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cholestyramine

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Brand names: Questran

Bile Acid Sequestrant Rx

Cholestyramine is a medicine that helps lower high cholesterol levels in your blood. It works by preventing your body from absorbing cholesterol in the intestines.

Drug Shortage Alert

cholestyramine is currently listed as to be discontinued by the FDA. Affected manufacturer: Upsher-Smith Laboratories, LLC.

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Drug Pricing (NADAC)

Generic Price

$0.85/unit

Generic Available

Yes (15 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

This medicine is used with a diet to lower high cholesterol, especially LDL cholesterol (the "bad" cholesterol).

Common side effects

Constipation

Key warnings

Since cholestyramine can affect how your body absorbs other medicines, take other drugs at least 1 hour before or 4 to 6 hours after taking cholestyramine.

How It Works

Cholestyramine is a resin that binds to bile acids in your intestines. Bile acids help digest fats, including cholesterol. By binding to bile acids, cholestyramine prevents them from being reabsorbed, so your body uses cholesterol to make more bile acids, which lowers cholesterol levels in your blood.

How to Take It

The usual starting dose is one pouch or scoop (5.7 grams) once or twice a day. The typical maintenance dose is 2 to 4 pouches or scoops daily, divided into two doses. Mix the powder with 2 to 3 ounces of water or another beverage before taking it. You can take it with meals, but you may need to adjust the timing to avoid it interfering with other medicines you take.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. Cholestyramine may affect how you absorb vitamins, so your doctor may recommend supplements. Talk to your doctor about the risks and benefits of taking this medicine while breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store at room temperature (68° to 77°F) and keep the lid tightly closed.

Side Effects (from patient reports)

Based on 7,930 FDA adverse event reports.

Diarrhea
1,631
Using the medicine for a condition it is not approved for
1,051
The medicine is not working
897
Tiredness
878
Feeling sick to your stomach
783
Joint pain
622
Head pain
543
Stomach pain
524
Throwing up
503
Weight loss
498

FDA Adverse Event Report Analysis

Detailed analysis of 11,539 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

11,539

Death-Related Reports

811

Hospitalization Reports

3,888

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 6,637 (63%)
Male 3,962 (37%)

Age Distribution

0–17 217
18–44 1,070
45–64 2,482
65–74 1,989
75+ 1,584

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DIARRHOEA 1,631
2 OFF LABEL USE 1,051
3 DRUG INEFFECTIVE 896
4 FATIGUE 877
5 NAUSEA 783
6 ARTHRALGIA 621
7 HEADACHE 543
8 ABDOMINAL PAIN 524
9 VOMITING 503
10 WEIGHT DECREASED 498
11 DYSPNOEA 488
12 PAIN 476
13 ASTHENIA 456
14 CONSTIPATION 390
15 MALAISE 387

Reactions in Death Reports

DEATH 339
DIARRHOEA 87
DYSPNOEA 62
ACUTE KIDNEY INJURY 61
SEPSIS 55
RENAL FAILURE 51
THROMBOCYTOPENIA 48
OFF LABEL USE 46
PNEUMONIA 45
ASTHENIA 43

Reactions in Hospitalization Reports

DIARRHOEA 597
DRUG INEFFECTIVE 307
FATIGUE 303
NAUSEA 290
DYSPNOEA 272
VOMITING 271
ABDOMINAL PAIN 257
PNEUMONIA 254
OFF LABEL USE 253
WEIGHT DECREASED 244

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Since cholestyramine can affect how your body absorbs other medicines, take other drugs at least 1 hour before or 4 to 6 hours after taking cholestyramine.

Known Drug Interactions

moderate naproxen

Cholestyramine Clinical Impact: Concomitant administration of cholestyramine can delay the absorption of naproxen. Intervention: Concomitant administration of cholestyramine with naproxen tablets or naproxen sodium tablets is not recommended.

Mechanism: Cholestyramine can slow down the absorption of naproxen into your system.

What to do: It is not recommended to take these two medications at the same time.

moderate olmesartan

7 DRUG INTERACTIONS Lithium: Risk of lithium toxicity ( 7.2 ) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Reduced diuretic, natriuretic and antihypotensive effects; increased risk of renal toxicity ( 7.3 ) Dual inhibition of the renin-angiotensin system: Increased risk of renal impairment, hypotension, and hyperkalemia ( 7.4 ) Colesevelam hydrochloride: Consider administering olmesartan at least 4 hours before colesevelam hydrochloride dose ( 7.5 ) Antidiabetic drugs: Dosage adjustment may be required ( 7.6 ) Cholestyramine and colestipol: Reduced absorption of thiazides ( 7.6 ) 7.1 Age...

