Budesonide and formoterol and Levalbuterol interaction
Budesonide and formoterol and Levalbuterol: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Budesonide and formoterol (Budesonide and Formoterol Fumarate Dihydrate) label · effective 2026-04-24
Use with additional long-acting beta 2 -agonist: Do not use in combination because of risk of overdose.
Excessive Use of Budesonide and Formoterol Fumarate Dihydrate and Use with Other Long-Acting Beta 2 -Agonists As with other inhaled drugs containing beta 2 -adrenergic agents, budesonide and formoterol fumarate dihydrate should not be used more often than recommended, at higher doses than recommended, or in conjunction with other medications containing LABA,…
In clinical studies, concurrent administration of budesonide and formoterol fumarate dihydrate and other drugs, such as short-acting beta 2 -agonists, intranasal corticosteroids, and antihistamines/decongestants has not resulted in an increased frequency of adverse reactions.
If paradoxical bronchospasm occurs following dosing with budesonide and formoterol fumarate dihydrate, it should be treated immediately with an inhaled, short-acting bronchodilator, BUDESONIDE AND FORMOTEROL FUMARATE DIHYDRATE INHALATION AEROSOL should be discontinued immediately, and alternative therapy should be instituted.
From the Levalbuterol (XOPENEX HFA) label · effective 2025-06-02
Other short-acting sympathomimetic aerosol bronchodilators or epinephrine should not be used concomitantly with XOPENEX HFA.
If the patient needs more doses of XOPENEX HFA than usual, this may be a marker of destabilization of asthma and requires reevaluation of the patient and treatment regimen, giving special consideration to the possible need for anti-inflammatory treatment, e.g., corticosteroids.
Early consideration should be given to adding anti-inflammatory agents, e.g., corticosteroids, to the therapeutic regimen.
Other short-acting sympathomimetic aerosol bronchodilators and adrenergic drugs : May potentiate effect.
XOPENEX HFA is not a substitute for corticosteroids.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.