Class: Bile Acid Sequestrants
VA Class: CV350
CAS Number: 11041-12-6
Brands: Prevalite, Questran, Questran Light
Antilipemic agent; bile acid sequestrant.100
Uses for Cholestyramine Resin
Adjunct to dietary therapy to decrease elevated serum total and LDL-cholesterol concentrations in the management of primary hypercholesterolemia in patients who do not respond adequately to diet.100
Do not use in patients with primary dysbetalipoproteinemia (Frederickson type III).350 (See Hypertriglyceridemia under Cautions.)
ACC/AHA cholesterol management guideline states that nonstatin drugs (e.g., bile acid sequestrants) do not provide acceptable atherosclerotic cardiovascular disease (ASCVD) risk reduction benefits compared to their potential for adverse effects in the routine prevention of ASCVD.350 May be useful as adjuncts to statin therapy in high-risk patients (e.g., patients with ASCVD, LDL-cholesterol concentrations ≥190 mg/dL, or diabetes mellitus) who have a less-than-anticipated response to statins, are unable to tolerate even a less-than-recommended intensity of a statin, or are completely intolerant to statin therapy.350 Select nonstatin drug based on favorable benefit-risk ratio (i.e., demonstrated benefit of ASCVD risk reduction outweighs risks of adverse effects and drug interactions) and patient preferences.350
Current recommendations from ACC/AHA regarding prevention of ASCVD and lifestyle modifications to reduce cardiovascular risk are available at or 352 .
Pruritus Associated with Partial Cholestasis
Cholestyramine Resin Dosage and Administration
Patients should be placed on a standard lipid-lowering diet before initiation of cholestyramine therapy and should remain on this diet during treatment with the drug.100
Monitoring during Antilipemic Therapy
Determine serum cholesterol and triglyceride concentrations prior to and regularly (e.g., every 3–6 months) during cholestyramine therapy. ACC/AHA cholesterol management guideline recommends obtaining a fasting lipoprotein profile before initiating bile acid sequestrant therapy, after 3 months of therapy, and every 6–12 months thereafter.350
Administer orally at mealtime.100
Mix cholestyramine powder for oral suspension with an adequate amount (60–180 mL for 1 packet or level scoop of powder) of a liquid (e.g., water, fruit juice, other noncarbonated beverage) and stir to uniform consistency.100 186 187 188
Palatability and compliance may be increased if the entire next-day’s dose is mixed in one of these liquids in the evening and then refrigerated.127
Use of a heavy or pulpy fruit juice may minimize complaints about consistency of suspensions of the drug.148
If a carbonated beverage is used, mix the powder slowly in a large glass to minimize excessive foaming.b To minimize excessive swallowing of air, advise patients to avoid rapid ingestion of suspensions of the drug.148
Instruct patients to take other drugs at least 1 hour before or 4–6 hours after taking cholestyramine to minimize possible interference with absorption.100 157 173 187 188 (See Effects on GI Absorption of Drugs under Interactions.)
