Questran

Introduction

Written by Patricia Weiser, PharmD
Medically reviewed by Elizabeth Scheffel, PharmD
Updated on August 24, 2023

Cholestyramine (koe LES teer a meen) is a generic medication prescribed for lowering cholesterol. It’s also prescribed for itching related to a partial bile duct blockage. Cholestyramine belongs to a group of drugs called bile acid sequestrants.

This article doesn’t provide coupons for all forms of cholestyramine. To find coupons for cholestyramine light, see this article.

Common questions about cholestyramine

Below you’ll find answers to a few commonly asked questions about cholestyramine.

Can cholestyramine be used for diarrhea or IBS?

Possibly. While uncommon, problems with absorbing bile may cause diarrhea. In these cases, doctors may prescribe cholestyramine off-label for diarrhea. (With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for).

With irritable bowel syndrome (IBS), you have diarrhea or constipation that keeps coming back. The American College of Gastroenterology provides treatment guidelines for IBS. In these guidelines, cholestyramine is not a recommended treatment for IBS-related diarrhea unless the doctor determines your diarrhea is caused by problems with absorbing bile. (Determining this requires testing, such as scans, stool tests, and blood tests.) This is because cholestyramine isn’t known to be effective for other causes of diarrhea.

If you have questions about treatment options for diarrhea or IBS, talk with your doctor.

Are there foods I need to avoid while taking cholestyramine?

No, cholestyramine doesn’t interact with specific foods. You can take it with a meal. You can also take it at a different time of day to avoid drug interactions. (Take other medications at least 1 hour before or 4 hours after you take cholestyramine. This drug can interfere with the absorption of other medications.)

If you’d like to know more about cholestyramine and food, talk with your doctor or pharmacist.

What brand names are available for cholestyramine?

Cholestyramine is available as a few different brand-name drugs, including:

• Locholest
• Locholest Light
• Prevalite

Questran, the original brand name of cholestyramine, is no longer available.

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less compared to brand-name drugs.

If you’d like to know more about brand-name and generic drugs, talk with your doctor or pharmacist.

Is cholestyramine available as an oral tablet?

No. In the past, cholestyramine was available as an oral tablet and a chewable bar. However, these forms were discontinued.

Now, cholestyramine only comes as a powder you mix into a drink or soft food and swallow. The powder comes in jars or packets.

How does cholestyramine work? And how long does it take to start working?

Cholestyramine is used to lower cholesterol. The liver converts cholesterol into bile acid. Bile acid is important for digesting food in the intestines.

Typically, the intestines absorb bile acids and return them to the liver for recycling. Cholestyramine works by binding to bile acids, which blocks the intestine from absorbing them. Bile acids are removed as waste, with less available for the body to recycle. Your liver then converts more cholesterol into a new supply of bile acids. This results in lower levels of cholesterol in your body.

Cholestyramine starts working right away. To check how well the drug is lowering cholesterol, your doctor will order a blood test after 4–6 weeks of treatment. This blood test is used to measure your cholesterol levels.

Cholestyramine is also used to treat itching related to bile duct blockage. It works by helping your body get rid of bile acids quicker than usual. For this use, the drug starts to work right away. But it may take a few days or weeks to experience itching relief.

If you’d like to know more about how cholestyramine works, talk with your doctor or pharmacist.

Side effects of cholestyramine

Cholestyramine may cause mild or serious side effects. More common mild side effects of cholestyramine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about cholestyramine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for cholestyramine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of cholestyramine are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about cholestyramine’s side effects based on the form, refer to the prescribing information for cholestyramine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Cholestyramine powder for oral suspension’s mild side effects include:

• constipation
• pain or discomfort in your abdomen
• flatulence (gas)
• nausea
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for cholestyramine” section.

