Drug Interaction Report

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.