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Drug Interactions between budesonide and colesevelam

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

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Interactions between your drugs

Moderate

budesonide colesevelam

Applies to: budesonide and colesevelam

Bile acid binding resins such as cholestyramine, colestipol, and colesevelam may interfere with the absorption of budesonide and reduce its levels in the bloodstream. This may make the medication less effective in treating your condition. To minimize the possibility of interaction, it is recommended that you separate the dosing times of the bile acid binding resin and other oral medications. If you are taking cholestyramine or colestipol, you should take budesonide at least 1 hour before or 4 to 6 hours after the cholestyramine or colestipol dose. If you are taking colesevelam, you should take budesonide at least 4 hours before the colesevelam dose, or separate the dosing times by as much as possible if a 4 hour interval is not achievable. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and food/lifestyle interactions

Moderate

budesonide food/lifestyle

Applies to: budesonide

You should avoid the regular consumption of large amounts of grapefruits and grapefruit juice while taking budesonide. Grapefruit can raise the levels of budesonide in your body and lead to increased side effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Disease interactions

Major

colesevelam Diabetes Type 1

Applies to: Diabetes Type 1

Colesevelam should not be used for glycemic control in type 1 diabetes or for treating diabetic ketoacidosis.

Major

colesevelam Diabetic Ketoacidosis

Applies to: Diabetic Ketoacidosis

Colesevelam should not be used for glycemic control in type 1 diabetes or for treating diabetic ketoacidosis.

Major

colesevelam Dysphagia

Applies to: Dysphagia

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Major

colesevelam Gastrointestinal Obstruction

Applies to: Gastrointestinal Obstruction

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Major

colesevelam Gastroparesis

Applies to: Gastroparesis

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Moderate

budesonide Cataracts

Applies to: Cataracts

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with corticosteroids should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Moderate

budesonide Glaucoma/Intraocular Hypertension

Applies to: Glaucoma / Intraocular Hypertension

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with corticosteroids should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Moderate

budesonide Hyperadrenocorticism

Applies to: Hyperadrenocorticism

The use of corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.

Moderate

budesonide Infection - Bacterial/Fungal/Protozoal/Viral

Applies to: Infection - Bacterial / Fungal / Protozoal / Viral

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis or in hepatitis B carriers. Monitor patients for any new or worsening infection and use with caution in these patients. A serious or even fatal course of chickenpox and measles can occur in susceptible patients. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Moderate

budesonide Lactose Intolerance

Applies to: Lactose Intolerance

Some inhaled corticosteroid formulations contain lactose and may cause adverse reactions including cough, wheezing and bronchospasm in patients with severe milk protein allergy or intolerance. Caution is advised.

Moderate

budesonide Liver Disease

Applies to: Liver Disease

Corticosteroids are predominantly cleared by hepatic metabolism and impairment of the liver function may lead to their accumulation. Patients with hepatic disease should be closely monitored.

Moderate

colesevelam Malabsorption Syndrome

Applies to: Malabsorption Syndrome

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

Moderate

budesonide Ocular Herpes Simplex

Applies to: Ocular Herpes Simplex

Pharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.

Moderate

budesonide Osteoporosis

Applies to: Osteoporosis

Prolonged use of inhaled corticosteroids may be associated with a reduction in bone density. This effect appears to be dose-related and has been reported primarily with high dosages (800 mcg/day or more of beclomethasone or equivalent for 1 year or greater). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages. Long-term therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with osteoporosis. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Moderate

colesevelam Phenylketonuria

Applies to: Phenylketonuria

Questran Light and LoCholest Light (brands of cholestyramine) contain 16.8 mg and 22.4 mg of phenylalanine, respectively, per each dose. Flavored Colestid (brand of colestipol) contains 18.2 mg of phenylalanine per each 7.5-gram dose. WELCHOL (brand name of colesevelam) for Oral Suspension contains 13.5 mg phenylalanine per 1.875 gram dose and 27 mg phenylalanine per 3.75 gram dose. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics). Regular Colestid, Questran and LoCholest do not contain phenylalanine.

Moderate

budesonide Tuberculosis -- Latent

Applies to: Tuberculosis -- Latent

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis or in hepatitis B carriers. Monitor patients for any new or worsening infection and use with caution in these patients. A serious or even fatal course of chickenpox and measles can occur in susceptible patients. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

Moderate

colesevelam Vitamin A Deficiency

Applies to: Vitamin A Deficiency

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

Moderate

colesevelam Vitamin D Deficiency

Applies to: Vitamin D Deficiency

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

Moderate

colesevelam Vitamin K Deficiency

Applies to: Vitamin K Deficiency

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.

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.


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.