Interactions between questran(cholestyramine) and Aldactone (spironolactone)
cholestyramine and spironolactone (Moderate Drug-Drug)
MONITOR: Rare cases of severe hyperchloremic, hyperkalemic, metabolic acidosis have been associated with coadministration of spironolactone and cholestyramine. While spironolactone alone can cause metabolic acidosis, the addition of cholestyramine could provide an anion exchange of chloride for bicarbonate in the small bowel. The resulting loss of bicarbonate predisposes the patient to a hyperchloremic, nonanion gap, metabolic acidosis in the presence of renal failure.
MANAGEMENT: If these drugs must be used together, careful monitoring of electrolytes and metabolic status is strongly recommended, particularly in the presence of renal insufficiency.
