What diseases can Cholestyramine treat?

From the Guidelines

Cholestyramine is used to treat high cholesterol levels, pruritus (itching) associated with bile acid accumulation, diarrhea caused by bile acid malabsorption, and can help manage Clostridium difficile-associated diarrhea. The medication works by binding to bile acids in the intestine, preventing their reabsorption and promoting their elimination through stool. For hypercholesterolemia, cholestyramine is typically prescribed at doses of 4-8 grams taken 1-2 times daily before meals, with a maximum daily dose of 24 grams 1. The medication comes as a powder that must be mixed with water or other non-carbonated beverages. Some key points to consider when using cholestyramine include:

• Cholestyramine can be used to treat pruritus associated with bile acid accumulation, with a recommended dose of 4 g up to four times daily 1.
• The medication can also be used to treat diarrhea caused by bile acid malabsorption, with a reported success rate of 69.8% in patients with bile acid diarrhea 1.
• Cholestyramine may be used to remove certain drugs from the body in overdose situations, particularly for drugs that undergo enterohepatic circulation.
• Common side effects include constipation, bloating, and nausea.
• Patients should take cholestyramine at least 1 hour before or 4-6 hours after other medications to prevent interference with their absorption.
• The medication works through a mechanical action rather than being absorbed into the bloodstream, making it relatively safe but requiring careful timing with other medications. Some of the diseases that cholestyramine can treat include:
• Hypercholesterolemia
• Pruritus associated with bile acid accumulation
• Diarrhea caused by bile acid malabsorption
• Clostridium difficile-associated diarrhea It is essential to note that cholestyramine should be used under the guidance of a healthcare professional, and the dosage and administration should be individualized based on the patient's specific needs and medical condition 1.

From the FDA Drug Label

The increased fecal loss of bile acids due to cholestyramine resin administration leads to an increased oxidation of cholesterol to bile acids, a decrease in beta lipoprotein or low density lipoprotein plasma levels and a decrease in serum cholesterol levels. Although in man, cholestyramine resin produces an increase in hepatic synthesis of cholesterol, plasma cholesterol levels fall In patients with partial biliary obstruction, the reduction of serum bile acid levels by cholestyramine resin reduces excess bile acids deposited in the dermal tissue with resultant decrease in pruritus The subjects included in the study were men aged 35 to 59 with serum cholesterol levels above 265 mg/dL and no previous history of heart disease. In the NHLBI Type II Coronary Intervention Trial2, 116 patients (80% male) with coronary artery disease (CAD) documented by arteriography were randomized to cholestyramine resin or placebo for five years of treatment Thus in these randomized controlled clinical trials using coronary arteriography, cholestyramine resin monotherapy has been demonstrated to slow progression2,3 and promote regression3 of atherosclerotic lesions in the coronary arteries of patients with coronary artery disease

Cholestyramine can treat:

• Hypercholesterolemia: by decreasing serum cholesterol levels
• Pruritus: associated with partial biliary obstruction, by reducing excess bile acids deposited in the dermal tissue
• Coronary artery disease (CAD): by slowing progression and promoting regression of atherosclerotic lesions in the coronary arteries 2

From the Research

Diseases Treated by Cholestyramine

Cholestyramine is used to treat several diseases, including:

• Primary hypercholesterolemia and hypercholesterolemia associated with mild hypertriglyceridemia 3
• Pruritus associated with cholestatic disease, in patients with incomplete biliary obstruction 3
• Diabetes mellitus, as modulation of bile acid homeostasis has a good clinical effect in managing the disease 3
• Diarrhea from bile acid malabsorption, particularly in patients with mild to moderate bile acid malabsorption 4
• Hyperlipidemia, including type IIa hyperlipoproteinemia 5, 6

Specific Conditions

Cholestyramine is effective in:

• Lowering circulating low-density lipoprotein (LDL) cholesterol levels 5
• Retarding the progression of coronary atherosclerosis 5
• Inducing qualitative changes in lipoproteins, which may be significant in coronary disease prevention 5
• Reducing total plasma cholesterol levels, mainly due to a reduction in LDL cholesterol 7, 6