Drug General Information (ID: DDIHZDEGI2)
Drug Name			Cholestyramine		Drug Info		Estrone sulfate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bile Acid Sequestrants				Estrogens
Structure

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

Recommended Action
Management		Estrogens and/or progestin-containing oral medications should be administered at least one hour before or four to six hours after bile-acid binding resins such as cholestyramine, colestipol, and colesevelam. Patients receiving this combination should be advised to closely follow dosing schedules to prevent loss of therapeutic effects.

References
1	Cerner Multum, Inc. "Canadian Product Information.".
2	Product Information. Questran (cholestyramine). Par Pharmaceutical Inc, Chestnut Ridge, NY.
3	Underhill KL, Rotter BA, Thompson BK, Prelusky DB, Trenholm HL "Effectiveness of cholestyramine in the detoxification of zearalenone as determined in mice." Bull Environ Contam Toxicol 54 (1995): 128-34. [PMID: 7756775]