Cholestyramine, Oral

________________________________________________________________________

KEY POINTS

• This medicine is taken by mouth to lower cholesterol levels when diet and exercise alone have not lowered them enough. This medicine is also used to treat severe itching caused by high levels of bile acids in your blood. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

________________________________________________________________________

What are other names for this medicine?

Type of medicine: bile acid sequestrant; cholesterol-lowering

Generic and brand names: cholestyramine, oral; Prevalite; Questran; Questran Light

What is this medicine used for?

This medicine is taken by mouth to lower cholesterol levels when diet and exercise alone have not lowered them enough. It may be used alone or with other medicines.

This medicine is also used to treat severe itching caused by high levels of bile acids in your blood.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have:

• An allergy to any medicine
• Bleeding disorders
• Constipation, hemorrhoids, or a blockage in your intestines
• Gallbladder disease
• Heart disease
• High triglycerides
• Kidney or liver disease
• Phenylketonuria (some forms of this medicine contain phenylalanine.)
• Thyroid problems
• Trouble swallowing
• Ulcers
• Vitamin A, D, E, or K deficiency

Also tell your healthcare provider if you have had major abdominal surgery.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not stop taking this medicine without your healthcare provider's approval. This medicine will work only when taken regularly.

Check with your healthcare provider before using this medicine in children under 18 years of age.

Carefully follow the directions for mixing the powder with liquids or food. Do NOT take this medicine in its dry form. Mix with water, soups, other liquids, or soft foods such as applesauce. Do not hold the medicine in your mouth for a long time as can damage your teeth. Do not bake the medicine in foods. If you do not understand how to take this medicine, ask your healthcare provider or pharmacist to explain.

If you are taking other medicines, take them at least 1 hour before or 4 to 6 hours after you take this medicine.

Drink more liquid while you take this medicine to help prevent constipation. Talk to your healthcare provider about this.

What if I miss a dose?

If you miss a dose, take it with a meal as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: stomach pain, severe constipation, gas.

What should I watch out for?

This medicine may keep your body from absorbing certain vitamins and folic acid. Your healthcare provider may recommend that you take a vitamin supplement with folic acid.

This medicine is part of a complete program that includes diet and exercise. Follow the diet and exercise program your healthcare provider recommends.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Do not breathe in any of the powder form of this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reactions (hives, itching, rash, tightness in your chest, trouble breathing).

Serious (Report these to your healthcare provider right away.): Black tarry bowel movements, unusual bruising or bleeding, severe stomach pain, severe nausea and vomiting, severe constipation.

Other: Gas, heartburn, bloating, headache, dizziness, mild constipation, diarrhea, nausea.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Amiodarone (Cordarone, Pacerone)
• Antibiotics such as doxycycline (Doryx, Monodox, Vibramycin), minocycline (Dynacin, Minocin, Solodyn), penicillin, and tetracycline
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, phenytoin (Dilantin, Phenytek), and valproic acid (Depacon, Depakene, Depakote)
• Bexarotene (Targretin)
• Corticosteroids such as dexamethasone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), and prednisone (Prednisone Intensol)
• Diabetes medicines such as glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (Glynase)
• Digoxin (Lanoxin)
• Diuretics (water pills) such as bumetanide, chlorthalidone, furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), and torsemide (Demadex)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings, and estrogen hormones such as Cenestin, Estinyl, Estratab, FemPatch, and Premarin
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and mycophenolate (CellCept, Myfortic)
• Leflunomide (Arava)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Other cholesterol-lowering medicines such as atorvastatin (Lipitor), ezetimibe (Zetia), fenofibrate (Antara, Fenoglide, Lipofen, TriCor, Triglide), fluvastatin (Lescol), gemfibrozil (Lopid), lomitapide (Juxtapid), and pravastatin (Pravachol)
• Phosphate supplements
• Propranolol (Hemangeol, Inderal, InnoPran)
• Raloxifene (Evista)
• Retinoid medicines such as acitretin (Soriatane), isotretinoin (Absorica, Amnesteem, Claravis, Myorisan, Zenatane), and tretinoin (Atralin, Renova, Retin-A)
• Teriflunomide (Aubagio)
• Thyroid medicines such as levothyroxine (Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid), liothyronine (Cytomel, Triostat), liotrix (Thyrolar), and thyroid USP (Armour Thyroid, Nature-Throid)
• Ursodiol (Actigall, Urso Forte)
• Vitamins A, D, E, and K
• Warfarin (Coumadin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

---

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.