Mechanism: Cholestyramine can trap other medicines in your gut, which prevents your body from absorbing them properly. This can make your blood pressure medicine less effective.

What to do: You should talk to your doctor about how to time your doses. They may suggest taking your blood pressure medicine at least 4 hours before the cholestyramine.

moderate raloxifene

7 DRUG INTERACTIONS Cholestyramine : Use with raloxifene hydrochloride is not recommended. (7.3 , 12.3) 7.1 Cholestyramine Concomitant administration of cholestyramine with raloxifene hydrochloride is not recommended.

Mechanism: Cholestyramine can stick to other medicines in your digestive tract and prevent them from being absorbed into your body. This makes the other medicine, like raloxifene, much less effective.

What to do: You should not take these two medications together. Ask your doctor if there is a different treatment option or a specific way to time your doses.

Drug Interactions Cholestyramine resin may delay or reduce the absorption of concomitant oral medication such as phenylbutazone, warfarin, thiazide diuretics (acidic) or propranolol (basic), as well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins and digitalis.

Mechanism: Cholestyramine can bind to propranolol in your gut and prevent it from entering your bloodstream. This means you might not get the full effect of the propranolol.

What to do: Take your other medications at least one hour before or four to six hours after taking cholestyramine.

Drug Interactions Cholestyramine resin may delay or reduce the absorption of concomitant oral medication such as phenylbutazone, warfarin, thiazide diuretics (acidic) or propranolol (basic), as well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins and digitalis.

Mechanism: Cholestyramine can trap warfarin in your digestive system, which stops your body from absorbing it. This can make the blood thinner less effective.

What to do: Your doctor may need to check your blood clotting time more often and adjust your warfarin dose.

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Common Questions

Can I take cholestyramine with other medications?
It is best to take other medications at least 1 hour before or 4 to 6 hours after taking cholestyramine.
What should I do if I get constipated?
Most constipation is mild and can be managed with diet changes or over-the-counter remedies. Talk to your doctor if it becomes severe.
How long will it take to see results?
You should see a favorable trend in cholesterol reduction during the first month of therapy.
Can I mix cholestyramine with any liquid?
Yes, you can mix it with water, other beverages, or even fluid soups or pulpy fruits.
What is the maximum dose I can take?
The maximum recommended daily dose is 6 pouches or scoops.
Do I need to follow a special diet while taking this medicine?
Yes, this medicine is meant to be used along with a cholesterol-lowering diet.
What if I have trouble swallowing the mixture?
Make sure to mix the powder thoroughly with enough liquid. If you still have trouble, try mixing it with a pulpy fruit like applesauce.
Can cholestyramine cause vitamin deficiencies?
Yes, it can interfere with the absorption of fat-soluble vitamins (A, D, E, and K), especially with long-term use.
Will this medicine cure my high cholesterol?
No, this medicine helps manage your cholesterol levels. You will likely need to take it long-term along with diet and lifestyle changes.
What should I do if I experience side effects?
Talk to your doctor about any side effects you experience. They may be able to adjust your dose or recommend other treatments.
What are the common side effects of cholestyramine?
The most commonly reported side effects of cholestyramine include Constipation. Based on 7,930 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does cholestyramine interact with other medications?
Yes, cholestyramine has 34 known drug interactions. Notable interactions include naproxen, olmesartan, raloxifene. Always inform your doctor about all medications you are taking.
What drug class is cholestyramine?
cholestyramine belongs to the Bile Acid Sequestrant drug class. It requires a prescription (Rx). This medicine is used with a diet to lower high cholesterol, especially LDL cholesterol (the "bad" cholesterol).
Is cholestyramine safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. Cholestyramine may affect how you absorb vitamins, so your doctor may recommend supplements. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Is cholestyramine currently in shortage?
Yes, cholestyramine is currently listed as to be discontinued by the FDA. Affected manufacturer: Upsher-Smith Laboratories, LLC. Visit the FDA Drug Shortages database for the latest updates.

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Related Health & Safety Data

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What the FDA Data Shows for cholestyramine

The FDA label for cholestyramine (sold under brand names such as Questran) classifies it as a prescription-only medication in the Bile Acid Sequestrant class. This medicine is used with a diet to lower high cholesterol, especially LDL cholesterol (the "bad" cholesterol). Official labeling lists 1 commonly reported side effect, including Constipation.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 7,930 voluntary reports. The database also lists 34 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.85.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: December 15, 2021

All federal data sources used on this page