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Cholestyramine has also been shown to slow the progression of the development of atherosclerosis in a couple of studies. However, it has not been shown to prevent death or disability due to cardiovascular disease.
How Does Cholestyramine Work?
Cholestyramine binds to bile acids in the small intestine, preventing their reabsorption.Bile acids are derived from cholesterol and are needed to help with the digestion of fats consumed in your diet.
When cholestyramine binds to bile acids, they become depleted and will not be reabsorbed. To make more bile acids, cholesterol will be removed from the bloodstream and converted into bile acids. This activity lowers your cholesterol levels.
How Should You Take Cholestyramine?
Your healthcare provider may start you on smaller doses and increase your dose based on your response to the medication and side effects.
The recommended starting dose is one scoopful or packet (4 grams cholestyramine) once or twice a day.This may be increased to up to six doses a day. The dose should be mixed with at least 2 ounces of water, a fruit juice (with or without pulp), applesauce, a thin soup, or other beverage before consuming.
You should ingest the entire contents of the drink containing cholestyramine to get the full dose of the medication. Cholestyramine should be taken with a meal.
Who Shouldn’t Take It?
Due to its components, there are some instances where cholestyramine should not be taken. These would include:
Conditions That Need to Be Monitored
If you have any of the following conditions below, your healthcare provider may decide to start you on cholestyramine but will need to monitor you to determine whether or not taking cholestyramine will be potentially harmful to you. These medical conditions include:
Side Effects
Constipation is the most commonly noted side effect when taking cholestyramine. This usually goes away with continued treatment. Your healthcare provider may decide to lower your dose or give you a medication to treat your constipation if the side effects become too bothersome. Other common side effects include:
Other side effects have been reported due to prolonged use of cholestyramine. Increased likelihood of bleeding may be noted over time due to decreased Vitamin K. Additionally, changes in liver enzymes may occur.
Prolonged drinking of the product or holding the product in the mouth may cause tooth enamel erosion or discoloration.
Interacting Medications
If you are required to take one of the drugs or supplements listed below, your healthcare provider may need to adjust your dose or the time you take it, monitor you more closely for side effects, or discontinue your use of it all together:
There are several other medications that can also interact with cholestyramine, which is listed above. Therefore, you should make your healthcare provider aware of any prescribed and over-the-counter medications, and natural products that you are taking. This will help your healthcare provider to identify any potential interactions between cholestyramine and your other medications.
Bottom Line
Cholestyramine is one of the first cholesterol-lowering medications approved in the United States. It is primarily used to lower your LDL cholesterol but has not been directly shown to reduce death or complications from cardiovascular disease like some other lipid-lowering medications on the market.
You should let your healthcare provider know if you are experiencing any problems with taking cholestyramine since the powdered form may have a gritty taste that may be a little hard to swallow for some people.
Because cholestyramine only impacts your LDL cholesterol levels, your healthcare provider may decide to add other therapies—such as astatinorfibrate—to your lipid-lowering regimen.
2 SourcesVerywell 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.Singh A, Cho LS.Nonstatin therapy to reduce low-density lipoprotein cholesterol and improve cardiovascular outcomes.Cleve Clin J Med. 2024;91(1):53-63. doi:10.3949/ccjm.91a.23058DailyMed.Prevalite (cholestyramine). Updated June 18, 2020.Additional ReadingDipiro JT, Talbert RL, Yee GC, Matzke JR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach, 9th ed. Ney York: McGraw-Hill Education; 2014.
2 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.Singh A, Cho LS.Nonstatin therapy to reduce low-density lipoprotein cholesterol and improve cardiovascular outcomes.Cleve Clin J Med. 2024;91(1):53-63. doi:10.3949/ccjm.91a.23058DailyMed.Prevalite (cholestyramine). Updated June 18, 2020.Additional ReadingDipiro JT, Talbert RL, Yee GC, Matzke JR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach, 9th ed. Ney York: McGraw-Hill Education; 2014.
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.
Singh A, Cho LS.Nonstatin therapy to reduce low-density lipoprotein cholesterol and improve cardiovascular outcomes.Cleve Clin J Med. 2024;91(1):53-63. doi:10.3949/ccjm.91a.23058DailyMed.Prevalite (cholestyramine). Updated June 18, 2020.
Singh A, Cho LS.Nonstatin therapy to reduce low-density lipoprotein cholesterol and improve cardiovascular outcomes.Cleve Clin J Med. 2024;91(1):53-63. doi:10.3949/ccjm.91a.23058
DailyMed.Prevalite (cholestyramine). Updated June 18, 2020.
Dipiro JT, Talbert RL, Yee GC, Matzke JR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach, 9th ed. Ney York: McGraw-Hill Education; 2014.
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