Cholestyramine (Oral)

High levels of cholesterol in the blood are treated with Cholestyramine to prevent serious medical conditions from occurring.

Overview

Cholestyramine is used in the treatment of patients suffering from high cholesterol content in the blood. High cholesterol levels can cause severe medical conditions by filling and blocking the blood vessels if left untreated.

Cholestyramine attaches itself to certain substances in the intestines. As an indigestible substance, the Cholestyramine then passes out of the digestive system along with the substances that it is attached to. These substances cannot then be absorbed into the body and the blood.

Cholestyramine can also be used for the removal of bile acids from the patient's body. Liver problems can in some cases lead to an increased volume of bile acids that will make the patient suffer from severe itching known as pruritus. By removing the bile acids, Cholestyramine helps to relieve this symptom.

Cholestyramine can also be used in the treatment of other conditions when the doctor determines it appropriate to do so.

Cholestyramine is only available with a prescription from a doctor and is available as the following brands of medications:

  • Prevalite
  • Questran
  • Questran Light

The medication is consumed as either powder for suspension or a tablet.

This medication is not a cure for high cholesterol. It is a treatment to help control the condition to prevent the development of more serious medical conditions. This treatment is not a first resort and should be used only in addition to a healthy eating plan and regular exercise. It is important that patients taking this treatment follow the special diet provided by their doctor so that they may lower their cholesterol levels naturally and cease use of Cholestyramine gradually and safely.

Condition treated

  • High cholesterol
  • Excess bile acid

Type of medicine

  • Bile acid sequestrant

Side Effects

Along with the desired side effects of lowering the levels of cholesterol in the blood, Cholestyramine can also have unwanted side effects on the body. While not all of the following side effects may occur, some of these side effects will require the patient to seek medical attention. Other side effects may not require any medical attention.

If you experience any of the following side effects then you should contact your doctor:

  • Black stools with the appearance of tar
  • Severe pains of the stomach
  • Vomiting
  • Constipation
  • Sudden weight loss

The following side effects may occur that would not normally necessitate seeking medical attention. If these side effects are ongoing or become bothersome then you can seek advice from your healthcare professional on how best to alleviate the side effects. In most cases, however, these side effects will abate as your body becomes used to the medication.

  • Heartburn
  • Indigestion
  • Stomach pains
  • Belching
  • Bloating
  • Diarrhea
  • Dizziness
  • Headache

Other side effects that have not been listed herein can also occur. If you experience any other side effects then you should contact your doctor for advice. If, however, you are concerned about your wellbeing then contact emergency services for medical attention.

Dosage

This medicine should be taken exactly as prescribed by your doctor. Ensure that you do not miss any doses nor take more than you were prescribed.

You should not take this medication in its dry powder form. Doing so can cause you to choke. Follow the instructions on the medication or mix as follows:

  • Add the medication powder to 2 ounces of liquid and mix thoroughly.
  • Add an additional 2-4 ounces of liquid and mix thoroughly once again before drinking.
  • Note that this treatment will not dissolve so you will need to mix it just before drinking the liquid.
  • Add some more liquid once consumed and swill before drinking to ensure you have consumed all of the liquid.
  • This medication could also be added to cereals, soups or crushed fruit for consumption.

Patients taking this medication for the treatment of high cholesterol should consider the following:

Your condition should be controlled with a healthy diet as a preference over use of this treatment. Your doctor will prescribe a personal healthy diet to you that you should follow in order to lower your cholesterol naturally.

  • A healthy diet should be low in fats, sugars and cholesterol.
  • High cholesterol can be controlled effectively through proper diet and regular exercise.
  • This medication should only be prescribed when additional assistance is required and is not a treatment to be given instead of a healthy diet and exercise.
  • This medication is only effective with a correct diet and regular exercise.
  • This medication is less effective in patients who are grossly overweight or obese.
  • This medication will not cure a high cholesterol condition, it will merely help you to control it.
  • You should not cease this treatment without being directed to by your doctor as this will cause your cholesterol level to increase dramatically straight away, putting you at risk of serious medical conditions.

The dose of this medication will be different for each patient depending on a range of factors. These factors include weight, age, diet, cholesterol level and other medical conditions. The following dosing information is an average only and you should not change your dose unless directed to by your doctor.

For the treatment of high cholesterol or pruritus caused by biliary obstruction:

Adults: 4g once or twice daily before eating. This can be increased up to a total of 24g daily split into 2-6 doses.
Children: 2g twice daily before eating. This can be increased up to a total of 24g daily split into 2-6 doses.

If a dose of this treatment is missed then you should take it as soon as possible. If you are close to your next dose being due, however, then you should skip the dose and return to your normal schedule. Never take a double dose of this medication.

