OralPruritus associated with partial biliary obstruction or primary biliary cirrhosisAdult: 4-8 g daily.
Child: 6-12 yr 240 mg/kg daily in 2-3 divided doses or calculated as percentage of the adult (70 kg) dose. Max: 8 g daily.
OralBile acid-induced diarrhoea, Hyperlipidaemias, Ischaemic heart diseaseAdult: Initially, 4 g daily increased by 4 g at wkly intervals to 12-24 g daily in 1-4 divided doses, then adjusted as required. Max: 36 g daily.
Child: 6-12 yr 240 mg/kg daily in 2-3 divided doses or calculated as percentage of the adult (70 kg) dose. Max: 8 g daily.
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May be taken with or without food. Do not take in the dry form. Mix w/ 150 mL of water or fruit juice, stir to a uniform consistency before taking.
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Mix the powder w/ 60-180 mL of water or another noncarbonated beverage (e.g. fruit juice) and stir to a uniform consistency. Alternatively, it may also be mixed w/ skimmed milk, thin soup or a pulpy fruit w/ high moisture content (e.g. applesauce or crushed pineapple).
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Complete biliary obstruction.
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Patient w/ GI dysfunction (e.g. constipation); susceptible to fat-soluble vit deficiencies. Pregnancy and lactation.
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Constipation, faecal impaction, aggravation of haemorrhoids, abdominal discomfort or pain, heartburn, flatulence, nausea, vomiting, diarrhoea; increased bleeding tendency (chronic use), steatorrhoea (high doses), skin rashes, pruritus of the tongue, skin and perianal region; hyperchloraemic acidosis. Rarely, night blindness secondary vit A deficiency, vit D deficiency.
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Maintain good oral hygiene.
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Determine serum cholesterol and triglyceride concentrations prior to and regularly during therapy. Periodically monitor serum lipoprotein concentrations and serum electrolytes.
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Symptoms: GI obstruction. Management: Dependent on the degree and location of obstruction and GI motility. Consult experts for specific recommendations.
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Delayed or reduced absorption of folic acid, thiazide diuretics, propranolol, digoxin and related glycosides, loperamide, phenylbutazone, barbiturates, oestrogens, progestogens, thyroid hormones, warfarin and other coumarin-derivative anticoagulants, iron salts, deferasirox and some antibacterials (e.g. tetracycline, penicillin G). May prevent absorption of fat-soluble vit. Slightly decreased rate of absorption of clofibrate. May interfere w/ absorption of oral phosphate supplements.
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Description: Colestyramine releases Cl ions and binds w/ bile acids in the intestine to form a nonabsorbable complex which is excreted in the faeces, resulting in partial removal of bile acids from the enterohepatic circulation, thereby increasing the bile salt-bound LDL cholesterol.
Pharmacokinetics:
Absorption: Not absorbed from the GI tract.
Excretion: Via faeces as insoluble complex w/ bile acids.
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Anon. Colestyramine Resin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/10/2014. Buckingham R (ed). Colestyramine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/10/2014. Joint Formulary Committee. Colestyramine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/10/2014. McEvoy GK, Snow EK, Miller J et al (eds). Cholestyramine Resin. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 01/10/2014.
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