Cholestyramine with Sulindac Interaction Details
Brand Names Associated with Cholestyramine
- Cholestyramine Resin
- Locholest®
- Locholest® Light
- Prevalite®
- Questran®
- Questran® Light
Brand Names Associated with Sulindac
- Clinoril®
- Sulindac
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 28, 2024
Interaction Effect
Decreased sulindac plasma levels
Interaction Summary
Cholestyramine has been shown to reduce the bioavailability of sulindac[1].
Severity
Minor
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Reductions in sulindac bioavailability are minimized, although not completely avoided, when sulindac is given three hours before the cholestyramine. Sulindac and cholestyramine should be administered at least three hours apart.
Mechanism Of Interaction
Decreased sulindac bioavailability
Literature Reports
A) The influence of cholestyramine on the pharmacokinetics of sulindac was examined in six healthy volunteers [1]. The area under the curve (AUC) was significantly decreased in both sulindac and its major metabolite, sulindac sulfide. The decrease in AUC occurred when sulindac and cholestyramine were given concomitantly, as well as when sulindac was given 3 hours before the cholestyramine. However the magnitude of the decrease in the AUC was less when the agents were staggered. It is recommended that sulindac and cholestyramine be administered at least 3 hours apart to minimize the effect on bioavailability.
References
1 ) Malloy MJ, Ravis WR, Pennell AT, et al: Influence of cholestyramine resin administration on single dose sulindac pharmacokinetics. Int J Clin Pharmacol Ther 1994; 32:286-289.
Cholestyramine Overview
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Cholestyramine is used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and certain fatty substances in your blood. Accumulation of cholesterol and fats along the walls of your arteries (a process known as atherosclerosis) decreases blood flow and, therefore, the oxygen supply to your heart, brain, and other parts of your body. Lowering your blood level of cholesterol and fats may help to prevent heart disease, angina (chest pain), strokes, and heart attacks.
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This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Sulindac Overview
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Sulindac is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine). Sulindac also is used to treat pain in the shoulder caused by bursitis (inflammation of a fluid-filled sac in the shoulder joint) and tendinitis (inflammation of the tissue that connects muscle to bone). It is also used to relieve gouty arthritis (attacks of severe joint pain and swelling caused by a build-up of certain substances in the joints). Sulindac is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.