Interactions

This medication can interact with other medications in your body. You should inform your doctor of all treatments you are taking before using this treatment. This includes over the counter medications, vitamins, herbal remedies and other prescription medications. This is particularly important with the following medications:

The following medications should not be taken in conjunction with Cholestyramine. Your doctor may wish to change one or more prescription if you are taking the any of the following:

  • Mycophenolic Acid
  • Mycophenolate Mofetil
  • Digoxin
  • Deferasirox
  • Bezafibrate

The following medications are not normally recommended for use alongside Cholestyramine. Your doctor may prescribe both but may with to adjust does or frequency of use of one or other of the medications:

  • Warfarin
  • Valproic Acid
  • Propranolol
  • Phenprocoumon
  • Metronidazole
  • Meloxicam
  • Levothyroxine
  • Hydrochlorothiazide
  • Furosemide
  • Ezetimibe
  • Digitoxin
  • Dicumarol
  • Diclofenac
  • Cerivastatin
  • Cephalexin
  • Anisindione
  • Amiodarone
  • Aceclofenac

Other interactions can occur that are not listed herein. These medications have been listed due to severity of interactions, but you should inform your doctor of all treatments you are taking.

Other medical problems from which you suffer can also impact your safe use of certain medications. In some cases treatments can make other medical conditions worse so you should inform your doctor of all medical conditions from which you suffer. This is especially important before taking Cholestyramine if you suffer from any of the following medical conditions:

Cholestyramine should not be used in patients suffering from the following conditions as they may be worsened by this treatment:

  • Bleeding problems
  • Constipation
  • Gallstones
  • Heart disease
  • Blood vessel disease
  • Hemorrhoids
  • Stomach ulcer
  • Stomach problems
  • Underactive thyroid

The following condition will increase the risk of patients developing electrolyte imbalances:

Kidney disease

Patients with the following condition should avoid the use of the sugar-free versions of this medication as they contain aspartame, which can exacerbate this condition:

Phenylketonuria

Other interactions with conditions not listed herein may occur. Ensure that you inform your healthcare professional of any and all medical conditions from which you suffer.

Warnings

Before deciding to take this medication you should consider the risks of doing so in relation to the benefits that you will experience from taking it. You should make this decision with your doctor having considered all of the following factors that may affect use:

In some animal studies Cholestyramine was demonstrated to cause tumors. It is not known if Cholestyramine can cause tumors in humans. If you are concerned about this then you should discuss this with your doctor before use.

Allergies: You should inform your doctor if you have ever had an allergic or unusual reaction to any medication that you have taken in the past. You should also inform your doctor of any allergies you have experienced to foods, dyes, preservatives, animals or other substances.

Pediatric: Limited tests on children have been carried out with this medication. In effective levels of doing the medication has not been seen to cause any greater side effects or adverse effects than it does in adults.

Geriatric: Side effects are more likely to occur in patients over the age of 60.

Pregnancy: Risks of use has been demonstrated when pregnant. Pregnant women should avoid the use of this medication wherever possible. If you are pregnant or are trying to get pregnant then you should inform your doctor before use. If you suspect that you have become pregnant during use then you should inform your doctor immediately.

Breastfeeding: The use of this medication can alter milk production and composition. Discuss the use of this medication with your doctor before use if you are nursing an infant. Infants who nurse from a mother taking this treatment should be monitored for side effects.

This medication should not be taken with any other medications unless prescribed by your doctor. This medication can interact with other medications and change their effect.

This medication should not be ceased without discussing this with your doctor first. If you stop then your cholesterol level will increase immediately and you will be put at risk of serious medical conditions developing.

Storage

This medication should be stored in tightly sealed packaging at room temperature. Keep the medication in the supplied container until needed.

  • Keep away from heat, moisture and direct light. Prevent from freezing.
  • Medications should always be kept clear of areas within the reach of children.
  • Do not keep outdated medication for longer than it is needed. It should be disposed of properly as instructed by your healthcare professional.

Summary

Cholestyramine is used mainly for the treatment of two conditions. The first is a high level of cholesterol in the blood. The second is a build up of bile acid caused by liver problems.

Cholestyramine works by attaching itself to certain substances in the digestive tract. Cholestyramine is indigestible and it prevents the digestion of the substances that it attaches itself to as well. In doing so these substances are not digested and cannot make it into the blood.

In patients receiving treatment with Cholestyramine for high cholesterol levels, use will need to be accompanied by lifestyle changes to improve health. This treatment is not a cure for high cholesterol and the patient will need to take steps to lower their cholesterol naturally to be able to cease taking this medication. Your doctor will prescribe a healthy diet and regular exercise in addition to this treatment so that you can lower your cholesterol naturally and you should follow this regimen closely to improve your health.

This medication will work less effectively in the grossly overweight and obese.

This medication interacts with a wide range of other medications. It is therefore vital that you inform your doctor of all other substances you are taking before you begin treatment with this medication.

This medication has been shown to cause tumors in animals. It is not known whether this medication can or does cause tumors in humans. If you are concerned about this then you should discuss it with your doctor before you begin treatment.