Sulindac Colestyramine

ANION EXCHANGE RESINS NSAIDs Colestyramine i absorption of NSAIDs Colestyramine binds NSAIDs in the intestine, reducing their absorption it also binds those NSAIDs with a significant entero-hepatic recirculation (meloxicam, piroxicam, sulindac, tenoxicam) Give the NSAID 1 hour before or 4-6 hours after colestyramine however, meloxicam, piroxicam, sulindac and tenoxicam should not be given with colestyramine... 

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. 

In 6 healthy subjects colestyramine 4 g twice daily with meals was found to reduce the AUC of a simultaneous single 400-mg dose of sulindac by 78% the AUC of its sulfide metabolite was reduced by 84%. Even when the sulindac was given 3 hours before the colestyramine, its AUC of colestyramine and its sulphide metabolite were reduced by 44% and 55%, respectively. ... 

Established interactions. Colestyramine markedly reduces the initial absorption of some NSAIDs (shown for diclofenac), and if these NSAIDs also undergo enterohepatic recirculation, their clearance will also be increased (shown for meloxicam, piroxicam, sulindac, and tenoxicam). This latter interaction cannot be avoided by separating the doses, and it may be best not to use colestyramine with these NSAIDs. Colestyramine can be used to speed the removal of piroxicam and tenoxicam following overdosage. Diclofenac has been formulated with colestyramine in an attempt to reduce gastric mucosal damage by reducing direct mucosal contact 140 mg of diclofenac-colestyramine is considered equivalent to 70 mg of diclofenac. ... 

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See also in sourсe #XX -- [ ]

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