Drug Interactions between CellCept and colestipol
This report displays the potential drug interactions for the following 2 drugs:
- CellCept (mycophenolate mofetil)
- colestipol
Interactions between your drugs
colestipol mycophenolate mofetil
Applies to: colestipol and CellCept (mycophenolate mofetil)
GENERALLY AVOID: Coadministration with bile acid sequestrants or activated charcoal may decrease the bioavailability of mycophenolic acid. In 12 healthy volunteers, pretreatment with cholestyramine (4 g three times a day for 4 days) decreased the systemic exposure (AUC) of mycophenolic acid (from mycophenolate mofetil 1.5 g single dose) by 40% compared to administration of mycophenolate mofetil alone. The proposed mechanism is interruption of enterohepatic recirculation due to binding of recirculating mycophenolic acid glucuronide (a product of the first-pass metabolism of mycophenolic acid) with cholestyramine in the intestine. Some degree of enterohepatic recirculation is also anticipated following intravenous administration of mycophenolate mofetil, thus the interaction is not limited to the oral route.
MANAGEMENT: Given the risk of organ rejection associated with inadequate immunosuppressant blood levels, mycophenolic acid products should not be administered with cholestyramine or other agents that may interfere with enterohepatic recirculation or bind bile acids (e.g., activated charcoal).
References
- (2001) "Product Information. CellCept (mycophenolate mofetil)." Roche Laboratories
Drug and food interactions
colestipol food
Applies to: colestipol
ADJUST DOSING INTERVAL: Bile acid sequestrants and the phosphate binder, sevelamer, can decrease the absorption of fat-soluble vitamins A, D, E, and K. In non-clinical safety studies, rats administered colesevelam at doses greater than 30-fold the projected human clinical dose developed hemorrhage in association with vitamin K deficiency. In a crossover study involving healthy subjects, coadministration of sevelamer with calcitriol resulted in a significant reduction in bioavailability for calcitriol (calcitriol with sevelamer vs calcitriol alone: AUC 137 pg*h/mL vs 318 pg*h/mL and Cmax 40.1 pg/mL vs 49.7 pg/mL, respectively).
MANAGEMENT: Oral vitamin supplements should be administered at least 4 hours before colesevelam and either 1 hour before or 4 to 6 hours after other bile acid sequestrants and sevelamer.
References
- (2001) "Product Information. Rocaltrol (calcitriol)." Roche Laboratories
- (2001) "Product Information. Welchol (colesevelam)." Daiichi Sankyo, Inc.
- (2005) "Product Information. Fosamax Plus D (alendronate-cholecalciferol)." Merck & Co., Inc
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- Peirce D, Hossack S, Poole L, et al. (2011) "The effect of sevelamer carbonate and lanthanum carbonate on the pharmacokinetics of oral calcitriol." Nephrol Dial Transplant, 26, p. 1615-21
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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