Drug Index

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)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.
08/04/2022 14:45:55 Cholestyramine
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