Drug General Information (ID: DDIAQB6G8X)
Drug Name			Indapamide		Drug Info		Cholestyramine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Bile Acid Sequestrants
Structure

Mechanism of Indapamide-Cholestyramine Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Indapamide				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 Indapamide

Recommended Action
Management		Thiazide diuretics should be administered at least 1 to 2 hours before or 4 to 6 hours after cholestyramine administration. Patients should be monitored for potentially diminished therapeutic effects, and the thiazide dosage adjusted if necessary.

References
1	Hunninghake DB, Hibbard DM "Influence of time intervals for cholestyramine dosing on the absorption of hydrochlorothiazide." Clin Pharmacol Ther 39 (1986): 329-34. [PMID: 3948472]
2	Hunninghake DB, King S, LaCroix K "The effect of cholestyramine and colestipol on the absorption of hydrochlorothiazide." Int J Clin Pharmacol Ther Toxicol 20 (1982): 151-4. [PMID: 7076343]
3	Product Information. Atacand HCT (candesartan-hydrochlorothiazide) AstraZeneca Pharmaceuticals, Wilmington, DE.
4	Product Information. Questran (cholestyramine). Par Pharmaceutical Inc, Chestnut Ridge, NY.