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Drug Interactions between colesevelam and Mudrane GG-2

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

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Interactions between your drugs

Moderate

aminophylline colesevelam

Applies to: Mudrane GG-2 (aminophylline / guaifenesin) and colesevelam

ADJUST DOSING INTERVAL: Colesevelam may decrease the gastrointestinal absorption of coadministered drugs. Approximately 20% to 40% reductions in systemic exposure (AUC) and 10% to 45% reductions in peak plasma concentration (Cmax) have been reported for cyclosporine, ethinyl estradiol, glimepiride, glyburide, levothyroxine, olmesartan, and sustained-release verapamil during coadministration with colesevelam. Significant pharmacokinetic changes were not observed when the drugs were administered 4 hours prior to colesevelam. During postmarketing use of colesevelam, there have been rare reports of suspected interaction with phenytoin, as evidenced by increased seizure activity or decreased phenytoin levels. Elevated thyroid-stimulating hormone (TSH) levels have also been observed in patients receiving thyroid hormone replacement therapy.

MANAGEMENT: In general, drugs with a narrow therapeutic index as well as those that have been shown to interact with colesevelam should be administered at least 4 hours before the colesevelam dose. Clinical and laboratory monitoring of drug levels and effects should be considered.

References

  1. "Product Information. Welchol (colesevelam)." Daiichi Sankyo, Inc. PROD (2001):
  2. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):

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Drug and food interactions

Moderate

aminophylline food

Applies to: Mudrane GG-2 (aminophylline / guaifenesin)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
  4. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
  5. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
  6. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  7. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
View all 7 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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