The main active ingredient in this high cholesterol medication, Colestyramine, is an anion exchange resin, derived from a copolymer of styrene and divinylbenzene. Colestyramine works by forming non-absorbable ionic complexes with bile acids, which are excreted with feces. With this, a part of the bile acids produced in the liver is eliminated, which is why a compensatory biochemical process takes place, at the expense of circulating cholesterol in the blood. In this way, it reduces markedly the cholesterol levels (15 - 30%), as well as those of LDL. On the contrary, it does not affect or may even increase triglyceride levels. The effects on HDL are minimal.
Always use this medicine exactly as your doctor or pharmacist has told you. If in doubt, consult your doctor or pharmacist again.
This medicine is administered orally. The prescribed dose of medication should be added to half a glass of water, milk, or fruit juice, and taken orally before meals. It should be shaken before administration. colestyramine should never be taken as a dry powder, due to the danger of causing a spasm in the esophagus and choking or acute respiratory failure.
The recommended dose in adults is one sachet (4 g of colestyramine) 3-4 times a day (equivalent to 12-16 g of colestyramine a day).
Use in children and adolescents: The recommended dose is half an envelope (2 g of colestyramine) between 2 and 4 times a day (equivalent to 4-8 g of colestyramine per day), although it is preferable to administer the total daily dose in only 2 doses, before breakfast and dinner
Like all medicines, this high cholesterol med can cause side effects, although not everybody gets them.
To lessen these effects, you will start taking colestiramina with a low dose that will be gradually increased. These side effects usually disappear over time.
Gastrointestinal adverse reactions are the most frequent. The most frequently observed adverse reaction is constipation. Constipation can favor the appearance of fecaloma (hardened stools) and can aggravate the symptoms of pre-existing hemorrhoids.
Adverse effects may occur at certain frequencies, which are defined as follows:
Common (may affect up to 1 in 10 people)
- Constipation
- Indigestion
- Flatulence
- Sickness
- Vomiting
Uncommon (may affect up to 1 in 100 people)
- Decreased appetite
- Heartburn
- Abdominal pain
- Diarrhea
- Itching of the tongue
- Anal itching
- At high doses, it can cause the appearance of fat in the stool (steatorrhea)
Rare (may affect up to 1 in 1,000 people)
- Fecaloma (hardened stool)
Frequency not known (frequency cannot be estimated from the available data)
- Hypoprothrombinemia (decreased prothrombin, a substance necessary for blood clotting)
- Hyperchloremic acidosis (increased acid in body fluids)
- Osteoporosis (secondary to decreased absorption of calcium and vitamin D)
- Hemorrhage (the chronic use of Resincolestiramina can be associated with a greater tendency to the appearance of hemorrhages due to hypoprothrombinemia secondary to decreased absorption of vitamin K)
- Hemorrhoids
- Erythema (skin rash)
Warnings and precautions
Talk to your doctor or pharmacist before taking Questran (Colestyramine).
Resincolestyramine should never be taken as a dry powder, due to the danger of causing a spasm in the esophagus and choking or acute respiratory failure.
During treatment with this medication, blood triglycerides do not decrease or may even increase, usually transiently.
While you are taking this medicine, your doctor may order you to take a supplement of vitamins A, D, E, and K or folic acid. Carefully follow your doctor's instructions.
This medicine can cause constipation or make it worse if you have it. Carefully follow your doctor's instructions if you have hemorrhoids or if you have heart disease since in these cases you should adjust or decrease the dose of the medicine and increase your intake of fluids and dietary fiber.
If you have or have previously had a stomach ulcer, you should take this medicine with caution, as you could have a relapse.
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