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All about: Cholestyramine

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Generic name: Cholestyramine
Brand names: Questran Light, Questran

Why is Cholestyramine prescribed?

Questran is used to lower cholesterol levels in the blood of people with primary hypercholesterolemia (too much LDL cholesterol). Hypercholesterolemia is a genetic condition characterized by a lack of the LDL receptors that remove cholesterol from the bloodstream.

This drug can be used to lower cholesterol levels in people who also have hypertriglyceridemia, a condition in which an excess of fat is stored in the body.

This drug may also be prescribed to relieve itching associated with gallbladder obstruction.

It is available in two forms: Questran and Questran Light. The same instructions apply to both.

Most important fact about Cholestyramine

It's important to remember that Questran is a supplement to--not a substitute for--diet, exercise, and weight loss. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because together they may lower your risk of heart disease.

How should you take Cholestyramine?

Never take Questran in its dry form. Always mix it with water or other liquids before taking it. For Questran, use 2 to 6 ounces of liquid per packet or level scoopful; for Questran Light, use 2 to 3 ounces. Soups or fruits with a high moisture content, such as applesauce or crushed pineapple, can be used in place of beverages.

--If you miss a dose...

Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never try to "catch up" by doubling the dose.

--Storage instructions...

Store at room temperature. Protect from moisture and high humidity.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Questran.

  • More common side effects may include:
    Constipation

Why should Cholestyramine not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Questran or similar drugs such as Colestid, you should not take Cholestyramine. Make sure that your doctor is aware of any drug reactions that you have experienced.

Unless you are directed to do so by your doctor, do not take Cholestyramine if you are being treated for gallbladder obstruction.

Special warnings about Cholestyramine

If you have phenylketonuria, a genetic disorder, check with your doctor before taking Questran Light because this product contains phenylalanine.

If you are being treated for any disease that contributes to increased blood cholesterol, such as hypothyroidism (reduced thyroid function), diabetes, nephrotic syndrome (kidney and blood vessel disorder), dysproteinemia, obstructive liver disease, or alcoholism, or if you are taking any drugs that may raise cholesterol levels, consult your doctor before taking Cholestyramine. Caution is also in order if your kidney function is poor.

Questran should begin to reduce cholesterol levels during the first month of therapy. If adequate reduction of cholesterol is not obtained, your doctor may increase the dosage or add other cholesterol-lowering drugs. Therefore, it is important that your doctor check your progress regularly.

Questran does not cure the tendency to have high cholesterol levels; it merely helps control it. To maintain healthy levels, you therefore must continue taking the drug as directed.

The use of Cholestyramine may produce or worsen constipation and aggravate hemorrhoids. If this happens, inform your doctor. To prevent constipation, the doctor may increase your dosage very slowly, and ask you to drink more fluids, take more fiber, or take a stool softener. If severe constipation develops anyway, the doctor may switch to a different drug.

The prolonged use of Questran may change acidity in the bloodstream, especially in younger and smaller individuals in whom the doses are relatively higher. Again, it is important that you or your child be checked by your doctor on a regular basis.

Sipping Questran or holding it in your mouth for a long period can lead to tooth discoloration, enamel erosion, or decay. Be sure to brush and floss regularly.

Possible food and drug interactions when taking Cholestyramine

If Questran is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before taking Questran with the following:

Digitalis (Lanoxin, Crystodigin)
Estrogens and progestins (hormones)
Oral diabetes drugs such as DiaBeta and Diabinese
Penicillin G (Pentids, others)
Phenobarbital
Phenylbutazone (Butazolidin)
Propranolol (Inderal)
Spironolactone (Aldactazide, Aldactone)
Tetracycline (Achromycin V)
Thiazide-type water pills such as Diuril
Thyroid medication such as Synthroid
Warfarin (Coumadin)

Your doctor may recommend that you take other medications at least 1 hour before or 4 to 6 hours after you take Questran.

If you are taking a drug such as digitalis (Lanoxin), stopping Questran could be hazardous, since you might experience exaggerated effects of the other drug. Consult your doctor before discontinuing Questran.

This drug may interfere with normal digestion and absorption of fats, including fat-soluble vitamins such as A, D, E, and K. If supplements of vitamins A, D, E, and K are essential to your health, your doctor may prescribe an alternative form of these vitamins.

There are no special considerations regarding alcohol use with Cholestyramine.

Special information if you are pregnant or breastfeeding

The effects of Questran during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Because Cholestyramine can interfere with vitamin absorption, you may need to increase your vitamin intake before the baby is born and while nursing an infant.

Recommended dosage

ADULTS

The recommended starting dose is 1 single-dose packet or 1 level scoopful, 1 to 2 times daily. The usual maintenance dosage is a total of 2 to 4 packets or scoopfuls daily divided into 2 doses preferably at mealtime (usually before meals). The maximum daily dose is 6 packets or scoopfuls. Although the recommended dosing schedule is 2 times daily, your doctor may ask you to take Questran in up to 6 smaller doses per day.

CHILDREN

Experience with the use of Questran in infants and children is limited. If Cholestyramine is essential to your child's health, follow your doctor's recommended dosing schedule.

Overdosage

No ill effects from an overdose have been reported. The main potential harm of an overdose would be obstruction of the stomach and intestines. If you suspect an overdose, seek medical attention immediately.

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