What is the use of Cholestyramine (Questran) 4g packaging?

From the Guidelines

Cholestyramine (Questran) 4g packaging is used as an adjunct to diet to decrease LDL-C with primary hyperlipidemia.

Key Points

• The dose and route of administration for Cholestyramine is 8-16 g/day orally, divided into 2 doses 1.
• Mean % LDL reduction for Cholestyramine is 10.4% vs placebo 1.
• Cholestyramine is a bile acid sequestrant, which works by binding bile acids in the intestine and impeding their reabsorption, leading to an increased demand for cholesterol in the liver cells and resulting in increased clearance of LDL-C from the blood 1.
• Adverse effects of Cholestyramine include constipation, dyspepsia, and nausea, and may also increase triglyceride levels and interfere with the absorption of fat-soluble vitamins and some medications 1.
• Cholestyramine has been shown to reduce the risk of cardiovascular disease in a clinical trial, with a 19% reduction in risk of definite CHD death and/or definite nonfatal MI 1.
• The starting dose of Cholestyramine is often 4g daily, which can be titrated up to 20g daily as tolerated 1.
• It is essential to take other medications at least 1 hour before or 4 hours after Cholestyramine to avoid impeding their absorption 1.

From the FDA Drug Label

Nine grams of Cholestyramine for Oral Suspension, USP powder, contains 4 grams of anhydrous cholestyramine resin. The use of Cholestyramine (Questran) 4g packaging is for adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia, with each 9 gram pouch containing 4 grams of anhydrous cholestyramine resin 2.

• The packaging is available in cartons of sixty 9 gram pouches.
• The 4 grams of anhydrous cholestyramine resin is part of the 9 grams of Cholestyramine for Oral Suspension, USP powder.

From the Research

Cholestyramine (Questran) 4g Packaging Use

• The use of Cholestyramine (Questran) 4g packaging is primarily for the treatment of primary hypercholesterolemia and hypercholesterolemia associated with mild hypertriglyceridemia, as well as a second-line treatment for pruritus associated with cholestatic disease 3.
• Cholestyramine is a bile acid sequestrant that binds to bile acids in the intestine to form an insoluble complex, which is excreted in the feces, thereby reducing the amount of bile acids in the bloodstream 3.
• The 4g daily dose of Cholestyramine is also used in combination with ursodeoxycholic acid (UDCA) in patients with cholestatic liver diseases, although it is recommended to administer them at different times of the day to minimize the effect of Cholestyramine on UDCA serum levels 4.
• Additionally, Cholestyramine has been shown to slow gastric emptying of liquids and reduce appetite in healthy subjects, making it a potential therapeutic strategy for appetite suppression and weight loss 5.
• However, Cholestyramine can rarely cause hyperchloremic nonanion gap metabolic acidosis, particularly in patients who are volume depleted, in renal failure, or taking spironolactone 6.
• The effectiveness of Cholestyramine in reducing total cholesterol, LDL cholesterol, and Apo B lipoprotein levels has been demonstrated in several studies, including one where 11 adult patients with severe hypercholesterolemia were treated with 12g of Cholestyramine per day for 4 weeks 7.