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Drug Interactions between Locholest Light and TaperDex

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

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Interactions between your drugs

Moderate

cholestyramine dexAMETHasone

Applies to: Locholest Light (cholestyramine) and TaperDex (dexamethasone)

ADJUST DOSING INTERVAL: Concurrent administration of bile acid sequestrants may delay and/or decrease the absorption of oral corticosteroids. Bile acid sequestrants can bind certain drugs in the intestine to form an insoluble complex that is excreted in the feces. Reduced bioavailability of hydrocortisone has been reported during concomitant administration with cholestyramine and colestipol. It is not known whether the interaction occurs with other bile acid binding resins such as colesevelam or with corticosteroids other than hydrocortisone, but the possibility should be considered.

MANAGEMENT: Oral corticosteroids should be administered at least 1 hour before or 4 to 6 hours after a cholestyramine or colestipol dose, and at least 4 hours before a colesevelam dose.

References

  1. Johansson C, Adamsson U, Stierner U, Lindsten T "Interaction by cholestyramine on the uptake of hydrocortisone in the gastrointestinal tract." Acta Med Scand 204 (1978): 509-12
  2. "Product Information. Questran (cholestyramine)." Par Pharmaceutical Inc PROD (2002):
  3. "Product Information. Colestid (colestipol)." Pharmacia and Upjohn PROD
  4. Nekl KE, Aron DC "Hydrocortisone-colestipol interaction." Ann Pharmacother 27 (1993): 980-1
  5. "Product Information. Welchol (colesevelam)." Daiichi Sankyo, Inc. PROD (2001):
View all 5 references

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Drug and food interactions

Moderate

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

  1. "Product Information. Rocaltrol (calcitriol)." Roche Laboratories PROD (2001):
  2. "Product Information. Welchol (colesevelam)." Daiichi Sankyo, Inc. PROD (2001):
  3. "Product Information. Fosamax Plus D (alendronate-cholecalciferol)." Merck & Co., Inc (2005):
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  5. Cerner Multum, Inc. "Australian Product Information." O 0
  6. Peirce D, Hossack S, Poole L, et al. "The effect of sevelamer carbonate and lanthanum carbonate on the pharmacokinetics of oral calcitriol." Nephrol Dial Transplant 26 (2011): 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.

See also

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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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