Hydrocortisone with Cholestyramine Interaction Details
Brand Names Associated with Hydrocortisone
- Alkindi Sprinkle®
- Cortef®
- Cortisol
- Cortril®
- Hydrocortisone
- Hydrocortone®
Brand Names Associated with Cholestyramine
- Cholestyramine Resin
- Locholest®
- Locholest® Light
- Prevalite®
- Questran®
- Questran® Light
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 28, 2024
Interaction Effect
Decreased hydrocortisone effectiveness
Interaction Summary
In a controlled study, the concurrent use of cholestyramine 4 g and a single oral dose of hydrocortisone 50 mg resulted in lower peak cortisol levels and delayed time to peak levels, indicating both reduction and delay in hydrocortisone absorption. This action of cholestyramine appears to be dose-dependent[1]. A case report of an interaction between colestipol and hydrocortisone supports the assumption of an interaction between bile acid sequestering resins and hydrocortisone [2].
Severity
Minor
Onset
Delayed
Evidence
Theoretical
How To Manage Interaction
If both drugs are required, stagger administration times and consider increasing hydrocortisone dosage.
Mechanism Of Interaction
Decreased hydrocortisone absorption
References
1 ) Johansson C, Adamsson U, Stierner U, et al: Interaction by cholestyramine on the uptake of hydrocortisone in the gastrointestinal tract. Acta Med Scand 1978; 204:509-512.
2 ) Nekl KE & Aron DC: Hydrocortisone-colestipol interaction (letter). Ann Pharmacother 1993; 27:980-981.
Hydrocortisone Overview
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Hydrocortisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Hydrocortisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys, blood, thyroid, stomach, and intestines. It is also sometimes used to treat the symptoms of certain types of cancer. Hydrocortisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
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.
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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.