Drug interactions
Cholestyramine + Spironolactone
Severity: Moderate
Cholestyramine and Spironolactone: moderate 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
Hyperkalemic metabolic acidosis has been reported when cholestyramine is given with spironolactone. This may cause clinically important electrolyte and acid-base disturbance, particularly in patients with reduced renal function.
What this interaction means in plain words
Cholestyramine and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cholestyramine belongs to Cardiovascular; Spironolactone belongs to Cardiovascular.
Why it happens
Not firmly established; cholestyramine's chloride load and ion exchange may contribute to acidosis that aggravates spironolactone-related potassium retention.
What to do
Monitor serum potassium, bicarbonate and renal function when the combination is used. Separate dosing from cholestyramine by several hours and reassess therapy if acidosis develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Other interactions of Cholestyramine
Frequently asked questions
Can I take Cholestyramine with Spironolactone?
MediHelp rates the interaction as moderate. Cholestyramine and Spironolactone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Hyperkalemic metabolic acidosis has been reported when cholestyramine is given with spironolactone. This may cause clinically important electrolyte and acid-base disturbance, particularly in patients with reduced renal function.
How serious is the interaction between Cholestyramine and Spironolactone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium, bicarbonate and renal function when the combination is used. Separate dosing from cholestyramine by several hours and reassess therapy if acidosis develops.
What other medicines interact with Spironolactone?
MediHelp also lists interactions of Spironolactone with, for example, Amiloride, Eplerenone, Triamterene. The full list is on the Spironolactone page.
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