Drug Interactions between Pravigard Pac and Questran
This report displays the potential drug interactions for the following 2 drugs:
- Pravigard Pac (aspirin/pravastatin)
- Questran (cholestyramine)
Interactions between your drugs
cholestyramine pravastatin
Applies to: Questran (cholestyramine) and Pravigard Pac (aspirin / pravastatin)
ADJUST DOSING INTERVAL: When administered concomitantly, cholestyramine has been reported to decrease the rate and extent of fluvastatin bioavailability. Other bile acid sequestrants may also decrease the bioavailability of other HMG-CoA reductase inhibitors. The mechanism is most likely due to adsorption of the HMG-CoA reductase inhibitor to the bile acid sequestrant. Separating administration times has been shown to decrease the interaction.
MANAGEMENT: If therapy with both agents is necessary, the HMG-CoA reductase inhibitor should be administered at least 4 hours after the bile acid sequestrant.
References
- Smith HT, Jokubaitis LA, Troendle AJ, Hwang DS, Robinson WT (1993) "Pharmacokinetics of fluvastatin and specific drug interactions." Am J Hypertens, 6, s375-82
aspirin cholestyramine
Applies to: Pravigard Pac (aspirin / pravastatin) and Questran (cholestyramine)
Although cholestyramine does not reduce salicylate absorption, it may delay the time to peak salicylate concentrations. Separation of cholestyramine and salicylate doses by three to four hours is recommended.
References
- (2002) "Product Information. Questran (cholestyramine)." Par Pharmaceutical Inc
Drug and food interactions
aspirin food
Applies to: Pravigard Pac (aspirin / pravastatin)
GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
References
- (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
pravastatin food
Applies to: Pravigard Pac (aspirin / pravastatin)
MONITOR: Concomitant use of statin medication with substantial quantities of alcohol may increase the risk of hepatic injury. Transient increases in serum transaminases have been reported with statin use and while these increases generally resolve or improve with continued therapy or a brief interruption in therapy, there have been rare postmarketing reports of fatal and non-fatal hepatic failure in patients taking statins. Patients who consume substantial quantities of alcohol and/or have a history of liver disease may be at increased risk for hepatic injury. Active liver disease or unexplained transaminase elevations are contraindications to statin use.
MANAGEMENT: Patients should be counseled to avoid substantial quantities of alcohol in combination with statin medications and clinicians should be aware of the increased risk for hepatotoxicity in these patients.
References
- (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
- (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
- (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
- (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
- (2002) "Product Information. Altocor (lovastatin)." Andrx Pharmaceuticals
- (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- (2010) "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic)
cholestyramine food
Applies to: Questran (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
aspirin food
Applies to: Pravigard Pac (aspirin / pravastatin)
One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.
References
- Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6
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
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