Available as cholestyramine resin; dosage expressed in terms of anhydrous (i.e., dried) cholestyramine resin.100
Each 9 g of Questran100 or generic cholestyramine (1 dose, 1 packet, or 1 level scoop),188 5.5 g of Prevalite (1 dose, 1 packet, or 1 level scoop),187 or 5 g of Questran Light100 or generic cholestyramine light (1 dose, 1 packet, or 1 level scoop)188 contains about 4 g of anhydrous cholestyramine resin.100 187 188
In calculating pediatric dosages, each 100 mg of the commercially available powders contains either 44.4 mg (e.g., Questran, generic cholestyramine), 72.7 mg (e.g., Prevalite), or 80 mg (e.g., Questran Light, generic cholestyramine light) of anhydrous cholestyramine resin.100 187 188
Dyslipidemias or Pruritus Associated with Partial Cholestasis
Usual maintenance dosage recommended by manufacturers is 8–16 g daily, given in 2 divided doses.100 187 188 Usual dosage range suggested by Third Report of the National Cholesterol Education Program (NCEP) (Adult Treatment Panel [ATP] III) is 4–16 g daily.186
In patients with preexisting constipation: Initially, 4 g of anhydrous resin (1 packet or 1 level scoop) once daily for 5–7 days; then increase dosage to 4 g twice daily and monitor constipation and serum lipoprotein values, at least twice, 4–6 weeks apart.100 187 188 Thereafter, increase dosage as needed by 1 dose (i.e., 4 g) per day (at monthly intervals) with periodic monitoring of serum lipoprotein values.100 187 188
If constipation worsens or the desired effect is not achieved with acceptable adverse effects with the usual dosage of 1–6 doses (i.e., 4–24 g) per day, consider combined therapy or alternative treatment.100 187 188
Cautions for Cholestyramine Resin
Complete biliary obstruction in which no bile products reach the intestine.100
Known hypersensitivity to cholestyramine or any ingredient in the formulation.100
Individuals with phenylketonuria (i.e., homozygous genetic deficiency of phenylalanine hydroxylase) and other individuals who must restrict their intake of phenylalanine should be warned that each 5-g dose of Questran Light, 5-g dose of generic cholestyramine light, or 5.5-g dose of Prevalite contains aspartame (NutraSweet), which is metabolized in the GI tract to provide about 14, 14, or 14.1 mg, respectively, of phenylalanine following oral administration.100 187 188
Mild constipation has occurred, especially after high doses and in patients >60 years of age.100 Exacerbation of preexisting constipation and aggravation of hemorrhoids secondary to constipation may occur.100
Encourage increased fluid and fiber intake to alleviate constipation;100 a stool softener can be added if necessary.100 In addition, adjust dosage carefully and titrate slowly to minimize adverse GI effects (e.g., fecal impaction).100 (See Dosage under Dosage and Administration.)
Discontinuance of cholestyramine therapy may be required in some patients.100
Abdominal discomfort and/or pain, flatulence, nausea, vomiting, diarrhea, eructation, anorexia, biliary colic, and steatorrhea also reported.100 Intestinal obstruction, which rarely has been fatal, reported in pediatric patients.100
Use with caution in patients with baseline triglyceride concentrations of 250-299 mg/dL; discontinue when triglyceride concentrations <400 mg/dL.
Do not use in patients with baseline fasting triglyceride concentrations ≤300 mg/dL or in those with primary dysbetalipoproteinemia (Frederickson type III).
Fat-soluble Vitamin Deficiency
May interfere with the absorption of fat-soluble vitamins (e.g., vitamins A, D, E, K).100 Bleeding tendency due to hypoprothrombinemia secondary to vitamin K deficiency, night blindness secondary to vitamin A deficiency, and vitamin D deficiency have been reported.100 (See Specific Drugs under Interactions.)
Because cholestyramine is the chloride form of an anion-exchange resin, there is a possibility that prolonged use may lead to the development of hyperchloremic acidosis.100 Hyperchloremic acidosis reported in children.100
Use with caution; possible lack of proper vitamin absorption associated with cholestyramine therapy may have an effect on nursing infants.100
Safety and efficacy of long-term administration not established.100 The potential effect of cholestyramine on vitamin absorption and on electrolytes should be considered.100 116 117 118 119 120 121 122 123 124 125 157 173 181
Common Adverse Effects
Constipation, osteoporosis, rash, irritation of the skin/tongue/perianal area.100
