Medication·Interactions & depletion·Reviewed June 9, 2026
Cholestyramine interactions.
Cholestyramine has 7 documented interactions in the NutriStack database. Prolonged use is also associated with lower Vitamin D, Vitamin K, Vitamin A, and Vitamin E. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Cholestyramine at a glance.
A quick, data-grounded summary. The full tables are below.
Cholestyramine has 7 documented interactions in the NutriStack database. Prolonged use is also associated with lower Vitamin D, Vitamin K, Vitamin A, and Vitamin E. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with cholestyramine.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Calcium | Timing Sensitive | Cholestyramine may bind or delay absorption of some supplements when taken simultaneously. |
| Iron | Timing Sensitive | Cholestyramine can bind oral iron in the gastrointestinal tract and reduce its absorption when taken concurrently, potentially diminishing the... |
| Vitamin A | Timing Sensitive | Cholestyramine impairs absorption of fat-soluble vitamin A. Long-term therapy can lower serum vitamin A and beta-carotene levels, with potential for... |
| Vitamin B6 | Timing Sensitive | Cholestyramine can bind and reduce intestinal absorption of folate, and folate deficiency has been documented with prolonged therapy, especially in... |
| Vitamin D3 | Timing Sensitive | Cholestyramine can reduce absorption of fat-soluble vitamins including vitamin D. |
| Vitamin E | Timing Sensitive | Cholestyramine can reduce absorption of fat-soluble vitamin E during long-term use. |
| Vitamin K1 | Timing Sensitive | Cholestyramine can reduce vitamin K absorption and may increase bleeding risk or alter INR. |
What cholestyramine can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Vitamin D | Moderate | Bile acid sequestration can impair absorption of fat-soluble vitamin D. | Vitamin D3 | 25-hydroxyvitamin D |
| Vitamin K | Significant | Bile acid sequestration can impair vitamin K absorption and lower vitamin K dependent clotting factor activity. | Vitamin K1 | Prothrombin time/INR |
| Vitamin A | Moderate | Bile acid sequestration can impair absorption of fat-soluble vitamin A during long-term use. | Vitamin A if prescribed | Serum retinol if deficiency suspected |
| Vitamin E | Moderate | Bile acid sequestration can impair absorption of fat-soluble vitamin E during long-term use. | Vitamin E | Alpha-tocopherol if deficiency suspected |
| Folate | Mild | Cholestyramine can bind folate in the gut and lower its absorption; reduced serum and red-cell folate has been reported with prolonged therapy, with... | Folic acid, taken at least 1 hour before or 4 to 6 hours after cholestyramine | Serum folate and red-blood-cell folate |
The full cholestyramine profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common cholestyramine questions.
Quick answers drawn from the tables above.
What interacts with Cholestyramine?
In the NutriStack database, Cholestyramine has 7 documented interactions. The most notable include Calcium, Iron, Vitamin A, Vitamin B6, and Vitamin D3. Check any specific combination before taking it and confirm with your prescriber.
Does Cholestyramine deplete any nutrients?
Cholestyramine is associated with lowering Vitamin D, Vitamin K, Vitamin A, Vitamin E, and Folate with prolonged use. Useful biomarkers to monitor include 25-hydroxyvitamin D, Prothrombin time/INR, and Serum retinol if deficiency suspected. Ask your prescriber before adding any replacement supplement.
Is it safe to take Calcium with Cholestyramine?
NutriStack classifies the Calcium and Cholestyramine pairing as timing sensitive: Cholestyramine may bind or delay absorption of some supplements when taken simultaneously. Separate calcium and other oral supplements from cholestyramine by at least 4 hours. Always confirm with your prescriber.
Check your whole stack
See how cholestyramine fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.