Moderate
Budesonide × carvedilol
Inhaled corticosteroids (ICS)×Alpha and beta blocker (non-selective β + α1)
Mechanism
Systemic budesonide retains sodium and water, blunting the beta-blocker's antihypertensive effect. Inhaled budesonide does not clinically affect BP.
Symptoms
On long-term systemic therapy: return or rise of blood pressure, leg oedema.
Management
For short systemic budesonide courses, no specific adjustment needed. For long-term therapy, check BP weekly in the first month. If BP rises, increase carvedilol or add an ACE inhibitor. Inhaled budesonide with carvedilol is unproblematic.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.