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J Cyst Fibros. 2003 Jun;2(2):72-5.

Inhaled budesonide induced Cushing's syndrome in cystic fibrosis patients, due to drug inhibition of cytochrome P450.

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Department of Paediatrics, Paediatric Respiratory Medicine and Cystic Fibrosis Clinic, Academisch Ziekenhuis-Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.


Two CF patients developed Cushing's syndrome during administration of inhaled budesonide (400 microg/d) with oral itraconazole in one and with clarithromycin in the other patient. Clinical features appeared respectively after 2 and 6 weeks of drug co-administration, with prolonged adrenal suppression, and a slow recovery after ceasing the drugs. Inhibitors of the cytochrome P450 interfere with the metabolism of corticosteroids. Combination of these drugs even with moderate doses of budesonide should be closely monitored.

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