Interactions for Cholestyramine Resin
Effects on GI Absorption of Drugs
May bind to a number of drugs (e.g., phenylbutazone, warfarin, propranolol, tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins, digoxin, iron salts, loperamide) in the GI tract and may delay or reduce their absorption.100 Instruct patients to administer other drugs at least 1 hour before or 4–6 hours after cholestyramine (or allow as long a time interval as possible between ingestion of other drugs and cholestyramine).100
May interfere with the pharmacokinetics of drugs that undergo enterohepatic circulation.100
Consider the possibility that discontinuance of cholestyramine in patients stabilized on potentially toxic drugs that bind to the resin may lead to toxicity and that administration of cholestyramine to patients stabilized on other drugs may reduce the effect of these drugs.100
Fat-soluble Vitamins (i.e., vitamins A, D, E, K)
Decreased absorption of fat-soluble vitamins100
Consider supplemental administration of water-miscible (or parenteral) forms of fat-soluble vitamins if cholestyramine is to be given for a prolonged period.100
Bleeding secondary to vitamin K deficiency usually responds promptly to parenteral administration of phytonadione; recurrences can be prevented by oral administration of phytonadione100
Phosphate supplements, oral
Other bile acid binding resins reported to interfere with the absorption of oral phosphate supplements100
Thiazide diuretics (e.g., chlorothiazide, hydrochlorothiazide)
Cholestyramine Resin Pharmacokinetics
Not absorbed from the GI tract.100
Binds to bile acids in the intestine and forms a nonabsorbable complex that is excreted in feces.100
Powder for Oral Suspension
Actions and Spectrum
Binds to bile acids in the intestine and forms a nonabsorbable complex that is excreted in feces.100 Partial removal of bile acids from the enterohepatic circulation results in increased conversion of cholesterol to bile acids in the liver.100 This causes an increased demand for cholesterol in liver cells, resulting in a compensatory increase in hepatic uptake (and thus systemic clearance) of circulating LDL-cholesterol.100
Reduces serum total and LDL-cholesterol concentrations.100
In patients with partial biliary obstruction, reduction of serum bile acid concentrations reduces excess bile acids deposited in dermal tissues, resulting in relief of pruritus.100
Advice to Patients
Importance of advising patients that sipping or holding cholestyramine suspension in the mouth for prolonged periods may lead to changes in the surface of the teeth, resulting in discoloration, erosion of enamel, or decay.100 187 188 Maintain good oral hygiene.100 187 188
Importance of adhering to nondrug therapies and measures, including dietary management, weight control, physical activity, and management of potentially contributory disease (e.g., diabetes mellitus).184 186
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.100
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.100
Importance of informing patients of other important precautionary information.100 (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
4 g (of dried cholestyramine resin) per 9 g*
4 g (of dried cholestyramine resin) per 5.5 g
4 g (of dried cholestyramine resin) per 5 g*
AHFS DI Essentials. © Copyright, 2016, American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
Date published: May 01, 2004
Last reviewed: November 06, 2014
Date modified: February 08, 2016
100. Par Pharmaceutical Companies, Inc. Questran Powder (cholestyramine for oral suspension) and Questran Light (cholestyramine for oral suspension) prescribing information. Spring Valley, NY; 2005 Feb.
101. National Heart, Lung and Blood Institute Lipid Metabolism-Atherogenesis Branch. The Lipid Research Clinics Coronary Primary Prevention Trial results. Part I: reduction in incidence of coronary heart disease. JAMA. 1984; 251:351-64. [IDIS 180094] [PubMed 6361299]
102. National Heart, Lung and Blood Institute Lipid Metabolism-Atherogenesis Branch. The Lipid Research Clinics Coronary Primary Prevention Trial results. Part II: relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA. 1984; 251:365-74. [IDIS 180095] [PubMed 6361300]
103. Anon. Addition to labeling of cholestyramine. FDA Drug Bull. 1985; 15:7-8. [PubMed 3858190]
104. National Institutes of Health Office of Medical Applications of Research. Consensus conference: lowering blood cholesterol to prevent heart disease. JAMA. 1985; 25:2080-6.
