Drug Interactions between Demadex and Locholest Light
This report displays the potential drug interactions for the following 2 drugs:
- Demadex (torsemide)
- Locholest Light (cholestyramine)
Interactions between your drugs
cholestyramine torsemide
Applies to: Locholest Light (cholestyramine) and Demadex (torsemide)
ADJUST DOSING INTERVAL: Limited data have shown that the bioavailability of orally administered furosemide is reduced by 95% during concurrent administration of cholestyramine and by 80% during concurrent administration of colestipol. (These figures are based on data from the area under the plasma concentration-time curve and total urinary elimination data.) These decreases in bioavailability were associated with 77% and 58% reductions in the diuretic response to furosemide. No data are available for bumetanide, torsemide, or ethacrynic acid, but a similar interaction is suspected.
MANAGEMENT: Diuretics should be administered at least 2 to 3 hours before cholestyramine or colestipol. If alternating dosage schedules is ineffective, it may be necessary to increase diuretic dosage during coadministration. Patients should be monitored for altered diuretic efficacy.
References
- Neuvonen PJ, Kivisto K, Hirvisalo EL (1988) "Effects of resins and activated charcoal on the absorption of digoxin, carbamazepine and frusemide." Br J Clin Pharmacol, 25, p. 229-33
- "Product Information. Colestid (colestipol)." Pharmacia and Upjohn
Drug and food interactions
cholestyramine food
Applies to: Locholest Light (cholestyramine)
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
- (2001) "Product Information. Rocaltrol (calcitriol)." Roche Laboratories
- (2001) "Product Information. Welchol (colesevelam)." Daiichi Sankyo, Inc.
- (2005) "Product Information. Fosamax Plus D (alendronate-cholecalciferol)." Merck & Co., Inc
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- 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
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.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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