Cholestyramine Dosage

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Usual Adult Dose for Hyperlipoproteinemia

Initial: 4 g orally once or twice a day.

Maintenance: 4 g orally 3 times a day before meals. Dosage should be individualized and based on clinical response and patient tolerance of side effects. Doses range from 8 to 36 g per day in 2 to 4 doses.

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL)

Initial: 4 g orally once or twice a day.

Maintenance: 4 g orally 3 times a day before meals. Dosage should be individualized and based on clinical response and patient tolerance of side effects. Doses range from 8 to 36 g per day in 2 to 4 doses.

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL)

Initial: 4 g orally once or twice a day.

Maintenance: 4 g orally 3 times a day before meals. Dosage should be individualized and based on clinical response and patient tolerance of side effects. Doses range from 8 to 36 g per day in 2 to 4 doses.

Usual Adult Dose for Pruritus of Partial Biliary Obstruction

Initial: 4 g orally once or twice a day.

Maintenance: 4 g orally 3 times a day before meals. Dosage should be individualized and based on clinical response and patient tolerance of side effects. Doses range from 8 to 36 g per day in 2 to 4 doses.

Usual Pediatric Dose for Hyperlipoproteinemia

Initial:
< 10 years: 2 g orally per day in equally divided doses 2 to 4 times a day. Dosage should be individualized and based on clinical response and patient tolerance of side effects.

10 to 18 years: 2 g orally per day in equally divided doses 2 to 4 times a day. Dosage should be individualized and based on clinical response and patient tolerance of side effects.

Maintenance:
< 10 years: 1 to 4 g orally each day in equally divided doses administered 2 to 4 times a day. Dosage should be individualized and based on clinical response and patient tolerance of side effects.

10 to 18 years: 1 to 8 g orally per day in equally divided doses 2 to 4 times a day. Dosage should be individualized and based on clinical response and patient tolerance of side effects.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

For adults, doses may be adjusted based on clinical response and patient tolerance of side effects. Doses range from 8 to 36 grams per day in 2 to 4 divided doses.

Dialysis

Data not available

Other Comments

Patient should take other medications 1 hour before or 4-6 hours after taking binding resin.

Cholestyramine should not be administered without fluid. Use 2 to 6 fluid ounces of water, juice, noncarbonated beverages, soups or pulpy fruits, such as applesauce or crushed pineapple.

Cholestyramine may be administered in conjunction with HMG-CoA reductase inhibitors to achieve an additive effect of lowering total cholesterol as well as treating refractory or severe forms of hypercholesterolemia. However, some studies have not demonstrated significantly greater efficacy with the combination of cholestyramine and HMG-CoA reductase inhibitors (i.e., rosuvastatin).

Cholestyramine may also be used in the treatment of Clostridium difficile-related pseudomembranous colitis. The dosage required should be determined on an individualized basis by titrating to the desired effect.

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