Cholestyramine
Mechanism :
Cholestyramine is the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin adsorbs and combines with the bile acids in the intestine to form an insoluble complex which is excreted in the faeces. This results in a partial removal of bile acids from the enterohepatic circulation by preventing their absorption.
Indication :
- Biliary atresia
- Biliary obstruction
- Familial hypercholesterolemia
- Ileal resection
- Crohn’s disease
- Vagotomy
- Diabetic vagal neuropathy
- Radiation induced diarrhea
Contraindications :
Cholestyramine is contraindicated in patients with complete biliary obstruction where bile is not secreted into the intestine and in those individuals, who have shown hypersensitivity to any of its components.
Dosing :
Oral. 240 mg/kg/day in 8-12 hourly divided doses.
Maximum: 8 g/day.
Adverse Effect :
Cholestyramine impairs the absorption of vitamins A, D, E and K. Hyperchloremic acidosis, heartburn, flatulence, nausea, vomiting, diarrhea.
Interaction :
Digoxin, tetracycline, chlorothiazide, warfarin, levothyroxine, fat-soluble vitamins (A.D.E and K) and mycophenolate mofetil: cholestyramine may delay or reduce absorption.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
20-50 | Dose as in normal renal function |
10-20 | Dose as in normal renal function |
<10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
CAPD | Not dialysed. Dose as in normal renal function |
HD | Not dialysed. Dose as in normal renal function |
HDF/High flux | Not dialysed. Dose as in normal renal function |
CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.