Furosemide with Cholestyramine Interaction Details

Brand Names Associated with Furosemide

  • Furosemide
  • Lasix®

Brand Names Associated with Cholestyramine

  • Cholestyramine Resin
  • Locholest®
  • Locholest® Light
  • Prevalite®
  • Questran®
  • Questran® Light

Medical Content Editor
Last updated Feb 28, 2024

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Interaction Effect

Decreased furosemide effectiveness

Interaction Summary

The interference of the anion-exchange resin cholestyramine with furosemide has been shown to result in a marked decrease in furosemide serum concentrations[1]. This effect has also been shown in thiazide diuretics [2][3].

Severity

Moderate

Onset

Rapid

Evidence

Probable

How To Manage Interaction

If furosemide is used concurrently with cholestyramine, give the cholestyramine four hours after the diuretic and monitor the diuretic effect. A dosage adjustment for furosemide may be required.

Mechanism Of Interaction

Binding of furosemide by cholestyramine

Literature Reports

A) In a cross-over study involving six healthy volunteers, cholestyramine 8 g administered immediately after furosemide 40 mg resulted in a decrease in the furosemide absorption by 95%. Maximum concentration (Cmax) decreased from 1.2 mg/L to 0.05 mg/L, and the area under the concentration-time curve (AUC) of furosemide fell from 3.5 mg/L/h to 0.22 mg/L/h. The 4-hour diuretic response to furosemide was also reduced from a control value of 1510 mL to 350 mL in the presence of cholestyramine [1].

References

    1 ) Neuvonen PJ, Kivisto K, & Hirvisalo EL: Effects of resins and activated charcoal on the absorption of digoxin, carbamazepine and frusemide. Br J Clin Pharmacol 1988; 25:229-233.

    2 ) Hunninghake DB, King S, & LaCroix K: The effect of cholestyramine and colestipol on the absorption of hydrochlorothiazide. Int J Clin Pharmacol Ther Toxicol 1982; 20:151-154.

    3 ) Hunninghake DB & Hibbard DM: Influence of time intervals for cholestyramine dosing on the absorption of hydrochlorothiazide. Clin Pharmacol Ther 1986; 39:329-334.

Furosemide Overview

  • Furosemide is used alone or in combination with other medications to treat high blood pressure. Furosemide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, and liver disease. Furosemide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

  • High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

See More information Regarding Furosemide

Cholestyramine Overview

  • 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.

  • This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

See More information Regarding Cholestyramine Resin

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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.