2025 Guidelines for the Evaluation and Management of Adults With Congenital Heart Disease
December 19, 2025
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Brand Name :
Synonyms :
cholestyramine
Class :
Bile Acid Sequestrants
Brand Name :
Synonyms :
cholestyramine
Class :
Bile Acid Sequestrants
Dosage Forms & Strengths
Adult
Packet
4 g
Powder for oral suspension
231 g
378 g
210 g
4 g orally every 1-2 times a day; progressively increase over more than 1-month intervals
Maintenance: 8-16 g daily Orally divided every 12 hours; should not exceed more than 24 g/day.
Overdose: Gastrointestinal obstruction is one of the symptoms; therapy is supportive.
Dosage Forms & Strengths
Powder for oral suspension
5 g
5.5 g
5.7 g
6.4 g
9 g
240 mg/kg daily orally divided every 8-12hours; generally, should not exceed more than 8g/day
Refer to the adult dosing regimen
they may diminish the serum concentration when combined with fluvastatin
they may diminish the serum concentration when combined with rosiglitazone
they may diminish the serum concentration when combined with valproic acid
they may diminish the serum concentration when combined with vitamin k antagonists
they may diminish the serum concentration when combined with vitamin k antagonists
they may diminish the serum concentration when combined with vitamin k antagonists
they may diminish the serum concentration when combined with vitamin k antagonists
they may diminish the serum concentration when combined with vitamin k antagonists
they may diminish the serum concentration when combined with mycophenolate
they may have an increasingly adverse effect when combined with spironolactone
It may diminish the effect when combined with cholic acid by drug binding in the gastrointestinal tract
It may diminish the effects when combined with vitamin D
Action and Spectrum:
Cholestyramine resin is a bile acid sequestrant that limits reabsorption in the gastrointestinal tract. It is a strong anion exchange resin that forms a matrix with anionic bile acids.
Frequency not defined
Belching
Flatulence
Gallstones
Heartburn
Malabsorption of fat-soluble vitamins
Nausea and vomiting
Pancreatitis
Dental erosion
Duodenal ulcer bleeding
Perianal irritation
Rectal pain
Steatorrhea
Black box warning:
None
Contraindications/caution:
Contraindications:
Hypersensitivity to bile-sequestering resins
Complete biliary obstruction
Cautions:
Renal impairment
Volume depletion
Concomitant spironolactone therapy
Pregnancy Warnings:
Pregnancy category: C
Lactation: Excretion of the drug into the human breast milk is unknown
Pregnancy categories:
Pharmacology: Cholestyramine binds to bile acids in the intestine to prevent reabsorption into circulation. Then liver convert more cholesterol to bile acids for cover the losses.
Pharmacodynamics: Cholestyramine resin binds with bile acids in the intestine to form an insoluble complex excreted in feces. All bile acids are absorbed in the intestinal tract and recycled into the liver.
Pharmacokinetic:
Absorption:
It is not absorbed from the gastrointestinal tract.
Excretion and elimination:
It is excreted through feces.
Administration:
It is available in packet and powder (suspension) form for oral use.
Patient information leaflet:
Generic Name: Cholestyramine
Why do we use Cholestyramine?
Cholestyramine is indicated in the treatment of hyperlipidemia.
It is also used to treat hypercholesterolemia and bile acid diarrhea.
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