Drug General Information (ID: DDIDRP4JQA)
Drug Name			Cholestyramine		Drug Info		Obeticholic acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bile Acid Sequestrants				Gi Agents
Structure

Mechanism of Cholestyramine-Obeticholic acid Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Cholestyramine				Obeticholic acid
Mechanism		Anion exchange resin/polymer				Binds to 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 Obeticholic acid

Recommended Action
Management		When used with a bile acid sequestrant, obeticholic acid should be administered at least 4 hours before or 4 hours after dosing of the bile acid sequestrant, or at as great an interval as possible.

References
1	Product Information. Ocaliva (obeticholic acid). Intercept Pharmaceuticals, Inc., New York, NY.