105. Rahimtoola SH. Cholesterol and coronary heart disease: a perspective. JAMA. 1985; 253:2094-5. [PubMed 3974101]
106. American Heart Association Committee to Design a Dietary Treatment of Hyperlipoproteinemia. Recommendations for treatment of hyperlipidemia in adults: a joint statement of the Nutrition Committee and the Council on Arteriosclerosis. Circulation. 1984; 69:1065-90A. [PubMed 6713610]
107. Detre KM, Levy RI, Kelsey SF et al. Secondary prevention and lipid lowering: results and implications. Am Heart J. 1985; 110:1123-7. [IDIS 208440] [PubMed 3904378]
108. Glueck CJ. Nonpharmacologic and pharmacologic alteration of high-density lipoprotein cholesterol: therapeutic approaches to prevention of atherosclerosis. Am Heart J. 1985; 110:1107-15. [IDIS 208439] [PubMed 2865887]
109. Kronmal RA. Commentary on the published results of the lipid research clinics coronary primary prevention trial. JAMA. 1985; 253:2091-3. [PubMed 3883022]
110. Oliver MF. Hypercholesterolaemia and coronary heart disease: an answer. BMJ. 1984; 288:423-4. [IDIS 182823] [PubMed 6419948]
111. Brensike JF, Levy RI, Kelsey SF et al. Effects of therapy with cholestyramine on progression of coronary arteriosclerosis: results of the NHLBI Type II Coronary Intervention Study. Circulation. 1984; 69:313-24. [IDIS 180722] [PubMed 6360414]
112. Levy RI, Brensike JF, Epstein SE et al. The influence of changes in lipid values induced by cholestyramine and diet on progression of coronary artery disease: results of the NHLBI Type II Coronary Intervention Study. Circulation. 1984; 69:325-37. [IDIS 180723] [PubMed 6360415]
113. American Medical Association Council on Scientific Affairs. Dietary and pharmacologic therapy for the lipid risk factors. JAMA. 1983; 250:1873-9. [IDIS 176576] [PubMed 6620484]
114. Garrettson LK, Guzelian PS, Blanke RV. Subacute chlordane poisoning. J Toxicol Clin Toxicol. 1984-85; 22:565-71.
115. Rubenstein C, Romhilt D, Segal P et al. Dyslipoproteinemias and manifestations of coronary heart disease: the Lipid Research Clinics Program Prevalence Study. Circulation. 1986; 73(Suppl I):I-91-9.
116. West RJ, Lloyd JK. Long-term follow-up of children with familial hypercholesterolaemia treated with cholestyramine. Lancet. 1980; 2:873-5. [IDIS 125400] [PubMed 6107543]
117. Glueck CJ. Therapy of familial and acquired hyperlipoproteinemia in children and adolescents. Prev Med. 1983; 12:835-47. [PubMed 6676731]
118. Mancini M, Postiglione A, Farinaro E et al. Diet, drugs, and plasma exchange in the treatment of hyperlipidemia in childhood. Prev Med. 1983; 12:848-53. [PubMed 6676732]
119. Glueck CJ, Tsang RC, Fallat RW et al. Therapy of familial hypercholesterolemia in childhood: diet and cholestyramine resin for 24 to 36 months. Pediatrics. 1977; 59:433-41. [IDIS 83076] [PubMed 840563]
120. Glueck CJ, Fallat R, Tsang R. Pediatric familial type II hyperlipoproteinemia: therapy with diet and cholestyramine resin. Pediatrics. 1973; 52:669-79. [IDIS 37416] [PubMed 4355362]
121. Glueck CJ, Tsang RC, Fallat RW et al. Plasma vitamin A and E levels in children with familial type II hyperlipoproteinemia during therapy with diet and cholestyramine resin. Pediatrics. 1974; 54:51-5. [IDIS 42587] [PubMed 4365953]
122. West RJ, Lloyd JK. The effect of cholestyramine on intestinal absorption. Gut. 1975; 16:93-8. [IDIS 50401] [PubMed 1168607]
123. Glueck CJ. Pediatric primary prevention of atherosclerosis. N Engl J Med. 1986; 314:175-7. [PubMed 3941697]
124. Farah JR, Kwiterovich PO, Neill CA. Dose-effect relationship of cholestyramine in children and young adults with familial hypercholesterolaemia. Lancet. 1977; 1:59-63. [IDIS 68247] [PubMed 63709]
125. Levy RI, Rifkind BM. Diagnosis and management of hyperlipoproteinemia in infants and children. Am J Cardiol. 1973; 31:547-56. [IDIS 34550] [PubMed 4348998]
126. American Health Foundation. Summary and recommendations of the Conference on Blood Lipids in Children: optimal levels for early prevention of coronary artery disease. Prev Med. 1983; 12:728-40. [PubMed 6676727]
127. Hoeg JM, Gregg RE, Brewer HB. An approach to the management of hyperlipoproteinemia. JAMA. 1986; 255:512-21. [IDIS 209539] [PubMed 3510334]
128. National Institutes of Health Office of Medical Applications of Research. Consensus conference: treatment of hypertriglyceridemia. JAMA. 251:1196-200.