Serious side effects

Serious side effects of cholestyramine are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about cholestyramine’s side effects based on the form, refer to the prescribing information for cholestyramine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, cholestyramine’s serious side effects include:

• decreased levels of vitamins A, D, E, or K, which may lead to bleeding or vision problems
• osteoporosis (weakened bones)
• severe constipation, which may lead to a blockage in your bowel
• too much acid in your blood
• severe allergic reaction *

* For details about this side effect, see the “Interactions and warnings for cholestyramine” section.

Uses of cholestyramine

The Food and Drug Administration (FDA) approves prescription drugs such as cholestyramine for certain conditions. Approved uses for cholestyramine are described below.

Use for lowering cholesterol

Doctors may prescribe cholestyramine powder for suspension to lower cholesterol in people with high cholesterol. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

High cholesterol doesn’t cause symptoms. But having high cholesterol raises the risk of serious heart and blood vessel problems, such as:

• coronary artery disease
• heart attack
• stroke

Doctors sometimes prescribe cholestyramine together with a statin drug such as simvastatin or pravastatin for lowering cholesterol.

Use for itching related to partial bile duct blockage

Doctors may prescribe cholestyramine powder for suspension for treating itching related to a partial bile duct blockage. It’s used for this purpose in adults. It’s usually prescribed as a short-term treatment.

Bile acids are important for digestion. Bile flows from the liver to the intestine. With bile duct blockage, the usual path of bile becomes partly blocked. Bile acid builds up in other tissues, including your skin, leading to itching.

Other symptoms of a bile duct blockage may include:

• abdominal pain
• vomiting
• jaundice (yellowing of the skin or eyes)

Doctors will not prescribe cholestyramine if a person has a complete bile duct blockage (when the path of bile is fully blocked) and no bile flows into the intestine.

Interactions and warnings for cholestyramine

Below, you’ll find information about cholestyramine’s possible interactions and warnings.

Interactions of cholestyramine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take cholestyramine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for cholestyramine” section below.

Warnings for cholestyramine

Some people should not take cholestyramine, and others should take it cautiously.

Cholestyramine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether cholestyramine is a safe option for you.

Ask your doctor about specific warnings for cholestyramine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Cholestyramine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to cholestyramine or any of its ingredients, your doctor will likely not prescribe cholestyramine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to cholestyramine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of cholestyramine

If you take cholestyramine by mouth, you should not take more cholestyramine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much cholestyramine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and cholestyramine

Information about cholestyramine and pregnancy and breastfeeding is described below.

Cholestyramine and pregnancy

It’s not known whether cholestyramine should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Cholestyramine and breastfeeding

There are risks to taking cholestyramine while breastfeeding. But there are also risks with having untreated high cholesterol during this time. (Keep in mind that cholestyramine is used for treating high cholesterol.)

For instance, cholestyramine can interfere with how well the body absorbs certain vitamins. This can occur in someone taking cholestyramine as well as their breastfed child. These vitamins are important for you and your child’s health.

If you’re planning to breastfeed, talk with your doctor about cholesterol-lowering treatment options. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take cholestyramine during this time. Your doctor may recommend other healthy ways to feed your child.

What to ask your doctor

Let your doctor know if you have questions about cholestyramine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• To help avoid drug interactions, what is the ideal schedule for taking my other medications during cholestyramine treatment?
• In addition to taking cholestyramine, can certain dietary changes help manage my condition?
• How long will I need to take cholestyramine?
• How do I prepare my dose of cholestyramine properly?

Resources

• Cholestyramine – cholestyramine powder, for suspension. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/d82647da-465b-4e2e-8cf8-72d50f047b3e/spl-doc
• Cholestyramine light – cholestyramine light powder, for suspension. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/31655681-125c-4eaa-959b-8f434bb43590/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Lacy BE, et al. (2021). ACG clinical guideline: Management of irritable bowel syndrome. https://journals.lww.com/ajg/fulltext/2021/01000/acg_clinical_guideline__management_of_irritable.11.aspx

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.