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Updated 11 February 2013

Cholestyramine

Cholestyramine is prescribed to lower high levels of blood cholesterol.

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Cholestyramine is the active ingredient of Questran and Questran Lite.

General Information

Cholestyramine is prescribed to lower high levels of blood cholesterol. It is a resin that binds to bile acids in the gut, thereby reducing its re-uptake as well as the uptake levels of cholesterol in the blood. Cholestyramine is furthermore prescribed to treat some forms of diarrhoea.

Cholestyramine should never be taken in its dry form, but should always be mixed with appropriate amounts of water.

This medication does not cure high cholesterol, but simply helps to keep it under control. For it to be effective you need to keep taking the drug as prescribed. Diet, exercise and weight loss will help to lower cholesterol even further.

Cholestyramine may cause tooth discoloration. Rinsing the mouth after use, and regular brushing and flossing is advised.

Cholestyramine may affect the absorption of some medication and it is advised that you take your other medication at least 1 hour before, or 4-6 hours after taking cholestyramine.

How does cholestyramine work?

Cholesterol in the human body is normally converted to bile acids. Cholestyramine binds to these bile acids, thereby reducing cholesterol and adding bulk to bowel movements.

Fast facts

Drug schedule: schedule 4

Available as: cholestyramine is available as powder for solution

What does it do? cholestyramine has an anti-cholesterol and anti-diarrhoea action

Overdose risk: low

Dependence risk: low

Is cholestyramine available as a generic? no

Is cholestyramine available on prescription only? yes

User information

Onset of effect: When treating cholesterol it may take a few weeks for cholestyramine to exert its effects; when treating diarrhoea, its effects should be seen within 24 hours.

Duration of action: up to 24 hours

Dietary advice: A low-fat diet is advised as fatty foods may lead to a reduced effect of cholestyramine

Stopping this medicine: This medication should not be stopped without consulting your doctor; premature discontinuation may cause original symptoms to recur.

Prolonged use : Cholestyramine reduces absorption of fat-soluble vitamins including Vitamins A, D, E and K. The taking of supplements is advised.

Special precautions

Consult your doctor before using this drug if:

  • you have a stomach ulcer
  • if you are allergic to tartrazine
  • if you have jaundice
  • if you have haemorrhoids
  • if you are taking other medication

Pregnancy: Caution. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant; if this medication is to be taken, additional vitamin supplementation is advised.

Breastfeeding: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before use. If used additional vitamin supplementation is advised.

Porphyria: This medication is safe for use.

Infants and children: No dosage has been established for children younger than 6; cholestyramine is not recommended for children under the age of 2.

Elderly: Caution is advised in the elderly as side effects are more likely to occur.

Driving and hazardous work: No special precautions need to be taken.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Bloating/ abdominal discomfort

x

x

Nausea/ vomiting

x

x

Constipation

x

x

Flatulence

x

x

Indigestion

x

x

Headache

x

x

Dizziness

x

x

Diarrhoea

x

x

Unusual bruising/ bleeding

x

x

Interactions:

Drug interactions:

digoxin

absorption of digoxin affected; space at least 4 hours apart

vitamins A, D, E and K

absorption of vitamins affected; space at least 4 hours apart

paracetamol

absorption of this drug affected; space at least 4 hours apart

ibuprofen

absorption of this drug affected; space at least 4 hours apart

thiazide

absorption of this drug affected; space at least 4 hours apart

diuretics

absorption of this drug affected; space at least 4 hours apart

thyroxin

effect on thyroid reduced; space at least 4 hours apart

warfarin

absorption of this drug affected; space at least 4 hours apart

Food interactions

Low-fat meals are advised

Disease interactions

Consult your doctor before using this drug if you have a stomach ulcer, jaundice, haemorrhoids or if you are allergic to tartrazine.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage

Adults:

High cholesterol: 4g 1-2 daily in water. This may gradually be increased to 12-24 g/day in 3-4 divided doses.

Diarrhoea: 4g 3 times daily

Children:

Children over 6 years of age: 240 mg/kg/day in divided doses

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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