Cholestyramine

What is cholestyramine?

Cholestyramine belongs to a group of drugs called bile acid sequestrants. It is used to treat itching caused by partial blockage of the bile duct or liver disease, diarrhea caused by too much bile acid in children with short bowel syndrome, and to lower cholesterol.

You may hear cholestyramine called by its brand names, Olestyr or Novo-Cholamine. Cholestyramine comes in a powder to mix with water.

Before giving cholestyramine to your child

Tell your child's doctor if your child is allergic to cholestyramine or any ingredient in its formulation.

Talk with your child's doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• kidney or liver disease
• thyroid disease
• bleeding problems
• phenylketonuria (PKU)
• constipation or hemorrhoids
• gallbladder disease
• stomach ulcer or other stomach problems

How should you give your child cholestyramine?

• Give this medicine exactly as your doctor or your pharmacist tells you to, even if your child seems better.
• Encourage your child to drink plenty of fluids each day, unless told to drink less fluid by a healthcare provider. Make sure these fluids do not contain caffeine.
• The powder must be mixed with liquid before giving to your child. Avoid ingesting or breathing in the dried powder.
• Mix with 60 to 180 mL (¼ to ¾ of a cup) water, milk, fruit juice, broth, or other noncarbonated beverage. The powder may also be mixed into soups or pulpy fruits such as apple sauce or crushed pineapple because of their high moisture content.
• Let stand for 1 to 2 minutes before giving.
• Cholestyramine should be given at mealtime

What should you do if your child misses a dose of cholestyramine?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long should it take for cholestyramine to work?

In some conditions cholestyramine may take up to one month to work.

What are the possible side effects of cholestyramine?

Your child may have some of these side effects while he takes cholestyramine. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• belly pain
• nausea or vomiting; small frequent meals may help
• headache
• constipation; more liquids, regular exercise, or a fiber-containing diet may help. Talk with a health care provider about a stool softener or laxative.
• bloating and gas (this should subside with time)
• diarrhea

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• severe belly pain
• severe constipation
• severe diarrhea
• unusual bruising or bleeding
• rash, difficulty breathing, or any other sign of an allergic reaction

What safety measures should you take when your child is using cholestyramine?

There are some medicines that should not be taken together with cholestyramine. In some cases the dose of cholestyramine or the other medicine may need to be adjusted. Cholestyramine binds to many other medicines if they are taken at the same time. It is important that your child does not take any other medicines one hour before, or four to six hours after cholestyramine, unless your doctor or pharmacist tells you they can be given together.

Cholestyramine can also reduce the absorption of certain vitamins (in particular, vitamin A, K, and D) as well as folic acid.

It is important that you tell your doctor and pharmacist if your child takes any other medicines (prescription, over-the-counter, herbal, or natural products).

What other important information should you know about cholestyramine?

• Keep a list of all medicines your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
• Make sure you always have enough cholestyramine to last through weekends, holidays, and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep cholestyramine at room temperature in a cool, dry place away from sunlight. Do not store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.

Keep cholestyramine out of your child’s sight and reach and locked up in a safe place. If your child takes too much cholestyramine, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.