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Colestyramin
Active substance: colestyramine
Indications: primary hypercholesterolaemia (elevated LDL levels), prevention of atherosclerosis and its complications (including in coronary heart disease and myocardial infarction), pruritus in partial biliary obstruction; as an adjunctive measure in patients on a special diet intended to reduce elevated serum cholesterol concentrations
Strengths: 4 g
Shelf life: long
Pack: 50, 100 tab.
Synonyms available to order: Questran, Cholestyramine
Instructions for use: Colestyramin
Brief reference information compiled from official German sources (Gelbe Liste, Fachinfo, Apotheken Umschau). It does not replace a doctor’s consultation or the package insert. This is a prescription medicine — use it only as directed by a doctor.
Active substance
Colestyramine (Colestyramin) — an anion-exchange resin and bile acid sequestrant: it binds bile acids in the intestine and removes them from the body (ATC C10AC01)
Available forms
- Powder for oral suspension, sachets (Dosierbeutel) of 4 g of colestyramine each — Colestyramin-ratiopharm, Colestyramin-1A Pharma and other German generics; also Quantalan/Questran (including sugar-free), Vasosan, and Lipocol Merz chewable tablets
Indications
- Primary hypercholesterolaemia — lowering elevated total and LDL cholesterol in addition to diet: in combination with a statin when a statin alone is insufficient, or as monotherapy when statins are not tolerated or not possible
- Skin itching and jaundice in partial obstruction of the bile ducts (cholestasis)
- Bile acid diarrhoea — diarrhoea caused by bile acids (including after resection of the ileum)
How to take
The dose and duration are determined by the doctor on an individual basis. For adults the usual dose is 4–16 g of colestyramine per day: as a rule 1 sachet (4 g) 1–3 times a day with meals; treatment begins with a low dose and is increased gradually, up to a maximum — under the doctor’s supervision — of 6 sachets (24 g) per day. For itching/jaundice due to partial obstruction of the bile ducts, 4–8 g per day is usually sufficient. Do not swallow the powder dry: stir it into a glass of water, tea or juice, let it swell and drink it. IMPORTANT: colestyramine reduces the absorption of other medicines — take any other medicines at least 1 hour BEFORE or 4 hours AFTER colestyramine.
Contraindications
- Hypersensitivity to colestyramine or the medicine’s components
- Complete obstruction of the bile ducts (complete blockage of the bile ducts)
- Intestinal obstruction (ileus)
- With caution (as assessed by a doctor): swallowing disorders, inflammatory bowel disease, a tendency to constipation
- Contains sucrose/glucose/lactose — take this into account in cases of sugar intolerance and diabetes (depends on the manufacturer)
Possible side effects
- Constipation — the most common adverse reaction
- Bloating, flatulence, a feeling of fullness
- Nausea, vomiting, heartburn
- Diarrhoea
- Abdominal pain/discomfort
- With prolonged use of high doses — deficiency of fat-soluble vitamins (A, D, E, K) and folic acid
Special precautions
Prescription medicine (verschreibungspflichtig in Germany). With prolonged use the absorption of the fat-soluble vitamins A, D, E and K is impaired — the doctor may prescribe monitoring and additional intake of them. The interval from other medicines (1 hour before / 4 hours after) is mandatory, especially for medicines with a narrow therapeutic window (warfarin, digoxin, thyroid hormones, etc.). Treatment is carried out alongside a low-cholesterol diet.
Sources: www.gelbe-liste.de, www.gelbe-liste.de, www.apotheken-umschau.de, www.apotheken-umschau.de
