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Which Medications Can Interfere with My Bile Acid Resin?

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Updated September 15, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Which Medications Can Interfere with My Bile Acid Resin?
I am taking a bile acid resin to lower my cholesterol. Are there any medications that can interact with it?
Answer: Bile acid resins (BARs), also known as bile acid sequestrants, can be used successfully when your LDL, or "bad", cholesterol levels are slightly elevated. Currently available bile acid resins (BARs) include: Because bile acid resins primarily work on preventing the absorption of LDL cholesterol into the bloodstream from the small intestine, they can also interact with other medications also trying to gain entrance into your body from your digestive system. This could reduce the effectiveness of some of the other medications you are taking. Drugs that can interact with your BAR include:
  • Fat-soluble vitamins (vitamins A, D, E, K)
  • Cordarone (amiodarone)
  • Coumadin (warfarin)
  • Lanoxin (digoxin)
  • Thyroid hormone supplements (i.e. Synthroid (levothyroxine))
  • Tylenol (acetaminophen)
  • Diuretics -- including hydrocholorthiazide, Bumex (bumetanide), Demadex (torsemide), Lasix (furosemide), chlorthiazide
  • Antibiotics -- including tetracycline, cephalexin, metronidazole
  • Antiepileptics -- valproic acid, phenobarbital
  • Cholesterol-lowering medications, such as fibrates, niacin, Pravachol (pravastatin), Zetia (ezetimibe)
  • Oral contraceptives
  • Diltiazem
  • Anti-inflammatory -- such as Mobic (meloxicam), Aleve
  • Cell Cept (mycophenolate mofetil)
  • Iron supplements
This list is not comprehensive and does not apply to all BARs, so you should consult with your healthcare provider, pharmacist, or medication package insert to see if any other medications, or the medications above, will interact with your particular BAR. Additionally, consult with your healthcare provider if any other medications are prescribed to you, including supplements, over-the-counter products, or other prescription drugs, in order to make sure that they will not interact with your BAR.

Is There Anyway to Avoid These Interactions?

If you are taking a BAR, you can avoid interactions by spacing the times you take your BAR from your other medications by at least four to six hours. For example, if you take your BAR at 8 in the morning, you should refrain from taking other medications until noon or 2 in the afternoon unless otherwise directed by your healthcare provider. This will ensure that your BAR will work well and will not prevent the other medications you take from working poorly.

Sources:

Dipiro JT, Talbert RL. Pharmacotherapy: A Pathophysiological Approach, 7th ed 2008.

Micromedex Healthcare Series [intranet database]. Version 5.1. Greenwood Village,CO: Thomson Reuters (Healthcare) Inc.

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