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Drug Interactions between colesevelam and Mynatal PN

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

multivitamin, prenatal colesevelam

Applies to: Mynatal PN (multivitamin, prenatal) and colesevelam

ADJUST DOSING INTERVAL: Bile acid sequestrants can decrease the absorption of fat-soluble vitamins A, D, E, and K. By binding bile acids, these agents may interfere with normal fat digestion and absorption, thereby preventing the absorption of fat-soluble vitamins. Colesevelam did not induce any clinically significant reduction in the absorption of vitamins A, D, E or K during clinical studies of up to one year. However, chronic use of other bile acid sequestrants has been rarely associated with an increased bleeding tendency due to hypoprothrombinemia resulting from vitamin K deficiency. Isolated cases of Vitamin A (including one case of night blindness) and D deficiencies have also been reported with chronic cholestyramine therapy.

MANAGEMENT: Oral vitamin supplements should be administered at least 4 hours before colesevelam to minimize the potential impact on their absorption.

References

  1. Gross L, Brotman M (1970) "Hypoprothrombinemia and hemorrhage associated with cholestyramine therapy." Ann Intern Med, 72, p. 95-6
  2. Shojania AM, Grewar D (1986) "Hypoprothrombinemic hemorrhage due to cholestyramine therapy." Can Med Assoc J, 134, p. 609-10
  3. Acuna R, Gonzalez Ceron M (1977) "Hypoprothrombinemia and bleeding associated to treatment with cholestyramine (author's transl)." Rev Med Chil, 105, p. 27-8
  4. Vroonhof K, van Rijn HJM, van Hattum J (2003) "Vitamin K deficiency and bleeding after long-term use of cholestyramine." Neth J Med, 61, p. 19-21
  5. (2024) "Product Information. Colesevelam Hydrochloride (colesevelam)." Ascend Laboratories, LLC
  6. (2024) "Product Information. Colesevelam (colesevelam)." Dr Reddy's Laboratories (UK) Ltd
  7. (2020) "Product Information. Lodalis (colesevelam)." Bausch & Lomb Canada Inc
View all 7 references

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Drug and food interactions

Moderate

multivitamin, prenatal food

Applies to: Mynatal PN (multivitamin, prenatal)

ADJUST DOSING INTERVAL: Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa.

Food taken in conjunction with oral iron supplements may reduce the bioavailability of the iron. However, in many patients intolerable gastrointestinal side effects occur necessitating administration with food.

MANAGEMENT: Ideally, iron products should be taken on an empty stomach (i.e., at least 1 hour before or 2 hours after meals), but if this is not possible, administer with meals and monitor the patient more closely for a subtherapeutic effect. Some studies suggest administration of iron with ascorbic acid may enhance bioavailability. In addition, administration of oral iron products and some oral medications should be separated whenever the bioavailability of either agent may be decreased. Consult the product labeling for specific separation times and monitor clinical responses as appropriate.

References

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. (2021) "Product Information. Accrufer (ferric maltol)." Shield Therapeutics

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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.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.