Paracetamol Colestyramine

ANION EXCHANGE RESINS PARACETAMOL Colestyramine i paracetamol by 60% when they are given together Colestyramine binds paracetamol in the intestine Give colestyramine and paracetamol at least 1 hour apart... 

The absorption of paracetamol is decreased by anion exchange resins (colestyramine), whereas some drugs used to control nausea and vomiting, such as metoclopramide and domperidone, hasten the absorption of paracetamol. 

The absorption of paracetamol may be reduced if colestyramine is given at the same time, but the reduction in absorption is small if colestyramine is given an hour later. 

When 4 healthy subjeets took colestyramine 12 g and paracetamol 2 g together, the absorption of the paracetamol was reduced by 60% (range 30 to 98%) at 2 hours, but the results were said not to be statistically significant. When the colestyramine was given 1 hour after the paracetamol, the absorption was reduced by only 16%. ... 

Colestyramine reduces absorption, presumably because it binds with the paracetamol in the gut. Separating the dosages minimises mixing in the gut. 

Although information is limited, it suggests that colestyramine should not be given within 1 hour of paracetamol if maximal analgesia is to be achieved. It is normally recommended that other drugs are given 1 hour before or 4 to 6 hours after colestyramine. 

The absorption of raloxifene is reduced by colestyramine, and their concurrent use is not recommended. No clinically relevant changes in raloxifene pharmacokinetics occur with alumini-um/magnesium hydroxide, amoxicillin, ampicillin or calcium carbonate. Raloxifene does not alter digoxin or methylprednisolone levels. Oral antibacterials, antihistamines, aspirin, benzodiazepines, H2-receptor antagonists, ibuprofen or paracetamol (acetaminophen) were used in clinical studies without any obvious effect on raloxifene levels. Smoking does not appear to alter the efficacy of raloxifene. 

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