interacts the least with Symbicort. They’ll also monitor you throughout your treatment to see how Symbicort is working for you.

Certain antifungal drugs

Antifungal drugs are used to treat fungal infections, such as yeast infections.

Interaction result. Using Symbicort with certain antifungals may increase your risk of side effects of Symbicort. (For details about Symbicort’s side effects, see this article.)

Interaction explained. One of the active drugs in Symbicort, budesonide, is broken down by an enzyme in your body called CYP3A4. (An enzyme is a type of protein.) Some antifungal drugs block this enzyme from working.

If the enzyme isn’t working correctly and can’t break down budesonide, the level of budesonide in your body could rise. This could make side effects of Symbicort more likely to occur. The side effects could include a type of heart problem called arrhythmia.

Examples of antifungal drugs. Here are some antifungals that may interact with Symbicort:

Steps you or your doctor may take. Before you start using Symbicort, tell your doctor if you’re taking any antifungal medications. In many cases, they’ll recommend not taking certain antifungal drugs during Symbicort treatment. They may switch you to a different antifungal drug that doesn’t interact with Symbicort.

Symbicort may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Symbicort.

Symbicort interactions with supplements

Before you start treatment with Symbicort, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

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

Symbicort interactions with herbs

An herb called echinacea can interact with Symbicort. Some people take echinacea to help boost their immune system.

Taking echinacea in combination with Symbicort may decrease the effectiveness of Symbicort.

If you take any echinacea supplements, talk with your doctor before starting Symbicort treatment. They’ll likely advise you to stop taking the supplements.

Symbicort and vitamins

There are no specific reports of vitamins interacting with Symbicort. However, this doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Symbicort.

Symbicort interactions with food

It’s possible for Symbicort to interact with certain foods. Specifically, this medication can interact with:

Both caffeine and Symbicort can increase your heart rate. The combination of the two substances can further increase your risk of heart-related side effects from Symbicort, such as an increased heart rate.* Foods that contain caffeine include coffee, tea, and chocolate.

Also, your doctor will likely recommend that you do not consume grapefruit and grapefruit juice while using Symbicort. Eating grapefruit or drinking grapefruit juice during your treatment can increase your risk of side effects from Symbicort.*

In addition, the herb echinacea can interact with Symbicort, decreasing the effectiveness of the drug.† Your doctor may recommend that you not drink echinacea tea while you use Symbicort.

Your doctor and pharmacist can help answer questions you have about what’s safe to consume with Symbicort.

* For details about Symbicort’s side effects, see this article.
† To learn more about echinacea, see “Symbicort interactions with herbs” above.

Symbicort and vaccines

There aren’t any known interactions between Symbicort and vaccines. To find out whether you’re up to date on your vaccines, talk with your doctor or pharmacist.

Symbicort and lab tests

Symbicort isn’t known to interact with any lab tests. If you have questions about having lab tests during Symbicort treatment, talk with your doctor.

SYMBICORT INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Symbicort. Cannabis may interact with one of the active ingredients in Symbicort: budesonide.

It’s possible for cannabis to raise or lower the level of budesonide in your body. If the level is too high, you may be at an increased risk of side effects from Symbicort. If the level is too low, Symbicort may not work as well as it should.

Before you start treatment with Symbicort, tell your doctor and pharmacist if you use 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 U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Symbicort. Before you use this medication, be sure to talk with your doctor about your health history. Symbicort may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Symbicort include the following.

Allergic reaction. If you’ve had an allergic reaction to Symbicort or any of its ingredients, your doctor will likely not prescribe Symbicort. To learn more, see “When to avoid Symbicort” above.

Asthma attack. Symbicort is not approved to treat asthma attacks. To learn more, see “When to avoid Symbicort” above.

Sudden difficulty breathing due to COPD. Symbicort is not approved to treat sudden trouble breathing due to chronic obstructive pulmonary disorder (COPD). To learn more, see “When to avoid Symbicort” above.

Heart problems. If you have a heart condition, tell your doctor before starting Symbicort treatment. It’s possible for the drug to cause certain heart problems, such as changes in blood pressure or heart rhythm. And if you already have a heart condition, using Symbicort may worsen it. In this situation, your doctor can help determine whether Symbicort is safe for you.

Seizures. In rare cases, Symbicort may cause seizures. And if you have a seizure disorder, the medication may further increase your risk of having a seizure. In this situation, your doctor can advise you on whether Symbicort is right for you.

