Cholestyramine

What is the most important information I should know about cholestyramine?

Follow any diet or exercise plan outlined by your doctor. Diet and exercise are very important factors in controlling cholesterol.

Avoid ingesting or breathing in the dry powder. Taken dry, the powder can cause a severe adverse reaction.

Increase the amount of fluid in your diet to prevent constipation. Drink at least six to eight full glasses (8 ounces) of fluid daily. Talk to your doctor if constipation becomes a problem.

Take other medications at least 1 hour before or 4 to 6 hours after taking a dose of cholestyramine. Cholestyramine can decrease the effectiveness of many other drugs if they are taken too close to one another.

What is cholestyramine?

Cholestyramine is a drug that lowers cholesterol (a type of fat).

Cholestyramine is used to lower high levels of cholesterol in the blood. Cholestyramine is especially good at lowering levels of low-density lipoprotein (LDL) ("bad" cholesterol). A rise in triglycerides (another type of fat) may occur.

Lowering high cholesterol levels is an important part of preventing heart disease and arteriosclerosis (hardening of the arteries).

Cholestyramine has also been used to treat the itching that is associated with a blockage of the biliary tract.

Cholestyramine may also be used for purposes other than those listed in this medication guide.

Who should not take cholestyramine?

Do not take cholestyramine if you have a complete blockage of your biliary or gastrointestinal (stomach) tract.

Before taking this medication, tell your doctor if you

• have an underactive thyroid gland (hypothyroidism),
• have diabetes,
• have kidney disease,
• have liver disease, or
• suffer from constipation or hemorrhoids.

You may not be able to take cholestyramine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Before taking any "light" formulation of cholestyramine (Cholestyramine Light, Prevalite, Locholest Light, Questran Light), tell your doctor if you have phenylketonuria. These products contain phenylalanine.

Cholestyramine is in the FDA pregnancy category C. This means that it is not known whether cholestyramine will harm an unborn baby. Since the medication is not absorbed through the stomach, it is not believed to be dangerous during pregnancy. Do not take cholestyramine without first talking to your doctor if you are pregnant.

Cholestyramine decreases the absorption of certain vitamins. This could become a problem during breast-feeding. Do not take cholestyramine without first talking to your doctor if you are breast-feeding a baby.

How should I take cholestyramine?

Take cholestyramine exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Mix the powder with a noncarbonated beverage, soup, cereal, or pulpy fruit such as applesauce or crushed pineapple.

Cholestyramine may be taken one to six times a day. It is usually taken before a meal. Follow your doctor's instructions.

Avoid ingesting or breathing in the dry powder. Consuming the dry powder could cause a severe adverse reaction.

Increase the amount of fluid in your diet to prevent constipation. Drink at least six to eight full glasses (8 ounces) of fluid daily.

Take other medications at least 1 hour before or 4 to 6 hours after taking a dose of cholestyramine. Cholestyramine can decrease the effectiveness of many other drugs.

Store cholestyramine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a cholestyramine overdose are unknown, but an intestinal blockage leading to abdominal pain might be expected.

What should I avoid while taking cholestyramine?

Avoid ingesting or breathing in the dry powder. Doing so could cause a severe adverse reaction.

Take other medications at least 1 hour before or 4 to 6 hours after taking a dose of cholestyramine. Cholestyramine can decrease the effectiveness of many other drugs.

What are the possible side effects of cholestyramine?

If you experience any of the following serious side effects, stop taking cholestyramine and seek emergency medical attention:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
• an increased heart rate or chest pain;
• black, bloody, or tarry stools; or
• unusual bleeding or bruising.

Other, less serious side effects may be more likely to occur. Continue to take cholestyramine and talk to your doctor if you experience

• constipation;
• abdominal pain, cramps, bloating, or flatulence;
• nausea, vomiting, diarrhea, indigestion, heartburn, or decreased appetite;
• hiccups or a sour taste in your mouth;
• headache; or
• dizziness or drowsiness.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect cholestyramine?

The absorption of many drugs may be decreased when they are taken with cholestyramine. Take all other medications at least 1 hour before or 4 to 6 hours after taking a dose of cholestyramine. The following list includes some, but not all, of the drugs that may have decreased effects when taken with cholestyramine:

• pain, fever, and inflammation reducers such as aspirin, ibuprofen (Motrin, Advil, Nuprin), indomethacin (Indocin), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Aleve, Anaprox, Naprosyn), and others;
• antibiotics such as penicillins (Amoxil, Augmentin, Pen VK, Veetids, others), tetracyclines (Sumycin, Achromycin, Minocin, Doryx, Doxy, Vibramycin, others), and clindamycin (Cleocin);
• heart medicines such as digoxin (Lanoxin, Lanoxicaps), propranolol (Inderal), methyldopa (Aldomet), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril), chlorothiazide (Diuril), metolazone (Mykrox, Zaroxolyn), indapamide (Lozol), and others;
• diabetes medications such as glipizide (Glucotrol), tolbutamide (Orinase), and others;
• anticoagulants (blood thinners) such as warfarin (Coumadin);
• other cholesterol treatments such as gemfibrozil (Lopid), clofibrate (Atromid-S), and nicotinic acid (niacin);
• thyroid hormones such as levothyroxine (Synthroid, Levoxyl, Levothroid);
• medicines used to treat depression, such as imipramine (Tofranil);
• gallstone medications such as ursodiol (Actigall);
• seizure medicines such as phenytoin (Dilantin) and phenobarbital (Luminal, Solfoton);
• estrogen and progesterone hormones such as Premarin, Premphase, Prempro, Estraderm, Ogen, Menest, Estratest, Estratab, Provera, and others;
• fat-soluble vitamins such as vitamins A, D, E, and K (you may require vitamin supplements); and
• steroid drugs such as hydrocortisone (Cortef, Hydrocortone).

Drugs other than those listed here may also interact with cholestyramine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has more information about cholestyramine written for health professionals that you may read.

What does my medication look like?

Cholestyramine is available with a prescription generically and under the brand names Questran, Questran Light, Locholest, Locholest Light, and Prevalite in a powder formulation. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 4.05. Revision date: 2/13/04.