Cholestyramine

Aka: Cholestyramine, Questran, Prevalite

advertisement

II. Indications

  1. Hyperlipidemia adjunctive management (rare use)
  2. Cholestasis associated Pruritus (not FDA approved)
  3. Diarrhea Dominant Irritable Bowel Syndrome (not FDA approved)

III. Contraindications

  1. See Bile Acid Sequestrant
  2. Serum Triglycerides >400 mg/dl

IV. Mechanism

  1. See Bile Acid Sequestrant
  2. Binds bile salts
    1. Results in insoluble complexes that are excreted in the stool

V. Medications

  1. Questran contains 4 grams Cholestyramine per 9 grams powder packet
  2. Questran Light contains 4 grams Cholestyramine per 5 grams powder packet
  3. Prevalite contains 4 grams Cholestyramine per 5.5 grams powder packet

VI. Dosing: Adult

  1. Hyperlipidemia
    1. Start 4 grams orally twice daily before meals
    2. Target 12 to 24 grams orally per day divided 2 to 4 times daily
    3. Maximum: 24 grams per day
  2. Cholestasis associated Pruritus (not FDA approved)
    1. Start 4 grams orally twice daily before meals
    2. Target 4 to 8 grams orally 2 to 3 times daily
  3. Diarrhea Dominant Irritable Bowel Syndrome (not FDA approved)
    1. Start 4 grams orally twice daily before meals
    2. Target 4 to 8 grams orally once to twice daily

VII. Dosing: Child

  1. Not FDA approved in children
  2. Start 240 mg/kg/day orally up to 8 to 16 g/day divided three times daily before meals
  3. Maximum: 16 g/day

VIII. Drug Interactions

  1. See Bile Acid Sequestrant
  2. Take other medications at least 2 hours before or 4 to 6 hours after (esp. Warfarin, Digoxin and Amiodarone)
  3. Take with 2 to 6 ounces water, milk or fruit juice (e.g. orange juice) before meals
    1. Do not mix with carbonated beverages

IX. Efficacy

  1. See Bile Acid Sequestrant

X. Adverse Effects

  1. See Bile Acid Sequestrant
  2. Constipation
  3. Gastroesophageal Reflux
  4. Nausea
  5. Eructation
  6. Bloating

XI. Safety

  1. Pregnancy Category C
  2. Considered Safe in Lactation

XII. Metabolism

  1. Not absorbed

XIII. Resources

  1. Cholestyramine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2835b6f5-93da-4554-9d84-79132fd928ee

XIV. References

  1. (2022) Non-StatinLipid Lowering Agents, Presc Lett, Resource #380202
  2. (2022) Med Lett Drugs Ther 64(1659): 145-52
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  4. (2000) Med Lett Drugs Ther 42:102-4 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Cholestyramine." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Cost: Medications

cholestyramine (on 1/19/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CHOLESTYRAMINE LIGHT PACKET Generic $0.98 each
CHOLESTYRAMINE LIGHT POWDER Generic $0.24 per gram
CHOLESTYRAMINE PACKET Generic $1.06 each
CHOLESTYRAMINE POWDER Generic $0.14 per gram
prevalite (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PREVALITE PACKET Generic $0.98 each
PREVALITE POWDER Generic $0.22 per gram
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Ontology: Cholestyramine Resin (C0008402)

Definition (MSH) A strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium Cl(-) anion.
Definition (NCI) An anion exchange resin with hypolipidemic activity. Cholestyramine resin adsorbs and combines with bile acids in the intestine to form an insoluble complex, which is then excreted in the feces, resulting in an increased oxidation of cholesterol to bile acids, a decrease in low density lipoprotein in the plasma, and a decrease in serum cholesterol levels.
Definition (CSP) strongly basic anion exchange resin used to extract bile salts and cholesterol, to treat diarrhea and biliary obstruction, and as an antipruritic.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002792
SnomedCT 72824008, 317391006, 319945002, 387408001
English Colestyramin, Colestyramine, Resin, Cholestyramine, Cholestyramine [diarr], Cholestyramine [lipid low], Cholestyramine [antidiarrheal use], Cholestyramine [antidiarrhoeal use], Cholestyramine [lipid lowering use], cholestyramine, cholestyramine (medication), Cholestyramine Resins, Cholestyramines, Cholestyramine Resin, Cholestyramine, Colestyramins, Resins, Cholestyramine, Colestyramines, CHOLESTYRAMINE, Cholestyramine Resin [Chemical/Ingredient], cholestyramine resin, colestyramine, Colestyramine [antidiarrheal use], Cholestyramine [lipid lowering use] (product), Cholestyramine [antidiarrheal use] (product), Colestyramine [lipid lowering use], Colestyramine [antidiarrhoeal use], Cholestyramine resin, Cholestyramine product, Cholestyramine (product), Cholestyramine (substance), Cholestyramine [antidiarrheal use] (substance), Cholestyramine [lipid lowering use] (substance), Colestyramine product
Finnish Kolestyramiini
Russian KHOLESTIRAMIN, KOLESTIRAMIN, ХОЛЕСТИРАМИНОВАЯ СМОЛА, ХОЛЕСТИРАМИН, KHOLESTIRAMINOVAIA SMOLA, MK-135, КОЛЕСТИРАМИН
Japanese コレスチラミン樹脂, クエストラン, コレスチラミン
French Colestyramine, Résine de cholestyramine, Cholestyramine
Italian Colestiramina, Resina colestiramina
Portuguese Colestiramina, Resina de Colestiramina, Resina Colestiramina
Spanish Colestiramina, Resina de Colestiramina, colestiramina [uso como antidiarreico] (producto), colestiramina [uso como antidiarreico], colestiramina (como hipolipemiante), colestiramina (como hipolipemiante) (producto), colestiramina (producto), colestiramina (sustancia), colestiramina (uso como hipolipemiante) (producto), colestiramina (uso como hipolipemiante), colestiramina, resina de colestiramina
Croatian KOLESTIRAMIN
Swedish Kolestyraminresin
Czech cholestyraminová pryskyřice, cholestyramin
Polish Cholestyramina, Żywica cholestyraminowa
Norwegian Kolestyramin
German Cholestyramin-Harz, Cholestyramin, Colestyramin
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Pharmacology

advertisement

2025 Family Practice Notebook, LLC. Terms | Privacy | About | Site Map | Newsletter | Blog

Footer Site Logo