129. Forman MB, Baker SG, Mieny CJ et al. Treatment of homozygous familial hypercholesterolaemia with portacaval shunt. Atherosclerosis. 1982; 41:349-61. [PubMed 7066082]
130. Thompson GR, Lowenthal R, Myant NB. Plasma exchange in the management of homozygous familial hypercholesterolaemia. Lancet. 1975; 1:1208-11. [PubMed 48833]
131. Postiglione A, Thompson GR. Experience with plasma-exchange in homozygous familial hypercholesterolaemia. Prog Clin Biol Res. 1985; 188:213-20. [PubMed 3903770]
132. Starzl TE, Chase HP, Ahrens EH Jr et al. Portacaval shunt in patients with familial hypercholesterolemia. Ann Surg. 1983; 198:273-83. [PubMed 6615051]
133. King MEE, Breslow JL, Lees RS. Plasma-exchange therapy of homozygous familial hypercholesterolemia. N Engl J Med. 1980; 302:1457-9. [PubMed 7374711]
134. Hoeg JM, Demosky SJ Jr, Schaefer EJ et al. The effect of portacaval shunt on hepatic lipoprotein metabolism in familial hypercholesterolemia. J Surg Res. 1985; 39:369-77. [PubMed 4057999]
135. Schaefer EJ, Levy RI. Pathogenesis and management of lipoprotein disorders. N Engl J Med. 1985; 312:1300-10. [IDIS 199398] [PubMed 3887163]
136. Bilheimer DW, Goldstein JL, Grundy SM et al. Liver transplantation to provide low-density-lipoprotein receptors and lower plasma cholesterol in a child with homozygous familial hypercholesterolemia. N Engl J Med. 1984; 311:1658-64. [PubMed 6390206]
137. American Heart Association Committee on Atherosclerosis and Hypertension in Childhood of the Council of Cardiovascular Disease in the Young and the Nutrition Committee. Diagnosis and treatment of primary hyperlipidemia in childhood: a joint statement for physicians by the Committee on Atherosclerosis and Hypertension in Childhood of the Council of Cardiovascular Disease in the Young and the Nutrition Committee. Circulation. 1986; 74:1181-8A. [IDIS 224232] [PubMed 3779908]
138. Gordon DJ, Knoke J, Probstfield JL et al. High-density lipoprotein cholesterol and coronary heart disease in hypercholesterolemic men: the Lipid Research Clinics Coronary Primary Prevention Trial. Circulation. 1986; 74:1217-25. [IDIS 224234] [PubMed 3536151]
139. Nitsch J, Lüderitz B. Beschleunigte Elimination von Amiodaron durch Colestyramin. (German; with English abstract.) Deutsche Med Wochenschr. 1986; 111:1241-4.
140. Hunninghake DB, Hibbard DM. Influence of time intervals for cholestyramine dosing on the absorption of hydrochlorothiazide. Clin Pharmacol Ther. 1986; 39:329-34. [IDIS 213994] [PubMed 3948472]
141. Hunninghake DB, King S, LaCroix K. The effect of cholestyramine and colestipol on the absorption of hydrochlorothiazide. Int J Clin Pharmacol Ther Toxicol. 1982; 20:151-4. [PubMed 7076343]
142. Mangini RJ, ed. Drug interaction facts. St. Louis: JB Lippincott Co; 1984(Jul):583.
143. Hansten PD. Drug interactions. 5th ed. Philadelphia: Lea & Febiger; 1985:295.
144. Hibbard DM, Peters JR, Hunninghake DB. Effects of cholestyramine and colestipol on the plasma concentrations of propranolol. Br J Clin Pharmacol. 1984; 18:337-42. [IDIS 191419] [PubMed 6487473]
145. Schwartz DE, Schaeffer E, Brewer HB et al. Bioavailability of propranolol following administration of cholestyramine. Clin Pharmacol Ther. 1982; 31:268.