Diabetes. If you have diabetes, tell your doctor before using Symbicort. This medication may increase your blood sugar level, which can worsen diabetes. Your doctor can help determine whether Symbicort is a good treatment option for you.

Thyroid problems. Before starting Symbicort treatment, tell your doctor about any thyroid problems you have. An example is hyperthyroidism. It’s possible for Symbicort to worsen symptoms of your thyroid condition. Your doctor can help determine whether Symbicort is safe for you.

Osteoporosis. If you have osteoporosis, tell your doctor before using Symbicort. This medication can weaken your bones. And if you already have osteoporosis, using Symbicort may worsen your condition. Your doctor can help determine whether to prescribe Symbicort.

Eye problems. If you have an eye problem, such as glaucoma, tell your doctor before starting Symbicort treatment. In rare cases, the drug may cause glaucoma or cataracts. And if you already have an eye condition, Symbicort may worsen it. You can talk with your doctor about whether Symbicort is safe for you.

Weakened immune system. If you have a weakened immune system, be sure to tell your doctor before you start Symbicort treatment. The drug may weaken your immune system, which can increase the risk of infection.

If your immune system is not strong to begin with, Symbicort may weaken it further. This can make you more likely to develop an infection. In this situation, your doctor can advise you on Symbicort’s risks and benefits.

Infection. Be sure to tell your doctor about any infection you have before you begin using Symbicort. They’ll treat the infection before you start using Symbicort. This is because Symbicort can increase your risk of infections and may make an existing infection worse.

To help prevent infection, ask your doctor and pharmacist whether you’re up to date with any vaccines you need. You may need to receive certain vaccines before starting Symbicort treatment.

Pregnancy. There haven’t been enough clinical trials to determine whether Symbicort is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans.

If you’re pregnant or planning to become pregnant, tell your doctor before starting Symbicort. They can advise you on the right treatment plan for you.

Breastfeeding. It’s not known whether it’s safe to use Symbicort while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Symbicort may have on a child who is breastfed.

If you’re breastfeeding or planning to, talk with your doctor before using Symbicort. They can talk with you about treatment options and ways to feed your child.

Liver problems. Be sure to tell your doctor if you have any liver problems before you use Symbicort. Your liver helps your body gets rid of the drug. If you have a liver problem, Symbicort may not leave your system as quickly as it should. This can cause the medication to build up in your body, which may increase your risk of side effects.* In this situation, your doctor can advise you on whether Symbicort is right for you.

* For details about Symbicort’s side effects, see this article.

Here are some frequently asked questions about Symbicort and possible interactions.

Is it safe to use my albuterol inhaler with Symbicort?

Yes, it’s safe for you to use your albuterol inhaler (ProAir, Ventolin HFA) with Symbicort. In fact, if you experience symptoms of an asthma attack, such as trouble breathing, your doctor may recommend using albuterol. It’s important to note that Symbicort is not approved to treat asthma attacks.*

Doctors often prescribe an albuterol inhaler with Symbicort in case you have an asthma attack or other trouble breathing. If you find that you use your albuterol inhaler multiple times per day, be sure to tell your doctor. This may mean that your treatment plan isn’t working to manage your condition. Your doctor may adjust your treatment plan in this case.

If you have additional questions about albuterol inhalers and Symbicort, talk with your doctor or pharmacist.

* To learn more, see “When to avoid Symbicort” above.

Can I take Tylenol with Symbicort?

Yes, it’s safe to take acetaminophen (Tylenol) with Symbicort. There aren’t any known interactions between these medications.

Tylenol is a drug that’s typically used to ease pain and lower fevers.

If you experience pain while using Symbicort, talk with your doctor. They can help determine the cause. In addition, they may be able to recommend ways to manage your pain.

You can take certain steps to help prevent interactions with Symbicort. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Symbicort label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Symbicort doesn’t come with paperwork, you can ask your pharmacist to print a copy.) If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Symbicort by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Symbicort. These resources might help:

  • Overview of Symbicort. For a general overview of Symbicort, you can see this article.
  • Dosage specifics. To learn about the dosage of Symbicort, see this article.
  • Drug comparison. Find information about how Symbicort compares with Breo and Dulera.
  • Cost. You can find information about cost and Symbicort here.
  • Facts about your condition. To learn more about your condition, see our asthma and allergies hub and COPD hub.

Disclaimer: Medical News Today 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.