Dosing & Uses
Dosage Forms & Strengths
powder for oral suspension
- 4g resin/5g powder
- 4g resin/5.5g powder
- 4g resin/5.7g powder
- 4g resin/6.4g powder
- 4g resin/9g powder
4 g PO q12-24hr; not to exceed 24 g/day (4 g q4hr)
Overdose: Symptoms include gastrointestinal (GI) obstruction; treatment is supportive
Renal impairment: Supplemental doses not necessary with peritoneal dialysis (PD) or hemodialysis (HD)
Always mix with fluids or food
Take before or with meals
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Duodenal ulcer bleeding
Malabsorption of fat-soluble vitamins
Nausea and vomiting
Weight gain or loss
Hypersensitivity to bile-sequestering resins
Complete biliary obstruction
Use with caution in renal impairment
Concomitant spironolactone therapy
Secondary causes of hyperlipidemia must be ruled out before therapy is initiated
Not to be used as monotherapy in hypertriglyceridemia
With prolonged use, increased risk of bleeding because of hypoprothrombinemia from vitamin K deficiency
May interfere with fat absorption and decrease absorption of fat-soluble vitamins (A, D, E, K)
May exacerbate preexisting constipation (initiate therapy at lower dosage in patients with history of constipation)
Special care must be taken to avoid constipation in patients with symptomatic coronary heart disease
Always mix with water or fluids; never ingest dry powder
Some formulations contain phenylalanine
Because of large quantities of chloride ion released from resin (which may lead to hyperchloremic acidosis and increase urinary calcium excretion on prolonged use), it may be advisable to reduce chloride intake
Take other drugs at least 1 hour before or 4-6 hours after taking cholestyramine to minimize possible interference with absorption
Pregnancy & Lactation
Pregnancy category: C
Lactation: Drug does not enter breast milk; use with caution because of potential vitamin loss in mother
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Forms complex with bile acids that is not absorbed through intestine; inhibits enterohepatic reuptake of intestinal bile salts, and this, in turn, increases fecal loss of bile salt-bound LDL and consequently reduces serum cholesterol in patients with primary hypercholesterolemia
Peak effect: 21 days
Excretion: Feces (insoluble complex with bile acids)
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.