Drug General Information (ID: DDIYUWRDJT)
Drug Name			Cholestyramine		Drug Info		Teriflunomide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Bile Acid Sequestrants				Selective Immunosuppressants
Structure

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

Recommended Action
Management		Concomitant administration of these drugs is not recommended unless an accelerated elimination is desired. An alternative to bile acid sequestrants should be considered as separating drug administration times is unlikely to be effective at avoiding the interaction.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".