146. Mangini RJ, ed. Drug interaction facts. St. Louis: JB Lippincott Co; 1985(Jan):109a.
147. Hansten PD, Horn JR, eds. Amiodarone drug interactions. Drug Interact Newsl. 1987; 7:13-6.
148. The Expert Panel (coordinated by the National Heart, Lung, and Blood Institute). Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Arch Intern Med. 1988; 148:36-69. [IDIS 236890] [PubMed 3422148]
149. Bilheimer DW. Familial hypercholesterolemia: there is a need for early detection and treatment. JAMA. 1987; 257:69-70. [PubMed 3783906]
150. Vega GL, Grundy SM. Treatment of primary moderate hypercholesterolemia with lovastatin (mevinolin) and colestipol. JAMA. 1987; 257:33-8. [IDIS 223496] [PubMed 3537351]
151. Witztum JL. Intensive drug therapy of hypercholesterolemia. Am Heart J. 1987; 113(2 Part 2):603-9. [IDIS 226100] [PubMed 3544777]
152. Blankenhorn DH, Nessim SA, Johnson RL et al. Beneficial effects of colestipol-niacin therapy on coronary atherosclerosis and coronary bypass grafts. JAMA. 1987; 257:3233-40. [IDIS 230814] [PubMed 3295315]
153. Illingworth DR. Mevinolin plus colestipol in therapy for severe heterozygous familial hypercholesterolemia. Ann Intern Med. 1984; 101:598-604. [IDIS 191769] [PubMed 6567462]
154. Mabuchi H, Sakai T, Sakai Y et al. Reduction of serum cholesterol in heterozygous patients with familial hypercholesterolemia: additive effects of compactin and cholestyramine. N Engl J Med. 1983; 308:609-13. [IDIS 166852] [PubMed 6828091]
155. Malloy MJ, Kane JP, Kunitake ST et al. Complementarity of colestipol, niacin, and lovastatin in treatment of severe familial hypercholesterolemia. Ann Intern Med. 1987; 107:616-23. [IDIS 235737] [PubMed 3662275]
156. Kane JP, Malloy MJ, Tun P et al. Normalization of low-density-lipoprotein levels in heterozygous familial hypercholesterolemia with a combined drug regimen. N Engl J Med. 1981; 304:251-8. [IDIS 126648] [PubMed 7003391]
157. Parke-Davis. Cholybar (Cholestyramine resin bar) prescribing information. In: Barnhart ER, publisher. Physicians’ desk reference. 45th ed. Oradell, NJ: Medical Economics Company Inc; 1991:1637-8.
158. Reviewers’ comments on lovastatin (personal observations); 1988 Jul.
159. Illingworth DR, Bacon SP, Larsen KK. Long-term experience with HMG-CoA reductase inhibitors in the therapy of hypercholesterolemia. Atheroscler Rev. 1988; 18:161-87.
160. Tobert JA. New developments in lipid-lowering therapy: the role of inhibitors of hydroxymethylglutaryl-coenzyme A reductase. Circulation. 1987; 76:534-8. [IDIS 252224] [PubMed 3113763]
161. Brown MS, Goldstein JL. The hyperlipoproteinemias and other disorders of lipid metabolism. In: Harrison’s principles of internal medicine. 11th ed. New York: McGraw-Hill Book Co; 1987; 1650-61.
162. Goldstein JL, Brown MS. The low-density lipoprotein pathway and its relation to atherosclerosis. Ann Rev Biochem. 1977; 46:897-930. [PubMed 197883]
163. Brown MS, Goldstein JL. Lipoprotein receptors in the liver: control signals for plasma cholesterol traffic. J Clin Invest. 1983; 72:743-7. [PubMed 6309907]
164. Heber D, Koziol BJ, Henson LC. Low density lipoprotein receptor regulation and cellular basis of atherosclerosis: implications for nutritional and pharmacologic treatment of hypercholesterolemia. Am J Cardiol. 1987; 60(Suppl):4-8G.
