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Cholestyramine is a drug to lower high cholesterol levels in the blood. This medicine can also be used to overcome itching and diarrhea due to accumulation of bile in the skin or intestines. Cholestyramine can only be used with a doctor's prescription.

Cholestyramine works by binding bile in the intestine so that it cannot be absorbed by the intestine. Because bile is made of cholesterol, the removal of cholesterol from food will increase and its absorption into the blood will decrease.

Reduced absorption of bile in the intestine will trigger the liver to take more cholesterol from the blood to form new bile. In this way, blood cholesterol levels decrease. This will reduce the risk of complications from high cholesterol , such as coronary heart disease.

It should be remembered that cholestyramine does not cure high cholesterol, but only helps control it. Therefore, it is important to maintain a regular exercise routine and consume balanced nutritious food during treatment with this drug.

Brand name of cholestyramine: Sequest

What is Cholestyramine

Group Bile acid binder ( bile acid sequestrant )
Category Prescription drugs
Benefits Helps lower cholesterol levels and overcome the itch of bile duct blockage
Consumed by Adults and children
Cholestyramine for pregnant and lactating women Category C: Studies on experimental animals show side effects on the fetus, but there are no controlled studies on pregnant women.

Medicines can only be used if the magnitude of the expected benefit exceeds the magnitude of the risk to the fetus.

Cholestyramine is not absorbed into breast milk. However, if you are breastfeeding, consult your doctor first before consuming this medicine, because cholestyramine can interfere with the absorption of some vitamins.

Drug form Powder

Warnings Before Consuming Cholestyramine

Cholestyramine can only be used according to a doctor's prescription. Before consuming cholestyramine, you need to pay attention to the following things:

  • Do not consume cholestyramine if you have an allergy to this drug. Tell your doctor about any allergies you have.
  • Tell your doctor if you suffer from blocked bile ducts or gallstones . Cholestyramine may not be effective when used in such conditions.
  • Do not consume cholestyramine if you suffer from intestinal or gastric obstruction .
  • Tell your doctor if you have prolonged constipation , hypothyroidism , diabetes, kidney disease, liver disease, coronary heart disease, blood clotting disorders, gallstones, hemorrhoids , or stomach ulcers .
  • Tell your doctor if you have ever experienced vitamin A, D, E, or K deficiency.
  • Inform the doctor of all medications you are taking, including cholestyramine, if you are scheduled to undergo surgery.
  • Tell your doctor if you are taking any medication, including supplements and herbal products, to anticipate drug interactions.
  • Tell your doctor if you are pregnant, breastfeeding, or planning to become pregnant.
  • Immediately see a doctor if an allergic reaction or overdose occurs after consuming cholestyramine.

Dosage and Administration of Cholestyramine

The following is the dose of cholestyramine based on the condition to be overcome and the patient's age:

Conditions: High cholesterol ( hyperlipidemia ), diarrhea due to bile acids, and coronary heart disease

  • Adults: Initial dose 4 grams per day. The dose can be increased by 4 grams per week to 12–24 grams per day, which is divided into 1–4 consumption times. The dose can be adjusted based on the patient's condition and response to treatment. The maximum dose is 36 grams per day.
  • Children aged 6–12 years: 240 mg/kgBB per day, which is divided into 2–3 consumption times. The maximum dose is 8 grams per day.

Condition: Itching (pruritus) in jaundice

  • Adults: 4–8 grams per day.
  • Children aged 6–12 years: 240 mg/kgBB per day, which is divided into 2–3 consumption times. The maximum dose is 8 grams per day.

How to Consume Cholestyramine Correctly

Always follow the doctor 's advice and read the information on the medicine package before consuming cholestyramine.

Consume cholestyramine according to the prescribed dose and check yourself with a doctor regularly while taking this drug. You may be asked to undergo routine blood tests. The purpose is for the doctor to be able to determine whether this medicine is effective and whether or not the consumption of the medicine should be continued.

Cholestyramine should not be consumed in dry form. This medicine should be dissolved in drinks, such as water, fat-free milk (skimmed milk), and juice. Can also be dissolved into food, such as soup.

Dissolve 1 sachet of cholestyramine with 150 ml of water. Leave the mixture of water and medicinal powder for 1-2 minutes before stirring until smooth. Once dissolved, immediately consume the food or drink until it runs out in order to get the correct and appropriate dose.

Immediately swallow the cholestyramine solution and do not gargle or keep the medicine liquid in the mouth for too long, because this medicine can damage the enamel layer of the teeth. Always brush your teeth and gargle with water after consuming this medicine.

If you are taking other medicines, take them 4-6 hours after or 1 hour before taking cholestyramine.

If you forget to take cholestyramine, immediately use this medicine if it is not close to the next schedule. If it is close, ignore the missed dose and do not double the next dose.

Cholestyramine can affect the absorption of some vitamins. Therefore, the doctor may prescribe vitamin supplements for you. To prevent constipation, you are advised to drink more water.

In order for the treatment to be more effective, you must also practice a healthy lifestyle, such as exercising regularly, consuming balanced nutritious food, reducing foods high in cholesterol , and maintaining an ideal body weight.

Store cholestyramine at room temperature, not in the refrigerator. Keep cholestyramine out of the reach of children, heat, and exposure to direct sunlight. Dispose of leftover cholestyramine if not used or if it has expired.

Cholestyramine Interactions with Other Drugs

Some interaction effects that can occur if cholestyramine is used together with other drugs are:

  • Slows the absorption and effectiveness of paracetamol , folic acid, thiazide diuretics , propanolol, loperamide , digoxin, barbiturates , estrogen, progesterone, thyroid hormones, warfarin , iron, deferasirox, tetracycline , or penicillin G
  • Inhibits the absorption of fat-soluble vitamins, namely vitamin A, vitamin D, vitamin E, and vitamin K
  • Interferes with the absorption of phosphate supplements taken by mouth

Side Effects and Dangers of Cholestyramine

Side effects that may appear after consuming cholestyramine include:

  • Constipation
  • Diarrhea
  • Stomachache
  • Nausea
  • Loss of appetite
  • Flatulence
  • Often pass gas
  • Pain or soreness of the tongue
  • Pain or itching in the anal area

Check yourself with a doctor if the side effects do not improve or even get worse. See a doctor immediately if you experience more serious side effects, such as:

  • Constipation worsens or continues
  • Severe stomach pain
  • Bloody urine ( hematuria )
  • Bloody or pitch-black stools
  • Unusual bruising or bleeding
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