Cardiovascular Drugs/Nutrient Depletion:
- Beta-caroteneBeta-carotene: Based on secondary sources, concomitant use of beta-carotene in combination with selenium, vitamin C, and vitamin E appears to decrease the effectiveness of the combination of simvastatin (Zocor®) and niacin. Simvastatin may decrease the level of beta-carotene by 20%.
- CalciumCalcium: Based on animal evidence, the use of cholestyramine may increase binding (40578) and urinary excretion of calcium (3987479).
- Coenzyme Q10 (CoQ10)Coenzyme Q10 (CoQ10): Based on human study, simvastatin and the combination simvastatin and ezetimibe may decrease plasma CoQ10 levels (16872244). Based on clinical trials in hypercholesterolemic patients, statins may reduce serum CoQ10 levels (15942122, 15721028, 16003294, 16872244, 17389800).
- Folic AcidFolic Acid:Based on human evidence, cholestyramine may reduce folate concentrations within the body, resulting in a folate deficiency (1168607, 63709). This depletion was overcome by folic acid supplementation. Based on human evidence, a similar interaction may exist with colestipol as well (8660081).
- IronIron: Based on human study, cholestyramine may not impair iron levels (1168607). Animal study did not find a reduction of serum iron with concurrent cholestyramine use (3186761). Another animal study, however, suggests a possible decrease associated with cholestyramine use (5023882).
- MagnesiumMagnesium:Based on human evidence, digoxin may deplete magnesium levels (1768564). Based on animal evidence, the use of cholestyramine may increase the urinary excretion of magnesium, along with a reduction in serum magnesium (3987479).
- PhosphatePhosphate:Human evidence suggests a possible reduction in phosphate levels associated with colestipol use (724301) and a reduction in phosphate levels with the use of cholestyramine (1168607). The clinical significance of this reduction, however, is currently lacking (1583392).
- Vitamin B1Vitamin B1:Based on secondary sources, digoxin may deplete vitamin B1 levels. Based on in vitro evidence, both digoxin and furosemide may inhibit thiamine uptake in cardiac cells (9851552).
- Vitamin A:Vitamin A: Based on human evidence, cholestyramine may lower the absorption of vitamin A (4706914, 7460169). Animal studies have also suggested the reduction in liver storage of dietary vitamin A due to cholestyramine (14263050).
- Vitamin B6Vitamin B6: Based on secondary sources, vasodilator drugs may deplete levels of vitamin B6. An animal study suggests an interaction between hydralazine, a vasodilator, and pyridoxal, leading to a vitamin B6 deficiency (1688973).
- Vitamin B12:Vitamin B12: Based on in vitro studies, intrinsic-factor mediated binding of vitamin B12 and cholestyramine may occur, resulting in decreased levels of vitamin B12 (40578,30840). Animal studies have also suggested a decrease in serum vitamin B12 associated with cholestyramine use (5023882).
- Vitamin DVitamin D:Based on human and animal evidence, conflicting data exist pertaining to cholestyramine's ability to reduce vitamin D levels (8660081, 1583392, 2125243, 3987479, 640344, 4318526). Human evidence evaluating the effect of cholestyramine on calcium levels suggests a possible effect on excretion of calcium (5052395). Human evidence has also suggested a modulation of vitamin D levels associated with colestipol use (724301). Secondary sources suggest that patients should be monitored if long-term therapy with bile-sequestrants is expected.
- Vitamin EVitamin E: Based on human evidence, conflicting evidence exists pertaining to cholestyramine's effect on lowering vitamin E levels (11185669, 1168607). In another human study, the ratio of vitamin E/LDL-cholesterol increased with cholestyramine use (11185669). Based on human evidence, gemfibrozil may not affect LDL vitamin E concentrations (9699906).
- Vitamin KVitamin K:Based on a human case report, cholestyramine may lower vitamin K levels (12688565). Animal studies have also suggested the modulation of vitamin K due to cholestyramine (14263050).
- ZincZinc:Based on human evidence, captopril increased urinary excretion of zinc after six months of treatment, and may result in a possible zinc deficiency (9477394).
Copyright © 2011 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.