Cholestyramine (Questran) Drug Information

Cholestyramine (brand names: Questran, Prevalite) is a cholesterol-lowering medication that belongs to the bile acid resin class of drugs. Studies have shown that cholestyramine mainly lowers LDL ("bad") cholesterol by 15 to 30% and slightly raises HDL ("good") cholesterol by 3 to 5%. Cholestyramine does not appear to affect triglycerides and, in some cases, may actually raise triglycerides if taken for a prolonged amount of time.Cholestyramine works by binding to cholesterol in the small intestine and preventing the absorption of cholesterol into the blood. As a consequence, cholesterol is excreted through the feces instead of circulating in the body.The resin, or powdered, form of cholestyramine should be mixed with water or juice before consuming. Due to the gritty nature of the powder, you may add the powder to other foods and drinks in order to improve the taste of cholestyramine. The wafer should be chewed thoroughly before swallowing. Make sure you consume the entire contents of the dose in order to receive the full cholesterol-lowering benefit of cholestyramine.The following groups of people should not take cholestyramine:

• Individuals who have had an allergic reaction to cholestyramine or any of its components.
• Individuals diagnosed with a bowel obstruction.

Individuals with the following conditions may or may not be able to take cholestyramine. It's important that they should consult with their healthcare provider before doing so.

• difficulty swallowing
• gallbladder disease
• triglycerides greater than 300 mg/dL
• bleeding disorder

There have been few studies of cholestyramine use in pregnant women, so caution is advised. Since this drug can decrease the absorption of some vitamins, prenatal vitamins may not be effective while taking cholestyramine.

Gastrointestinal side effects are the most common side effects experienced. These include bloating, belching, nausea, vomiting, heartburn, constipation and abdominal pain. Dizziness and headache have also been reported.The following drugs may interact with cholestyramine by decreasing the amount of the medication absorbed into your blood. As a rule, it probably a good idea not to take any other medications or supplements two hours before or six hours after taking cholestyramine or any other bile acid resin. If you are required to take one of the drugs or supplements listed below, your health care provider may need to adjust your dose or the time you take it, monitor you more closely for side effects, or discontinue your use of it all together:

• Thyroid hormones
• Lanoxin (digoxin)
• Statins
• Iron
• Folic acid
• Methotrexate
• Corticosteroids
• Diuretics (examples include hydrochlorothiazide (HCTZ) and Lasix (furosemide))
• Propanolol
• Coumadin (warfarin)
• Nonsteroidal anti-inflammatory agents (NSAIDs)
• Fat soluble vitamins (vitamins A, D, E, and K)
• Dilantin (phenytoin)

Disclaimer

This is a brief, non-inclusive overview of cholestyramine. It should not replace the information provided by your healthcare provider or the manufacturer of this drug.

_Sources:

Dipiro JT, Talbert RL. Pharmacotherapy: A Pathophysiological Approach, 6th ed 2005.

Lacy CF, Armstrong LL, Goldman MP, et al. Lexicomp's Drug Information Handbook, 15th ed 2007.