Cholestyramine interaction

Acarbose Acarbose interacts with other hypoglycemics and drugs that act on the GI tract. Neomycin and cholestyramine interact with acarbose. 

Johns WH, Bates TR. Drug-cholestyramine interactions. I Physicochemical factors affecting in vitro binding of sodium fusidate to cholestyramine. JPhamiiJd (1972) 61, 730-5. 

Geeze DS, Wise MG, Stigelman WH. Doxepin-cholestyramine interaction. Psychosomatics (1988) 29, 233-6. 

Hannon SM, Seifert CF. Levotityroxine-cholestyramine interaction reemphasized. Arm Intern A/eif (1991) 115,658-9. 

A 45-year-old male takes simvastatin for hypercholesterolemia however, his cholesterol level remains above target at maximal doses. Cholestyramine is added to the therapeutic regimen. What drug-drug interaction can occur ... 

Cholestyramine, a chelating agent, binds chlordecone present in the gastrointestinal tract and limits its enterohepatic recirculation (Boylan et al. 1978 Cohn et al. 1978). This interaction leads to increased excretion of the chlordecone and decreased toxicity. Thus, persons being treated with cholestyramine to lower plasma cholesterol may experience increased excretion of chlordecone and decreased toxicity. The use of cholestyramine as a therapeutic agent in cases of chlordecone poisoning is discussed more fully in Section 2.8.2, Reducing Body Burden. 

Cholestyramine use is not without limitations. It does not bind chlordecone alcohol, a metabolite of chlordecone that is also excreted in the bile (Guzelian 1981). It has a gritty texture in the mouth, and it causes several gastrointestinal disturbances, which may limit the willingness of patients to take it. It may also interfere with the absorption of fat-soluble vitamins and interact with other medications (Goldfrank 1990). 

Drugs that may interact with raloxifene include ampicillin and cholestyramine. Raloxifene may affect warfarin. 

Drugs that may affect amiodarone include hydantoins, cholestyramine, fluoroquinolones, rifamycins, ritonavir, and cimetidine. Drugs that may be affected by amiodarone include anticoagulants, beta-blockers, calcium channel blockers, cyclosporine, dextromethorphan, digoxin, disopyramide, fentanyl, flecainide, hydantoins, lidocaine, methotrexate, procainamide, quinidine, and theophylline. Drug/Lab test interactions Amiodarone alters the results of thyroid function tests, causing an increase in serum T4 and serum reverse T3 levels and a decline in... 

The following drug interactions were reported for metronidazole, a chemically related nitroimidazole. Therefore, these drug interactions may occur with tinidazole. Drugs that may affect tinidazole include cholestyramine, CYP3A4 inducers and inhibitors and oxytetracycline. Drugs that may be affected by tinidazole include alcohols, anticoagulants, cyclosporine, tacrolimus, disulfiram, fluorouracil, hydantoins, and lithium. 

Steroids, Systemic, Tables VI-1 and VI-2 Interactions T Effects Wf cyclosporine, estrogens, OCPs, macrolides T effects OF cyclosporine T effects W/ aminog-lutethimide, antacids, barbiturates, carbamazepine, cholestyramine, colestipol. 

WARNING May T risk of CV events GI bleeding Uses Osteoarthritis, RA, JRA Action NSAID w/ T COX-2 activity Dose Adults. 7.5-15 mg/d PO Feds (>2 y). 0.125 mg/kg/d, max 7.5 mg 4- in renal insuff take w/ food Caution [C, D (3rd tri) /-] Peptic ulcer, NSAID, or ASA sensitivity Disp Tabs, susp SE HA, dizziness, GI upset, GI bleeding, edema Interactions T Effects OF ASA, anticoagulants, corticosteroids, Li, EtOH, tobacco effects W/ cholestyramine 4-effects OF antihypertensives EMS T Effects of anticoagulants concurrent EtOH/tobacco use can T adverse GI effects (bleeding, D) T risk of photosensitivity Rxns OD May cause NA and lethargy activated charcoal may be effective... 

Interferes w/ DNA synth Dose Adults. Anaerobic Infxns 500 mg IV q6-8h Amebic dysentery 750 mg/d PO for 5-10 d Trichomoniasis 250 mg PO tid for 7 d or 2 g PO X 1 C. difficile 500 mg PO or IV qSh for 7-10 d (PO preferred IV only if pt NPO) Vaginosis 1 applicator-full intravag bid or 500 mg PO bid for 7 d Acne rosacea/skin Apply bid Peds. 30 mg/ kg PO/IV/d q6H, 4 g/d max-s-. Amebic dysentery 35-50 mg/kg/24 h PO in 3 -s- doses for 5-10 d Rx 7-10 d for C. difficile-, in hepatic impair Caution [B, M] Avoid EtOH Contra 1st tri of PRO Disp Tabs, caps, IV, topical lotion, intravag gel, cream SE Disulfiram-like Rxn dizziness, HA, GI upset, anorexia, urine discoloration Interactions t Effects W/ cimetidine T effects OF carbamazepine, fluorouracil, Li, warfarin -1- effects W/ barbiturates, cholestyramine, colestipol, phenytoin EMS t Effects of anticoagulants concurrent EtOH use can cause disulfiram-like Rxn (tach, N/V, sweating, flushing, headache, blurred vision, confusion) may cause a metallic taste and discolored urine OD May cause N/V/D, numbness in hands and feet, Szs, and loss of coordination symptomatic and supportive... 

Prednisolone [Corticosteroid] [See Steroids and Table VI-1] Interactions T Effects W/ clarithromycin, erythromycin, estrogen, ketoconazole, OCPs, troleandomycin X effects W/ antacids, aminoglutethimide, barbiturates, cholestyramine, colestipol, phenytoin, rifampin X effects OF anticoagulants, hypoglycemics, INH, salicylates, vaccine toxoids EMS Infxns may be masked OD May cause wt gain, T hair growth, acne, HTN, peripheral edema, and sore muscles symptomatic and supportive... 

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