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Uses

What is cholestyramine used for?

Cholestyramine is commonly used to lower bad cholesterol (LDL-C) in people with high cholesterol.

Cholestyramine is also used to relieve itching caused by a bile duct blockage (partial biliary obstruction).

Cholestyramine may also be used for other conditions as determined by your healthcare provider.

How does cholestyramine work (mechanism of action)?

Cholestyramine works by increasing bile acid removal from your body. Bile acid is a liquid substance your liver produces that helps with food digestion. Because bile acid is made from cholesterol, removing bile acid also decreases cholesterol levels in your body. 

How is cholestyramine supplied (dosage forms)?

Brands and other names

  • LoCholest
  • LoCholest Light
  • Prevalite

Dosage forms and strengths

  • 4 g/packet or pouch of powder for oral suspension
  • 4 g/scoopful of powder for oral suspension

How should I store cholestyramine?

Cholestyramine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of cholestyramine?

The most common side effect of cholestyramine is constipation (see below). 

There may be other side effects of cholestyramine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada or by calling 866-234-2345.

What are the serious side effects of cholestyramine?

While less common, the most serious side effects of cholestyramine are described below, along with what to do if they happen.

Severe Allergic Reactions. Cholestyramine may cause allergic reactions, which can be serious. Stop using cholestyramine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Severe Constipation. Some people taking cholestyramine have had severe constipation. Severe constipation can also worsen hemorrhoids. Some needed to go to the hospital. Being over 60 years old and taking higher doses of cholestyramine increase your risk of constipation. To decrease this risk, be sure you are getting enough fluids and fiber. Stop taking cholestyramine and get help right away if you have severe constipation.

Abnormal Bleeding. People taking cholestyramine may have an increased risk of bleeding or bruising. Bleeding from hemorrhoids and known ulcers have been reported in people taking cholestyramine. You may be at higher risk if you are also taking aspirin, a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen, or a blood thinner such as warfarin (Coumadin, Jantoven), apixaban (Eliquis), or rivaroxaban (Xarelto). Tell your healthcare provider if you notice any changes in how easily you bruise or bleed.

Warnings & Precautions

Who should not use cholestyramine?

Allergies to Ingredients. People who are allergic to any of the following should not take cholestyramine.

  • LoCholest and LoCholest Light
  • Prevalite
  • Cholestyramine
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific cholestyramine products they stock.

Bile Duct Blockage. Do not take cholestyramine if you have a complete biliary obstruction. 

What should I know about cholestyramine before using it?

Do not take cholestyramine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share cholestyramine with other people, even if they have the same condition as you. It may harm them.

Keep cholestyramine out of the reach of children.

Cholestyramine powder should not be taken as a dry powder. Always mix dry powder with water or other fluids before consuming as directed. Use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

Sipping or holding the cholestyramine suspension for prolonged periods may cause side effects, such as teeth discoloration and enamel decay.

Taking cholestyramine with meals is recommended if possible. 

What should I tell my healthcare provider before using cholestyramine?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if cholestyramine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Other Medicines and Supplements. Cholestyramine may interact with other medicines and supplements. Before using cholestyramine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how cholestyramine could affect pregnancy or harm an unborn baby. However, cholestyramine may interfere with the absorption of certain vitamins, and prenatal vitamin absorption may be affected. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if cholestyramine passes into breast milk. However, it may affect vitamin absorption in the infant. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take cholestyramine while you are breastfeeding. 

Interactions

Does cholestyramine interact with foods or drinks?

There are no known interactions between cholestyramine and foods or drinks.

It is unknown if drinking alcohol will affect cholestyramine. Both cholestyramine and alcohol can increase your risk of bleeding. Alcohol consumption can also affect your cholesterol levels. It is best to limit the amount of alcohol you drink.

Does cholestyramine interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking cholestyramine.

  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Propranolol (Inderal and others) which a medicine commonly used for blood pressure
  • A tetracycline, which is a medicine commonly used for infections
  • Penicillin G (Bicillin LA), which a medicine commonly used for infections
  • A thyroid or thyroxine product, which is a medicine used for hypothyroidism
  • An estrogen or progestin, which is commonly used as a birth control
  • A blood thinner, such as warfarin (Coumadin), which is a medicine used to treat or prevent blood clots
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Phenobarbital, which is a medicine used for seizures
  • Phosphate containing supplements
  • Vitamins A, D, E, and K

You should take other drugs at least 1 hour before or 4 to 5 hours after you take cholestyramine. This will decrease your risk of drug interactions.

Cholestyramine may affect the absorption of some other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much cholestyramine?

If you or someone else has used too much cholestyramine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of cholestyramine?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.