Drug interactions
Cholestyramine + Leflunomide
Severity: Major
Cholestyramine and Leflunomide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cholestyramine binds teriflunomide in the gut and interrupts its enterohepatic recirculation, causing a marked fall in plasma levels. This is exploited for rapid elimination after leflunomide toxicity, but unintended use reduces efficacy.
What this interaction means in plain words
Cholestyramine and Leflunomide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Cholestyramine belongs to Cardiovascular; Leflunomide belongs to Musculoskeletal.
Why it happens
Cholestyramine binds teriflunomide in the intestine, preventing reabsorption and enhancing fecal elimination.
What to do
Avoid concurrent use unless a washout is intended; for accelerated elimination, use the labeled cholestyramine regimen. Otherwise choose another lipid-lowering agent.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Other interactions of Cholestyramine
Frequently asked questions
Can I take Cholestyramine with Leflunomide?
MediHelp rates the interaction as major. Cholestyramine and Leflunomide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cholestyramine binds teriflunomide in the gut and interrupts its enterohepatic recirculation, causing a marked fall in plasma levels. This is exploited for rapid elimination after leflunomide toxicity, but unintended use reduces efficacy.
How serious is the interaction between Cholestyramine and Leflunomide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use unless a washout is intended; for accelerated elimination, use the labeled cholestyramine regimen. Otherwise choose another lipid-lowering agent.
What other medicines interact with Leflunomide?
MediHelp also lists interactions of Leflunomide with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Leflunomide page.
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