Sequest Dosage/Direction for Use

Cholestyramine should not to be taken in its dry form. Always mix with water or other fluids before ingesting.
Place the content of one sachet in a glass and add least 60-180 mL of water or the beverage of your choice. Stir to a uniform consistency. Since Cholestyramine may bind other drugs given currently, patients should take other drugs at least one hour before or 4-6 hours after Cholestyramine to avoid impending their absorption.
Adult: To reduce cholesterol levels and incidence of heart attack: begin with one sachet (equivalent to 4 grams of anhydrous Cholestyramine resin) in 60-180 mL of fluid in the morning and in the evening. After 2-4 weeks, increase dose to 8 grams of Cholestyramine resin in 120-360 mL water in the morning and in the evening. If necessary, increase medication to the maximum 24 grams of Cholestyramine resin for cholesterol reduction. The suggested time of administration is mealtime, but this may be modified to avoid interference with absorption of other medications. Although the recommended dosing schedule is twice daily, Cholestyramine may be administered in 1-6 doses per day. If dose increases are necessary, they should be done gradually, and with periodic assessment of lipid/lipoprotein levels. Doses of more than 24 grams a day of Cholestyramine resin may interfere with normal fat absorption.
Concomitant therapy: The cholesterol-lowering effect of Cholestyramine on Total and LDL-Cholesterol is enhanced when it is combined with an HMG-CoA reductase inhibitor (e.g. Pravastatin, Simvastatin, Lovastatin). Enhanced lowering of LDL-cholesterol is also seen with combined Nicotinic Acid/Cholestyramine therapy.
To relieve pruritus due to partial biliary obstruction and primary biliary cirrhosis: 4-8 grams of Cholestyramine resin daily.
Children 6-12 years: To reduce cholesterol levels or to relieve pruritus: (see equation)


Click on icon to see table/diagram/image


Further adjustment may be required depend on the patient condition. Dosage for children below 6 years has not been established. To minimize potential gastrointestinal side effects, it is desirable to begin all therapy in children with one dose of Cholestyramine daily. The dosage is then increased gradually, every 5-7 days to desired level for effective control.
Note: In all patients presenting with a diarrhea induced by bile acid malabsorption, a response should be seen within days, if this is not the case, alternate therapy should be initiated. To relieve diarrhea induced by the bile-acid malabsorption: The initial dosage of Cholestyramine should be 4 grams Cholestyramine resin 3 times a day, with subsequent adjustment as needed.