CHOLESTYRAMINE (Oral)
Some commonly used brand names are:
In the U.S.?
In Canada?
Category
- Antidiarrheal, postoperative colonic bile acids
- Antidote, anion-exchange resin
- Antihyperlipidemic
- Antihyperoxaluric
- Antipruritic, cholestasis
Description
Cholestyramine (koe-less-TEAR-a-meen) is used to lowerhigh cholesterol levels in the blood. This may help prevent medical problemscaused by cholesterol clogging the blood vessels. Cholestyramine is also usedto remove substances called bile acids from your body. With some liver problems,there is too much bile acid in your body and this can cause severe itching.
Cholestyramine works by attaching to certain substances in the intestine.Since cholestyramine is not absorbed into the body, these substances alsopass out of the body without being absorbed.
Cholestyramine may also be used for other conditions as determined by yourdoctor.
Cholestyramine is available only with your doctor's prescription, in thefollowing dosage form:
Oral- Powder (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For cholestyramine,the following should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to cholestyramine. Also tell your health care professionalif you are allergic to any other substances, such as foods, preservatives,or dyes.
Pregnancy?Cholestyramine is not absorbed into the body andis not likely to cause problems. However, it may reduce absorption of vitaminsinto the body. Ask your doctor whether you need to take extra vitamins.
Breast-feeding?Cholestyramine is not absorbed into the body andis not likely to cause problems. However, the reduced absorption of vitaminsby the mother may affect the nursing infant.
Children?This medicine has been tested in a limited numberof children. In effective doses, the medicine has not been shown to causedifferent side effects or problems than it does in adults.
Older adults?Side effects may be more likely to occur in patientsover 60 years of age, who are usually more sensitive to the effects of cholestyramine.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingcholestyramine it is especially important that your health care professionalknow if you are taking any of the following:
- Anticoagulants (blood thinners)?The effects of the anticoagulantmay be changed and this may increase the chance of bleeding.
- Digitalis glycosides (heart medicine) or
- Diuretics (water pills) or
- Penicillin G, taken by mouth or
- Phenylbutazone or
- Propranolol (e.g., Inderal) or
- Tetracyclines, taken by mouth (medicine for infection) or
- Thyroid hormones or
- Vancomycin, taken by mouth?Cholestyramine may prevent thesemedicines from working properly
Other medical problems?The presence of other medicalproblems may affect the use of cholestyramine. Make sure you tell your doctorif you have any other medical problems, especially:
- Bleeding problems or
- Constipation or
- Gallstones or
- Heart or blood vessel disease or
- Hemorrhoids or
- Stomach ulcer or other stomach problems or
- Underactive thyroid?Cholestyramine may make these conditionsworse
- Kidney disease?There is an increased risk of developing electrolyteproblems (problems in the blood)
- Phenylketonuria?Phenylalanine in aspartame is included in thesugar-free brand of cholestyramine and should be avoided. Aspartame can causeproblems in people with phenylketonuria. Therefore, it is best if you avoidusing the sugar-free product.
Proper Use of This Medicine
Take thismedicine exactly as directed by your doctor. Try not to miss any doses anddo not take more medicine than your doctor ordered.
This medicine should never be taken in its dry form,since it could cause you to choke. Instead, always mix as follows:
- Place the medicine in 2 ounces of any beverage and mix thoroughly.Then add an additional 2 to 4 ounces of beverage and again mix thoroughly(it will not dissolve) before drinking. After drinking all the liquid containingthe medicine, rinse the glass with a little more liquid and drink that also,to make sure you get all the medicine.
- You may also mix this medicine with milk in hot or regular breakfastcereals, or in thin soups such as tomato or chicken noodle soup. Or you mayadd it to some pulpy fruits such as crushed pineapple, pears, peaches, orfruit cocktail.
For patients taking this medicine for high cholesterol:
- Importance of diet?Before prescribing medicine for your condition,your doctor will probably try to control your condition by prescribing a personaldiet for you. Such a diet may be low in fats, sugars, and/or cholesterol.Many people are able to control their condition by carefully following theirdoctor's orders for proper diet and exercise. Medicine is prescribed onlywhen additional help is needed. Follow carefully thespecial diet your doctor gave you, since the medicine is effectiveonly when a schedule of diet and exercise is properly followed.
- Also, this medicine is less effective if you are greatly overweight.It may be very important for you to go on a reducing diet. However, checkwith your doctor before going on any diet.
- Remember that this medicine will not cure your cholesterol problembut it will help control it. Therefore, you must continue to take it as directedif you expect to lower your cholesterol level.
Dosing?The dose of cholestyramine will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of cholestyramine. If your dose isdifferent, do not change it unless your doctor tells you to do so.
- For oral dosage form (powder for oralsuspension):
- For high cholesterol or pruritus (itching) related to biliary obstruction:
- Adults?At first, 4 grams one or two times a day before meals.Then, your doctor may increase your dose to 8 to 24 grams a day. This is dividedinto two to six doses.
- Children?At first, 4 grams a day. This is divided into twodoses and taken before meals. Then, your doctor may increase your dose to8 to 24 grams a day. This is divided into two or more doses.
Missed dose?If you miss a dose of this medicine, take it assoon as possible. Then go back to your regular dosing schedule. However, ifit is almost time for your next dose, skip the missed dose and go back toyour regular dosing schedule. Do not double doses.
Storage?To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
- Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
It is very important that your doctor check your progress atregular visits. This will allow your doctor to see if the medicineis working properly and to decide if you should continue to take it.
Do not take any other medicine unless prescribed byyour doctor since cholestyramine may change the effect of other medicines.
Do not stop taking this medicine without first checkingwith your doctor. When you stop taking this medicine, your blood cholesterollevels may increase again. Your doctor may want you to follow a special dietto help prevent this from happening.
Side Effects of This Medicine
In some animal studies, cholestyramine was found to cause tumors. It isnot known whether cholestyramine causes tumors in humans.
Along with its needed effects, a medicine maycause some unwanted effects. Although not all of these side effects may occur,if they do occur they may need medical attention.
Other sideeffects may occur that usually do not need medical attention. These side effectsmay go away during treatment as your body adjusts to the medicine. However,check with your doctor if any of the following side effects continue or arebothersome:
Other side effects notlisted above may also occur in some patients. If you notice any other effects,check with your doctor.
Additional Information
Once a medicine has been approvedfor marketing for a certain use, experience may show that it is also usefulfor other medical problems. Although these uses are not included in productlabeling, cholestyramine is used in certain patients with the following medicalconditions:
- Digitalis glycoside overdose
- Excess oxalate in the urine
Other than the above information, there is no additional information relatingto proper use, precautions, or side effects for these uses.
Revised: 08/13/1998