165. Thompson GR, Ford J, Jenkinson M et al. Efficacy of mevinolin as adjuvant therapy for refractory familial hypercholesterolaemia. Q J Med. 1986; 60:803-11. [IDIS 222246] [PubMed 3640503]
166. East C, Grundy SM, Bilheimer DW. Normal cholesterol levels with lovastatin (mevinolin) therapy in a child with homozygous familial hypercholesterolemia following liver transplantation. JAMA. 1986; 256:2843-8. [IDIS 222763] [PubMed 3534334]
167. Grundy SM. HMG-CoA reductase inhibitors for treatment of hypercholesterolemia. N Engl J Med. 1988; 319:24-33. [IDIS 243240] [PubMed 3288867]
168. McNamara DJ, Ahrens EH Jr, Kolb R et al. Treatment of familial hypercholesterolemia by portcaval anastomosis: effect on cholesterol metabolism and pool sizes. Proc Natl Acad Sci USA. 1983; 80:564-8. [PubMed 6572906]
169. Witztum JL, Williams JC, Ostlund R et al. Successful plasmapheresis in a 4-year-old child with homozygous familial hypercholesterolemia. J Pediatr. 1980; 97:615-8. [PubMed 6775065]
170. Graisely B, Cloarec M, Salmon S et al. Extracorporeal plasma therapy for homozygous familial hypercholesterolaemia. Lancet. 1980; 2:1147. [PubMed 6107765]
171. Stoffel W, Borberg H, Greve V. Application of specific extracorporeal removal of low density lipoprotein in familial hypercholesterolaemia. Lancet. 1981; 2:1005-7. [PubMed 6118475]
172. Thompson GR, Miller JP, Breslow JL. Improved survival of patients with homozygous familial hypercholesterolaemia treated with plasma exchange. BMJ. 1985; 291:1671-3. [PubMed 3935235]
173. Bristol Laboratories, Div. of Bristol-Myers Co. Questran Light (cholestyramine for oral suspension) prescribing information. Evansville, IN; 1988 Feb.
174. Gossel TA. A review of aspartame: characteristics, safety and uses. US Pharm. 1984; 9:26,28-30.
175. Food and Drug Administration. Asparatame as an inactive ingredient in human drug products; labeling requirements. Proposed rule. [21 CFR Part 201] Fed Regist. 1983; 48:54993-5. (IDIS 178728)
176. Food and Drug Administration. Food additives permitted for direct addition to food for human consumption; aspartame. Final rule. [21 CFR Part 172] Fed Regist. 1983; 48:31376-82. (IDIS 172957)
177. Anon. Aspartame and other sweeteners. Med Lett Drugs Ther. 1982; 24:1-2. [PubMed 7054648]
178. American Medical Association Council on Scientific Affairs. Aspartame: review of safety issues. JAMA. 1985; 254:400-2. [IDIS 202002] [PubMed 2861297]
179. American Heart Association. AHA conference report on cholesterol. Circulation. 1989; 80:715-48. [PubMed 2670320]
180. Parke-Davis. Cholybar (cholestyramine resin bar) prescribing information. In: Physician’s desk reference. 45th ed. Medical Economics Company Inc. Oradell, NJ: 1991 (Suppl A):A41.
181. The Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992; 89(Suppl):525-84. [PubMed 1538956]
182. American Academy of Pediatrics Committee on Nutrition. Statement on cholesterol. Pediatrics. 1992; 90:469-73. [PubMed 1518712]
183. The Expert Panel. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation. 1994; 89:1329-1445.
184. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of high Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486-97. [IDIS 464555] [PubMed 11368702]
185. Anon. Choice of lipid-regulating drugs. Med Lett Drugs Ther. 2001; 43:43-8. [PubMed 11378632]
186. National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Adult Treatment Panel III Report. From AHA web site.
187. Upsher Smith. Prevalite (cholestyramine for oral suspension) prescribing information. Minneapolis, MN; 2001 Jun.
188. Par Pharmaceutical Companies, Inc. Cholestyramine powder (cholestyramine for oral suspension) and Cholestyramine Light (cholestyramine for oral suspension) prescribing information. Spring Valley, NY; 2005 Feb.
350. Stone NJ, Robinson J, Lichtenstein AH et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; :. [PubMed 24239923]
352. Eckel RH, Jakicic JM, Ard JD et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014; 63:2960-84. [PubMed 24239922]
357. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011; 128 Suppl 5:S213-56. [PubMed 22084329]
b. AHFS Drug Information 2003. McEvoy GK , ed. cholestyramine hydrochloride. Bethesda, MD: American Society of Health-System Pharmacists; 2003:1594-6.
c. Medications. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of pediatrics. 16th ed. Philadelphia: WB Saunders Company; 2000:2247.