Maralixibat and Colestipol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Colestipol
Maralixibat
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced exposure and efficacy of maralixibat
Interaction Deep Dive
Administer bile acid binding resins (eg, cholestyramine, colesevelam, or colestipol) at least 4 hours before or 4 hours after administration of maralixibat. Bile acid binding resins may bind odevixibat in the gut, which may reduce odevixibat efficacy1.
Why it happens (mechanism)
Decreased absorption of maralixibat due to binding in the gut
Common questions
Can I take Maralixibat and Colestipol together?
Reduced exposure and efficacy of maralixibat Always confirm with your pharmacist or prescriber before making any change.
How serious is the Maralixibat and Colestipol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Maralixibat or Colestipol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: LIVMARLI(TM) oral solution, maralixibat oral solution. Mirum Pharmaceuticals Inc (per FDA), Foster City, CA, 2021. DailyMed
Keep reading about Colestipol
Keep reading about Maralixibat
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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