Table of ContentsView AllTable of ContentsWhat It IsHow It WorksIndicationsDosageSide EffectsInteractions
Table of ContentsView All
View All
Table of Contents
What It Is
How It Works
Indications
Dosage
Side Effects
Interactions
This article explains how and when cholestyramine is used to treat chronic diarrhea. It also describes how the drug is taken along with the possible risks and side effects.
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What Is Cholestyramine?
What Is Bile?Bile is a fluid produced in the liver and stored in the gallbladder that aids with digestion. Bile breaks down fats into fatty acids, which are then absorbed in the digestive tract. Bile acids make up around 80% of the organic compounds in bile.
What Is Bile?
Bile is a fluid produced in the liver and stored in the gallbladder that aids with digestion. Bile breaks down fats into fatty acids, which are then absorbed in the digestive tract. Bile acids make up around 80% of the organic compounds in bile.
How Does Cholestyramine Help With Diarrhea?
Under normal circumstances, bile is reabsorbed and returned to the liver after it has broken down dietary fats. But with BAM, bile doesn’t get reabsorbed and instead starts to build up in the intestines, causingwatery diarrhea.
By removing excess bile, cholestyramine can help ease bile acid diarrhea.However, the drug is not a quick fix and can take several weeks to work depending on the severity of your symptoms.
Are Cholestyramine and Imodium the Same?
Other Off-Label Uses
When Should You Take Cholestyramine?
Some healthcare providers may test a stool sample for high bile acids.Others may prescribe cholestyramine without tests if they suspect BAM is the cause. This is because at least 30% of people diagnosed with functional diarrhea (chronic diarrhea with no known cause) have BAM.
Causes of BAM include:
BAM can also affect people who have undergone medical treatments like:
Who Should Not Take Cholestyramine?
Cholestyramine should not be taken if you’re allergic to the drug or your bile duct is completely blocked (meaning that no bile is being released into your intestines).
Cholestyramine is available as a generic drug and typically comes in a powder form that is mixed into beverages. It is also available as a chewable bar.
When used for diarrhea, cholestyramine is typically prescribed at 4 grams (g) per day. If needed, the dose can be increased to 4 g six times per day.
Children’s DoseChildren’s doses are based on body weight but generally do not exceed 8 g per day, split into two or three equal doses.
Children’s Dose
Children’s doses are based on body weight but generally do not exceed 8 g per day, split into two or three equal doses.
How to Take It
Cholestyramine is most effective when used as follows:
Your healthcare provider may recommend a daily vitamin supplement while taking cholestyramine as the drug can make it harder to absorb vitamins from food.
If cholestyramine is left on the teeth for a long time, it can cause tooth discoloration, erosion of enamel, and tooth decay.Drink the liquid quickly and brush your teeth regularly to avoid dental problems.
If cholestyramine is left on the teeth for a long time, it can cause tooth discoloration, erosion of enamel, and tooth decay.
Drink the liquid quickly and brush your teeth regularly to avoid dental problems.
Side Effects of Cholestyramine
As with all drugs, cholestyramine can cause side effects. People over age 60 are at highest risk.
Common
Common side effects of cholestyramine include:
Severe
Seek medical help if you experience the following uncommon side effects:
Warnings and Interactions
Tell your healthcare provider if you’re pregnant, breastfeeding, or have a chronic health condition like diabetes, kidney disease, or heart disease. Cholestyramine needs to be used with caution in these groups.
Cholestyramine can affect the absorption of other drugs. Let your healthcare provider know if you take any of the following as the dose may need to be adjusted or a substitute found:
Take other medications or vitamins at least one hour before or four hours after taking cholestyramine as it can interfere with their absorption.
Summary
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Vijayvargiya P, Camilleri M.Current practice in the diagnosis of bile acid diarrhea.Gastroenterol. 2019;156(5):1233-1238. doi:10.1053/j.gastro.2018.11.069
Lee KJ.Pharmacologic agents for chronic diarrhea.Intest Res.2015;13(4):306–12. doi:10.5217/ir.2015.13.4.306
National Institutes of Health.Cholestyramine - cholestyramine powder, for suspension.
Marasco G, Cremon C, Barbaro MR, et al.Pathophysiology and clinical management of bile acid diarrhea.J Clin Med.2022 Jun;11(11):3102. doi:10.3390/jcm11113102
DiBaise JK.Does your patient have bile acid malabsorption?Practical Gastroenterol. May 2020.
National Institute of Diabetes and Digestive and Kidney Diseases.Graves’ disease.
University of Michigan Health.Cholestyramine.
National Library of Medicine.Cholestyramine resin.
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