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Drug Interactions between Colestid Flavored and deferasirox

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

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Interactions between your drugs

Moderate

colestipol deferasirox

Applies to: Colestid Flavored (colestipol) and deferasirox

GENERALLY AVOID: Coadministration with cholestyramine may decrease the bioavailability and efficacy of deferasirox. The mechanism involves binding of cholestyramine to deferasirox and its glucuronide metabolites, which are secreted into the bile. This interferes with the enterohepatic recycling of deferasirox by preventing intestinal deconjugation of the glucuronide metabolites and subsequent reabsorption. In healthy volunteers, administration of cholestyramine (12 grams twice daily) 4 and 10 hours after a single dose of deferasirox resulted in a 45% decrease in deferasirox systemic exposure (AUC). The interaction has not been studied with other bile acid sequestrants.

MANAGEMENT: The concomitant use of deferasirox with cholestyramine should generally be avoided. Otherwise, consideration should be given to increasing the initial dosage of deferasirox by 50% with subsequent adjustments made according to serum ferritin levels and clinical response. It is not known whether other bile acid sequestrants interact similarly with deferasirox.

References

  1. (2005) "Product Information. Exjade (deferasirox)." Novartis Pharmaceuticals

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Drug and food interactions

Moderate

deferasirox food

Applies to: deferasirox

ADJUST DOSING INTERVAL: According to product labeling, the bioavailability of deferasirox was variably increased when taken with a meal.

MANAGEMENT: To ensure consistent plasma drug levels, deferasirox should be taken on an empty stomach 30 minutes before eating preferably at the same time everyday.

References

  1. (2005) "Product Information. Exjade (deferasirox)." Novartis Pharmaceuticals

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Moderate

colestipol food

Applies to: Colestid Flavored (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

  1. (2001) "Product Information. Rocaltrol (calcitriol)." Roche Laboratories
  2. (2001) "Product Information. Welchol (colesevelam)." Daiichi Sankyo, Inc.
  3. (2005) "Product Information. Fosamax Plus D (alendronate-cholecalciferol)." Merck & Co., Inc
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. Cerner Multum, Inc. "Australian Product Information."
  6. 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
View all 6 references

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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.

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