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cholestyramine

Generic Name: cholestyramine (koe le STYE ra meen)
Brand Name: Cholestyramine Light, Prevalite, Questran, ...show all 9 brand names

What is cholestyramine?

Cholestyramine helps reduce cholesterol (fatty acids) in the blood. High cholesterol is associated with an increased risk of heart disease and atherosclerosis (clogged arteries).

Cholestyramine is used to lower high levels of cholesterol in the blood, especially low-density lipoprotein (LDL) ("bad" cholesterol).

Cholestyramine powder is also used to treat itching caused by a blockage in the bile ducts of the gallbladder.

Cholestyramine may also be used for purposes not listed in this medication guide.

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

You should not use this medicine if you have a blockage in your stomach or intestines.

Wait at least 4 to 6 hours after taking cholestyramine before you take any other medications.

What should I discuss with my healthcare provider before taking cholestyramine?

You should not use cholestyramine if you are allergic to it, or if you have:

  • a blockage in your digestive tract (stomach or intestines).

To make sure cholestyramine is safe for you, tell your doctor if you have:

  • chronic constipation;

  • a thyroid disorder;

  • diabetes;

  • kidney disease;

  • liver disease; or

  • coronary artery disease (clogged arteries).

This medicine may contain phenylalanine. Talk to your doctor before using cholestyramine if you have phenylketonuria (PKU).

Taking cholestyramine can make it harder for your body to absorb certain vitamins. Your doctor may recommend you take a vitamin supplement.

You may have an even greater need for vitamin supplements during pregnancy or while you are breast-feeding a baby. Follow your doctor's instructions about taking vitamin supplements during treatment with cholestyramine.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

How should I take cholestyramine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Although cholestyramine is usually taken once or twice per day, this medicine may be taken up to 6 times per day. Carefully follow your doctor's dosing instructions.

Mix the cholestyramine powder with at least 2 to 3 ounces of water or other non-carbonated beverage. You may also mix the powder with a brothy soup, crushed pineapple, or applesauce. Measure the powder using the scoop provided with your medication. Do not use any other scoop or measuring cup to measure your cholestyramine dose.

Cholestyramine works best if you take it with meals. However, your dosing schedule may depend on when you need to take any other medications. Cholestyramine should not be taken within 1 hour after or 4 hours before you take other medications.

Use cholestyramine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Cholestyramine can affect the surfaces of your teeth. Sipping the cholestyramine/liquid mixture slowly or holding the liquid in your mouth for too long may result in tooth discoloration, enamel erosion, or tooth decay. Be sure to brush your teeth regularly while you are using this medicine.

Drink extra fluids to prevent constipation while you are taking cholestyramine.

While using cholestyramine, you may need frequent blood tests.

Cholestyramine is only part of a complete program of treatment that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe stomach pain or constipation.

What should I avoid while taking cholestyramine?

Avoid taking other medications at the same time you take cholestyramine. Wait at least 4 to 6 hours after taking cholestyramine before you take any other medications.

Cholestyramine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • ongoing or worsening constipation;

  • severe stomach pain;

  • blood in your urine;

  • black, bloody, or tarry stools; or

  • easy bruising, unusual bleeding.

Side effects such as constipation may be more likely in older adults.

Common side effects may include:

  • mild constipation, diarrhea;

  • stomach pain, nausea, loss of appetite;

  • bloating or gas;

  • irritation of your tongue; or

  • itching or irritation around your rectal area.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Cholestyramine dosing information

Usual Adult Dose for Hyperlipoproteinemia:

Initial dose: 4 g (1 packet or level scoop) orally once or twice a day
Maintenance dose: 8 to 16 g (2 to 4 packets or level scoops orally in 2 divided doses
Maximum dose: 24 g (6 packets or level scoops) per day

Comments:
-Increases in dose should be gradual with periodic assessment of lipid/lipoprotein levels at intervals of not less than 4 weeks.
-Although the recommended dosing schedule is up to twice a day, this drug may be administered in 1 to 6 doses per day.

Uses:
-As adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia (elevated low density lipoprotein [LDL] cholesterol) who do not respond adequately to diet; may be useful to lower LDL cholesterol in patients who also have hypertriglyceridemia, but it is not indicated where hypertriglyceridemia is the abnormality of most concern; this drug has also been shown to delay the progression and increase the rate of regression of coronary atherosclerosis
-For the relief of pruritus associated with partial biliary obstruction

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL):

Initial dose: 4 g (1 packet or level scoop) orally once or twice a day
Maintenance dose: 8 to 16 g (2 to 4 packets or level scoops orally in 2 divided doses
Maximum dose: 24 g (6 packets or level scoops) per day

Comments:
-Increases in dose should be gradual with periodic assessment of lipid/lipoprotein levels at intervals of not less than 4 weeks.
-Although the recommended dosing schedule is up to twice a day, this drug may be administered in 1 to 6 doses per day.

Uses:
-As adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia (elevated low density lipoprotein [LDL] cholesterol) who do not respond adequately to diet; may be useful to lower LDL cholesterol in patients who also have hypertriglyceridemia, but it is not indicated where hypertriglyceridemia is the abnormality of most concern; this drug has also been shown to delay the progression and increase the rate of regression of coronary atherosclerosis
-For the relief of pruritus associated with partial biliary obstruction

Usual Adult Dose for Pruritus of Partial Biliary Obstruction:

Initial dose: 4 g (1 packet or level scoop) orally once or twice a day
Maintenance dose: 8 to 16 g (2 to 4 packets or level scoops orally in 2 divided doses
Maximum dose: 24 g (6 packets or level scoops) per day

Comments:
-Increases in dose should be gradual with periodic assessment of lipid/lipoprotein levels at intervals of not less than 4 weeks.
-Although the recommended dosing schedule is up to twice a day, this drug may be administered in 1 to 6 doses per day.

Uses:
-As adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia (elevated low density lipoprotein [LDL] cholesterol) who do not respond adequately to diet; may be useful to lower LDL cholesterol in patients who also have hypertriglyceridemia, but it is not indicated where hypertriglyceridemia is the abnormality of most concern; this drug has also been shown to delay the progression and increase the rate of regression of coronary atherosclerosis
-For the relief of pruritus associated with partial biliary obstruction

Usual Pediatric Dose for Hyperlipoproteinemia:

240 mg/kg/day orally in 2 to 3 divided doses not to exceed 8 g/day with dose titration based on response and tolerance

Comments:
-An optimal dosage schedule has not been established in pediatric patients.
-Dosage expressed in terms of anhydrous resin.
-The effects of long-term administration as well as this drug's effect in maintaining lowered cholesterol levels in pediatric patients are unknown.

Use: As adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia (elevated low density lipoprotein [LDL] cholesterol) who do not respond adequately to diet; may be useful to lower LDL cholesterol in patients who also have hypertriglyceridemia, but it is not indicated where hypertriglyceridemia is the abnormality of most concern

What other drugs will affect cholestyramine?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • birth control pills or hormone replacement therapy;

  • digoxin (digitalis);

  • a diuretic or "water pill";

  • penicillin G;

  • phenobarbital;

  • phenylbutazone;

  • propranolol;

  • spironolactone;

  • tetracycline;

  • thyroid medication such as levothyroxine (Synthroid and others); or

  • warfarin (Coumadin, Jantoven).

This list is not complete. Other drugs may interact with cholestyramine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about cholestyramine.
  • 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.
  • Disclaimer: 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 1996-2012 Cerner Multum, Inc. Version: 5.01.

Date modified: November 15, 2017
Last reviewed: March 10, 2017

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