Interaction between Fludrocortisone and Cholestyramine
Moderate
Absorption
| ID | DDInter747 and DDInter368 |
| Interaction | 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 | |
| Alternative for Fludrocortisone |
S02C
Triamcinolone (nasal)
Dexamethasone (ophthalmic)
Dexamethasone (nasal)
Dexamethasone (topical)
Triamcinolone (topical)
Triamcinolone (ophthalmic)
Hydrocortisone (topical)
Fluocinolone acetonide
Hydrocortisone (ophthalmic)
Prednisolone (ophthalmic)
S01C
More
|
| Alternative for Cholestyramine |
C10A
More
|
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.