Mix the powder from each sachet with at least 150 ml of liquid. You can mix it with water, skimmed milk, thin soup, fruit juice or puréed fruit.
Avoid taking any other medicines at the same time as colestyramine. Either take your other medicines one hour before colestyramine, or wait until 4-6 hours afterwards.
The most common side-effect is constipation.
|Type of medicine||A bile acid sequestrant (binder)|
|Used for||Lowering cholesterol; itching caused by damage to the bile ducts; diarrhoea|
|Also called||Cholestyramine (in US); Questran®; Questran® Light|
|Available as||Sachets of powder|
Colestyramine is a powder which works in the body as a bile acid sequestrant. This means that it binds to bile acids in your digestive system. It prevents bile acids from being reabsorbed (recycled) into your body, and this action can be useful in a number of different conditions.
You may be prescribed colestyramine sachets to help lower the amount of cholesterol in your blood, or to reduce itching caused by a problem in your bile ducts (such as primary biliary cirrhosis), or to help reduce diarrhoea caused by certain medical conditions or treatments.
When it is prescribed to lower cholesterol, by preventing the bile acids from being reabsorbed, your liver has to make more bile acids, which it does by using cholesterol from your blood. This lowers the amount of cholesterol in your blood and reduces your risk of blood vessel disease.
When colestyramine is prescribed for itching or diarrhoea, it helps to control your symptoms by reducing the amount of bile acids in your blood.
Before taking colestyramine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking colestyramine it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you are taking other medicines, including those available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take colestyramine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about colestyramine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take the sachets exactly as your doctor tells you to. It is usual to be prescribed one or two sachets to take each day to begin with. Depending upon your symptoms, your doctor may slowly increase the number of sachets until you are taking 3-6 sachets daily. The maximum dose is nine sachets daily. You may need to take all your sachets as one dose or as separate doses up to four times a day.
- The powder from each sachet should be added to at least 150 ml of water. Allow the mixture to stand for 1-2 minutes, and then stir it well. If you prefer, you can also mix colestyramine with skimmed milk, soup, fruit juice or fruit smoothies. Do not take the powder without mixing it into some liquid first.
- If you forget to take a dose, take it as soon as you remember. Try to take the correct number of sachets each day.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You may need to have blood tests from time to time.
- Avoid taking any other medicines at the same time as you take colestyramine because it can stop the other medicines from being absorbed by your body. Either take your other medicines at least an hour before you take colestyramine, or wait until 4-6 hours after taking colestyramine before you take the other medicines. If you have any problems planning when to take your medicines, speak with your doctor or pharmacist for advice.
- Treatment with colestyramine is often long-term. Continue to take it unless you are advised otherwise.
- Taking colestyramine over a period of time may reduce your body's absorption of fat-soluble vitamins (vitamins A, D and K) and folic acid. Your doctor may advise you to take a supplement containing these vitamins.
- If you have been prescribed colestyramine to lower cholesterol, your doctor may give you advice about lifestyle changes that could help you get the most out of your treatment. This may include reducing the amount of salt in your diet, stopping smoking, losing weight, reducing the amount of alcohol you drink, and taking regular exercise. Following this advice will help you to reduce your risk of developing heart and blood vessel disease in the future.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- If you buy any medicines 'over-the-counter', check with a pharmacist that they are suitable for you to take.
Can colestyramine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with colestyramine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common colestyramine side-effects||What can I do if I experience this?|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day. If it becomes troublesome, speak with your doctor|
|Upset stomach||Stick to simple meals - avoid rich or spicy foods|
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store colestyramine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Questran® Powder for Oral Suspension 4 g; Cheplapharm Arzneimittel GmbH, The electronic Medicines Compendium. Dated May 2019.
Manufacturer's PIL, Questran® Light, Powder for Oral Suspension 4 g; Cheplapharm Arzneimittel GmbH, The electronic Medicines Compendium. Dated May 2019.
British National Formulary, 79th Edition (Mar 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.