Cholestyramine with tetracyclines

With regard to complex formation, tetracyclines and cholestyramine are common examples—although their mechanisms are different. In the case of tetracyclines, complexes of the antibiotic can be formed with a number of positive, polyvalent mineral ions such as Al3+, Ca2+, and Mg2+. Such minerals are commonly present in antacids and milk. The result of such complex formation is diminished absorption of tetracycline. This is the reason why patients taking tetracyclines are directed to avoid taking milk with their medication. 

Clinically important, potentially hazardous interactions with alprazolam, amiodarone, amphotericin B, arbutamine, bendroflumethiazide, benzthiazide, bisacodyl, bumetanide, carbimazole, chlorothiazide, chlorthalidone, cholestyramine, clarithromycin, conivaptan, cyclosporine, cyclothiazide, dan-shen, demeclocycline, devil s claw, dexmedetomidine, doxycycline, erythromycin, esomeprazole, ethacrynic acid, flunisolide, furosemide, ginseng, glycopyrrolate, glycopyrronium, hawthorn (fruit, leaf, flower extract), horsetail, hydrochlorothiazide, hydroflumethiazide, indapamide, licorice, lopinavir, mepenzolate, methyclothiazide, metolazone, minocycline, mistletoe, oxprenolol, oxytetracycline, paroxetine, phenylbutazone, polythiazide, propafenone, propantheline, quinethazone, quinidine, rabeprazole, rifampin, roxithromycin, sarsaparilla, senna, Siberian ginseng, squill, St John s wort, telithromycin, teriparatide, tetracycline, thiazide diuretics, tolvaptan, trichlormethiazide, verapamil... 

Clinically important, potentially hazardous interactions with acitretin, antacids, bexarotene, cholestyramine, co-trimoxazole, corticosteroids, fish oil supplements, minocycline, retinoids, tetracycline, vitamin A... 

G1 distress, nausea, and vomiting can be minimized by administration of tetracyclines with food. Cholestyramine and colestipol can bind orally administered tetracychnes and interfere with their absorption. Generally, tetracyclines should be administered 2 hours before or 2 hours after meals and other drugs that interfere with their absorption. 

The bile acids sequestrants, particularly cholestyramine, can decrease tlie absorption of numerous dru. For tliis reason, tlie bile acid sequestrants should be administered alone and otlier dru given at least 1 hour before or 4 hours after administration of the bile acid sequestrants. There is an increased risk of bleeding when tlie bile acid sequestrants are administered with oral anticoagulants. The dosage of the antico ulant is usually decreased. The bile acid sequestrants may bind with digoxin, tliiazide diuretics, penicillin, propranolol, tetracyclines, folic acid, and tlie thyroid hormone, resulting in decreased effects of th e dru. ... 

Tetracyclines can interact with other medications. Avoid giving tetracyclines two hours before or after the patient receives colestipol (Colestid) or cholestyramine ((Questran) because these medications decrease the absorption of tetracycline. 

C. Diarrhoea. Diarrhoea is a common symptom in diabetic autonomic neuropathy. First line treatment includes a short course of antibiotics such as tetracycline or erythromycin. Opiate-like anti diarrhoeal agents like loperamide and codeine sulphate represents other first line treatments. Cholestyramine given with loperamide might be beneficial, and octreotide have shown to be effective as well. 

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