Cholestyramine is an oral bile acid sequestrant and cholesterol lowering medication supplied as a powder for suspension. Each sachet provides 4g of cholestyramine resin, and Health Canada currently lists multiple 4g/sachet cholestyramine products as marketed prescription medications in Canada. Unlike statins, which reduce cholesterol synthesis within the liver, cholestyramine works locally inside the gastrointestinal tract and is not absorbed systemically. The resin binds negatively charged bile acids within the intestine, forming an insoluble complex that is subsequently eliminated through the stool.
Bile acids are produced in the liver from cholesterol and are normally recycled back into circulation through the enterohepatic system. By preventing part of this bile acid reabsorption, cholestyramine increases the amount of bile acids eliminated from the body. The liver responds by converting additional cholesterol into new bile acids, contributing to a reduction in circulating LDL cholesterol and total cholesterol. Cholestyramine is indicated as an adjunct to diet for patients with primary hypercholesterolemia and elevated LDL cholesterol when dietary measures alone have not provided adequate control. It may also lower LDL cholesterol in patients who have elevated triglycerides, although it is not intended primarily for conditions where high triglycerides are the principal lipid abnormality.
Because cholestyramine binds bile acids within the intestinal tract, it also has applications outside cholesterol management. In patients with certain forms of partial biliary obstruction, reducing circulating bile acids can help relieve itching associated with excess bile acid accumulation in the skin. Cholestyramine is also used clinically in some patients with bile acid diarrhea or bile acid malabsorption, where excessive bile acids entering the colon can contribute to chronic watery diarrhea. This application may be off label depending on the jurisdiction and individual product indication.
This product provides:
- Active Ingredient: Cholestyramine Resin
- Strength: 4g per sachet
- Quantity: 30 Sachets
- Drug Class: Bile Acid Sequestrant
- Dosage Form: Powder for Oral Suspension
- Common Uses: LDL cholesterol reduction and certain bile acid related conditions
Health Canada lists cholestyramine resin 4g per sachet as a prescription powder for oral suspension, with several marketed Canadian products available in this strength.
An important consideration with cholestyramine is its ability to bind other medications in the gastrointestinal tract, potentially reducing their absorption. Current prescribing information recommends that other medications generally be taken at least one hour before or four to six hours after cholestyramine, or with as much separation as practical. Long term cholestyramine use may also interfere with the absorption of fat soluble vitamins A, D, E and K because bile acids are important for normal fat digestion and vitamin absorption. Appropriate monitoring or supplementation may therefore be considered during prolonged treatment.
The most commonly reported adverse effect is constipation. Other gastrointestinal effects can include abdominal discomfort, bloating, gas, nausea and changes in bowel habits. Cholestyramine powder should be prepared as an oral suspension according to the specific product instructions rather than consumed as dry powder.
Cholestyramine is a prescription medication and should be used according to the directions and monitoring recommendations of a qualified healthcare professional.
