Naproxen Colestyramine

Colestyramine Naproxen and probably other NSAIDs The anion exchange resin binds NSAIDs in gut, reducing the rate ( and extent) of absorption Separate dosing times by 4 hours may need higher than expected dosages of NSAIDs... 

Simultaneous colestyramine marked reduced the absorption of diclofenac and sulindac, modestly reduced the absorption of ibu-profen, but only delayed and did not reduce the extent of absorption of naproxen. Administration of colestyramine three or more hours after oral sulindac, piroxicam, or tenoxicam still markedly reduced their plasma levels. Markedly reduced NSAID levels have also been found when colestyramine is given after intravenous meloxicam or tenoxicam. 

The absorption of a single 250-mg dose of naproxen was delayed but not reduced in 8 healthy fasting subjects by the simultaneous use of colestyramine 4 g in 100 mL of orange juice. The amount absorbed after 2 hours was reduced from 96% to 51%, but was complete after 5 hours. ... 

The reduction in absorption of ibuprofen with colestyramine is probably not clinically important, and naproxen is not affected. Nevertheless, colestyramine delayed the absorption of both ibuprofen and naproxen, which may be relevant if they are being taken for the management of acute pain. Information on many other NSAIDs appears to be lacking. Animal studies suggest that mefenamic acid, flufenamic acid and phenylbutazone will also be affected by colestyramine." " Note that it is usually recommended that other drugs are given 1 hour before or 4 to 6 hours after colestyramine. 

A 51-ycar-old man who had been taking Iovastatin 40 mg daily for 5 years developed muscle aches and fever one day after finishing a 5-day course of azithromycin 250 mg daily. His creatine phosphokinase levels were elevated and he was diagnosed as having rhabdomyolysis. This patient was also taking colestyramine, diltiazem, doxazosin, glibenclamide (glyburide), thyroid , allopurinol, naproxen, prednisone, loratadine and inhaled beclometasone. ... 

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See also in sourсe #XX -- [ ]

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