Colestyramine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Bile acid-induced diarrhoea; Hyperlipidaemias; Ischaemic heart disease Initial: 4 g/day increased by 4 g at wkly intervals to 12-24 g/day in 1-4 divided doses. Max: 36 g/day. Pruritus associated w/ partial biliary obstruction or primary biliary cirrhosis 4-8 g/day.
Dosage Details
Oral
Pruritus associated with partial biliary obstruction or primary biliary cirrhosis
Adult: 4-8 g daily.
Child: 6-12 yr 240 mg/kg daily in 2-3 divided doses or calculated as percentage of the adult (70 kg) dose. Max: 8 g daily.

Oral
Bile acid-induced diarrhoea, Hyperlipidaemias, Ischaemic heart disease
Adult: Initially, 4 g daily increased by 4 g at wkly intervals to 12-24 g daily in 1-4 divided doses, then adjusted as required. Max: 36 g daily.
Child: 6-12 yr 240 mg/kg daily in 2-3 divided doses or calculated as percentage of the adult (70 kg) dose. Max: 8 g daily.
Administration
May be taken with or without food. Do not take in the dry form. Mix w/ 150 mL of water or fruit juice, stir to a uniform consistency before taking.
Reconstitution
Mix the powder w/ 60-180 mL of water or another noncarbonated beverage (e.g. fruit juice) and stir to a uniform consistency. Alternatively, it may also be mixed w/ skimmed milk, thin soup or a pulpy fruit w/ high moisture content (e.g. applesauce or crushed pineapple).
Contraindications
Complete biliary obstruction.
Special Precautions
Patient w/ GI dysfunction (e.g. constipation); susceptible to fat-soluble vit deficiencies. Pregnancy and lactation.
Adverse Reactions
Constipation, faecal impaction, aggravation of haemorrhoids, abdominal discomfort or pain, heartburn, flatulence, nausea, vomiting, diarrhoea; increased bleeding tendency (chronic use), steatorrhoea (high doses), skin rashes, pruritus of the tongue, skin and perianal region; hyperchloraemic acidosis. Rarely, night blindness secondary vit A deficiency, vit D deficiency.
Patient Counseling Information
Maintain good oral hygiene.
MonitoringParameters
Determine serum cholesterol and triglyceride concentrations prior to and regularly during therapy. Periodically monitor serum lipoprotein concentrations and serum electrolytes.
Overdosage
Symptoms: GI obstruction. Management: Dependent on the degree and location of obstruction and GI motility. Consult experts for specific recommendations.
Drug Interactions
Delayed or reduced absorption of folic acid, thiazide diuretics, propranolol, digoxin and related glycosides, loperamide, phenylbutazone, barbiturates, oestrogens, progestogens, thyroid hormones, warfarin and other coumarin-derivative anticoagulants, iron salts, deferasirox and some antibacterials (e.g. tetracycline, penicillin G). May prevent absorption of fat-soluble vit. Slightly decreased rate of absorption of clofibrate. May interfere w/ absorption of oral phosphate supplements.
Action
Description: Colestyramine releases Cl ions and binds w/ bile acids in the intestine to form a nonabsorbable complex which is excreted in the faeces, resulting in partial removal of bile acids from the enterohepatic circulation, thereby increasing the bile salt-bound LDL cholesterol.
Pharmacokinetics:
Absorption: Not absorbed from the GI tract.
Excretion: Via faeces as insoluble complex w/ bile acids.
Storage
Store between 20-25°C.
References
Anon. Colestyramine Resin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/10/2014.

Buckingham R (ed). Colestyramine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/10/2014.

Joint Formulary Committee. Colestyramine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/10/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Cholestyramine Resin. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 01/10/2014.

Disclaimer: This information is independently developed by MIMS based on Colestyramine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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