CHOLESTYRAMINE

Brand & Generic Names

Cholybar
Questran
Questran Light

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Antihyperlipidemic, antipruritic

Uses

• Removes excess bile acids that occur with some liver problems. Reduces persistent itch caused by bile acids.
• Lowers cholesterol level.
• Treatment of one form of colitis (rare).

Dosage & Usage Information

How to take:
Powder, granules--Sprinkle into 8 oz. liquid. Let stand for 2 minutes, then mix with liquid before swallowing. Or mix with cereal, soup or pulpy fruit. Don't swallow dry.

When to take:
3 or 4 times a day on an empty stomach, 1 hour before or 2 hours after eating.
If taking other medicines, take 1 hour before or 4 to 6 hours after taking cholestyramine.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Binds with bile acids to prevent their absorption.

Time lapse before drug works:
Cholesterol reduction--1 day.
Bile-acid reduction--3 to 4 weeks.

Don't take with:
Any drug or vitamin simultaneously. Space doses 2 hours apart.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Increased side effects and adverse reactions.

WHAT TO DO:

Overdose unlikely to threaten life. Depending on severity of symptoms and amount taken, call doctor, poison-control center or hospital emergency room for instructions.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Constipation.

Infrequent:

• Belching, bloating, diarrhea, mild nausea, vomiting, stomach pain, rapid weight gain.
• Heartburn (mild).

Rare:

• Severe stomach pain; black, tarry stool.
• Rash, hives, hiccups.
• Sore tongue.

Warnings & Precautions

Don't take if:
You are allergic to cholestyramine.

Before you start, consult your doctor:

• If you plan to become pregnant within medication period.
• If you have angina, heart or blood-vessel disease.
• If you have stomach problems (including ulcer).
• If you have tartrazine sensitivity.
• If you have constipation or hemorrhoids.
• If you have kidney disease.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Safety not established. Decide with your doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
No problems expected, but consult doctor.

Infants & children:
Not recommended.

Prolonged use:

• May decrease absorption of folic acid.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check serum cholesterol and triglycerides.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
No problems expected.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*,	Increased anti-
oral	coagulant effect.
Beta carotene	Decreased absorption of beta carotene.
Dextrothyroxine	Decreased dextrothyroxine effect.
Digitalis	Decreased digitalis
preparations*	effect.
Indapamide	Decreased indapamide effect.
Thiazides*	Decreased absorption of
	cholestyramine.
Thyroid hormones*	Decreased thyroid effect.
Trimethoprim	Decreased absorption of
	cholestyramine.
Ursodiol	Decreased absorption of ursodiol.
Vancomycin	Increased chance of hearing loss or
	kidney damage. Decreased
	therapeutic effect of vancomycin.
Vitamins	Decreased absorption of fat-soluble
	vitamins (A,D,E,K).
All other medicines	Decreased absorption, so dosages or
	dosage intervals may require
	adjustment.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Beverages:	None expected.
Cocaine:	None expected.
Foods:	Absorption of vitamins in foods
	decreased. Take vitamin
	supplements, particularly A, D, E &
	K.
Marijuana:	None expected.
Tobacco:	None expected.