cholestyramine, Questran, Questran Light (cont.)

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PREPARATIONS: Powder (Resin): 4 grams (Packet or Scoopful)

STORAGE: Cholestyramine should be stored at room temperature, 15-30 C (59-86 F)

PRESCRIBED FOR: Cholestyramine is used for reducing cholesterol levels in the blood, to relieve the itching of liver and biliary disease, and to treat overdoses of digoxin (Lanoxin), or thyroid hormone. Cholestyramine also is recommended for the rapid elimination of leflunomide (Arava).

DOSING: The usual dose for reducing cholesterol is 4 to 8 grams once or twice a day. The maximum dose is 24 grams per day. Powder should be mixed with 60 to 180 ml (2 to 6 fl oz) of water, noncarbonated beverage, pulpy fruits or soup.

 DRUG INTERACTIONS: Cholestyramine decreases the absorption of warfarin (Coumadin), thyroid hormones (levothyroxine sodium [Synthroid, Levoxyl, Liotrix], digoxin (Lanoxin), and thiazide diuretics (Hydrodiuril, Oretic, Dyazide, Maxide). Therefore, these drugs should be administered 1 hour before or 4-6 hours after the administration of cholestyramine. Cholestyramine decreases the conversion of leflunomide (Arava) to its active form and reduces the absorption of vitamin A, D, E and K.

PREGNANCY: Use of cholestyramine in pregnant women has not been adequately evaluated. Since cholestyramine is not absorbed into the bloodstream, the risk of adverse effects on the fetus probably is low.

NURSING MOTHERS: Cholestyramine decreases the intestinal absorption of vitamins A, D, E and K by the mother. This could lead to a decrease in the concentration of these vitamins in the mother's milk and potentially cause vitamin deficiency in the infant.

SIDE EFFECTS: The most common side effects of cholestyramine are constipation, abdominal pain, bloating, vomiting, diarrhea, belching, gallstones, weight loss, and excessive passage of gas (flatulence).

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