Drug General Information (ID: DDI1KW095E)
  Drug Name Anisindione Drug Info Cholestyramine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anticoagulants Bile Acid Sequestrants
  Structure

 Mechanism of Anisindione-Cholestyramine Interaction (Severity Level: Moderate)
     Complex formation Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Anisindione Cholestyramine
      Mechanism Binds to anion exchange resin/polymer Anion exchange resin/polymer
      Key Mechanism Factor 1
Factor Name Chelation
Factor Description Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
      Mechanism Description
  • Decreased absorption of Cholestyramine due to formation of complexes caused by Anisindione 

Recommended Action
      Management Warfarin or other oral anticoagulants should be administered at least one hour before or four to six hours after cholestyramine. The INR or PT should be closely monitored. Patients should be advised to promptly report any signs of bleeding (e.g., pain, swelling, headache, dizziness, weakness, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools) or clots (e.g. chest pain, shortness of breath, sudden loss of vision, or pain, redness or swelling in an extremity).

References
1 Gross L, Brotman M "Hypoprothrombinemia and hemorrhage associated with cholestyramine therapy." Ann Intern Med 72 (1970): 95-6. [PMID: 5410402]
2 Koch-Weser J, Sellers EM "Drug interactions with coumarin anticoagulants (first of two parts)." N Engl J Med 285 (1971): 487-98. [PMID: 4397794]
3 Ku LL, Ward CO, Durgin SJ "A clinical study of drug interaction and anticoagulant therapy." Drug Intell Clin Pharm 4 (1970): 300-6.
4 Longstreth GF, Newcomer AD "Drug-induced malabsorption." Mayo Clin Proc 50 (1975): 284-93. [PMID: 1127993]
5 Product Information. Questran (cholestyramine). Par Pharmaceutical Inc, Chestnut Ridge, NY.
6 Robinson DS, Benjamin DM, McCormack JJ "Interaction of warfarin and nonsystemic gastrointestinal drugs." Clin Pharmacol Ther 12 (1971): 491-5. [PMID: 5567801]
7 Wells PS, Holbrook AM, Crowther NR, Hirsh J "Interactions of warfarin with drugs and food." Ann Intern Med 121 (1994): 676-83. [PMID: 7944078]