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| {{drugbox
| | #REDIRECT [[Cholestyramine#Pharmacology]] |
| | IUPAC_name =
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| | image = Cholestyramine resin.png
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| | CAS_number = 11041-12-6
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| | ATC_prefix = C10
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| | ATC_suffix = AC01
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| | ATC_supplemental =
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| | PubChem =
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| | DrugBank =
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| | C =
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| | molecular_weight = Average MW exceeds 10<sup>6</sup> Daltons
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| | bioavailability =
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| | protein_bound =
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| | metabolism = bile acids
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| | elimination_half-life = .1 hr
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| | excretion = feces
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| | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
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| | pregnancy_US = C
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| | pregnancy_category =
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| | legal_AU = <!-- Unscheduled / S2 / S4 / S8 -->
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| | legal_UK = <!-- GSL / P / POM / CD -->
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| | legal_US = <!-- OTC / Rx-only -->
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| | legal_status =
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| | routes_of_administration = gastrointestinal
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| }}
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| {{CMG}}
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| ==[[Cholestyramine (patient information)|For patient information, click here]]==
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| ==Overview==
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| '''Cholestyramine''' or '''colestyramine''' ('''Questran®, Questran Light®''', '''Cholybar®''') is a [[bile acid sequestrant]], which binds [[bile]] in the [[gastrointestinal tract]] to prevent its reabsorption. The resin is a strong anion exchange resin, which means that it can exchange its chloride anions with anionic bile acids in the gastrointestinal tract and bind them strongly in the resin matrix. The functional group of the anion exchange resin is a quaternary ammonium group attached to an inert styrene-divinylbenzene copolymer.
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| Cholestyramine removes bile acids from the body by forming insoluble complexes with bile acids in the intestine, which are then excreted in feces. When bile acids are excreted, plasma cholesterol is converted to bile acid to normalize bile acid levels. This conversion of cholesterol into bile acids lowers plasma cholesterol concentrations.
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| Bile acid sequestrants such as cholestyramine are primarily used to treat [[hypercholesterolemia]], but can also be used to treat the [[pruritus]], or itching, that often occurs during [[liver failure]] due to the liver's inability to eliminate bile.
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| Cholestyramine is also used in patients who have undergone post ileal (part of the small bowel) resection in Crohn's disease to prevent diarrhoea. This is due to the fact that the terminal ileum is where the bile acids are reabsorbed. So when this is resected the bile acids pass into the large bowel and pull water into the bowel due to their osmotic effect thereby causing diarrhea. Cholestyramine prevents this by making them insoluble and therefore not osmotically active. | |
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| ==Available forms==
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| Cholestyramine is available as powder form, in 4 gram packets. In the [[United States]], it can be purchased either as a generic medicine, or as Questran® or Questran Light® ([[Bristol-Myers Squibb]]).
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| ==Dosage==
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| 4 to 8 grams once or twice daily, maximum dose 24 grams a day.
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| == Side-effects ==
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| The following side effects have been noted.[http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/que1366.shtml]
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| * Most frequent: [[Constipation]]
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| * Seldom: tooth discoloration; tooth enamel erosion; premature tooth decay; all from prolonged oral exposure of the suspension.
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| == Warnings ==
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| Patients with [[hypothyroidism]], [[diabetes]], [[nephrotic syndrome]], [[dysproteinemia]], obstructive liver disease, [[kidney disease]], or [[alcoholism]], should consult their doctor before taking this medication.[http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/que1366.shtml]
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| Other drugs should be taken at least one hour before or four to six hours after cholestyramine to reduce possible interference with absorption.
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| Patients with [[phenylketonuria]], should consult with a physician before taking Questran Light because that product contains [[phenylalanine]].
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| == Drug interactions ==
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| The following interactions have been noted.[http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/que1366.shtml]
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| * [[Digitalis]]
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| * [[Estrogens]] and [[progestins]]
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| * [[antidiabetic drug|Oral antidiabetic drug]]
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| * [[Penicillin#Benzylpenicillin_.28penicillin_G.29|Penicillin G]]
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| * [[Phenobarbital]]
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| * [[Spironolactone]]
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| * [[Tetracycline]]
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| * [[Thiazide]]-type diuretic pills
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| * [[Thyroid]] medication
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| * [[Warfarin]]
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| Most interactions are due to risk of decreased absorption of these drugs since Cholestyramine will prevent full absorption.
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| == Duration of treatment ==
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| The duration of treatment is not limited, but the prescribing physician should reassess in regular intervals, if continued treatment is still necessary.
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| ==Overdose==
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| Principal overdose risk is blockage of intestine or stomach.
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| == Other remarks ==
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| Cholestyramine may interfere in the absorption of fat soluble vitamins such as Vitamins [[Vitamin A|A]], [[Vitamin D|D]], [[Vitamin E|E]], and [[Vitamin K|K]]. There are no special considerations regarding alcohol consumption. [http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/que1366.shtml]
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| == References ==
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| {{refbegin}}
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| * The Merck Index, 12th Edition. 2257
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| {{refend}}
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| <br>
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| {{Lipid modifying agents}}
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| [[Category:Hypolipidemic agents]]
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| [[Category:Hepatology]]
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| [[Category:Drugs]]
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| [[de:Colestyramin]]
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| [[pl:Cholestyramina]]
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