What is cholestyramine for oral suspension usp used for

what is cholestyramine for oral suspension usp used for

Cholestyramine

Cholestyramine for Oral Suspension, USP powder, the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin is quite hydrophilic, but insoluble in water. Cholestyramine resin is not absorbed from the digestive tract. Nine grams of Cholestyramine for Oral Suspension, USP powder contain 4 grams of cholestyramine resin. It is . Aug 01,  · Cholestyramine for Oral Suspension, USP, the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin is quite hydrophilic, but insoluble in water. Cholestyramine resin is not absorbed from the digestive tract. grams of Cholestyramine for Oral Suspension, USP contain 4 grams of Cholestyramine resin. It is .

Cholestyramine for oral suspension USP light powder, the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin is quite hydrophilic, but insoluble in water. The cholestyramine resin in cholestyramine for oral suspension USP light powder is not absorbed from the digestive tract.

Four grams of anhydrous cholestyramine resin is contained in 5. It is represented by the following structural formula:. Cholesterol is probably the sole precursor of bile acids. During normal digestion, bile acids are secreted into the intestines. A major portion of the bile acids is absorbed from the intestinal tract and returned to the liver via the enterohepatic circulation.

Only very small amounts of bile acids are found in normal serum. Cholestyramine for oral suspension USP light powder resin adsorbs and combines with the bile acids in sued intestine to form an insoluble complex which is excreted in the feces.

This results in a partial removal of bile acids from the enterohepatic circulation by preventing their absorption. The increased fecal loss of bile acids due to cholestyramine how to make your hair curl naturally oral suspension USP light powder administration leads to an increased oxidation of cholesterol to bile acids, a decrease in beta lipoprotein or low density lipoprotein plasma levels and a decrease in serum cholesterol levels.

Although in man, cholestyramine for oral suspension USP light powder produces an increase in hepatic synthesis of cholesterol, plasma cholesterol levels fall. In patients with how to get an agent as a director biliary obstruction, the reduction of serum bile acid levels by cholestyramine for oral suspension USP light powder reduces excess bile acids deposited in the dermal tissue with resultant decrease in pruritus.

In a large, placebo-controlled, multi-clinic study, LRC-CPPT 1hypercholesterolemic subjects treated with cholestyramine for oral suspension had mean reductions in total and low-density lipoprotein cholesterol LDL-C which exceeded those for diet and placebo treatment by 7.

It is not clear to what extent these findings can be extrapolated to females and other segments of the hypercholesterolemic population. Two controlled clinical trials have examined the effects of cholestyramine for oral suspension monotherapy upon coronary atherosclerotic lesions using coronary arteriography.

In the St. Thomas Atherosclerosis Regression Study STARS 390 hypercholesterolemic men with CAD were randomized to three blinded treatments: usual care, lipid-lowering diet, wyat lipid-lowering diet plus cholestyramine for oral suspension.

The mean absolute width of coronary segments decreased in the usual care group, increased slightly 0. Thus in these whaat controlled clinical trials using coronary arteriography, cholestyramine for oral suspension monotherapy has been demonstrated to slow progression 2,3 and promote regression 3 of otal lesions in the coronary arteries of patients with coronary artery disease.

The effect of intensive lipid-lowering therapy on coronary atherosclerosis has been usef by arteriography in hyperlipidemic patients. In these randomized, controlled clinical trials, patients were treated for two to four years by either conventional measures diet, placebo, or in some cases low dose resinor intensive combination therapy using diet plus colestipol an anion exchange resin with a mechanism of action and an effect on serum lipids similar to that of cholestyramine for oral suspension plus either nicotinic acid or lovastatin.

When compared to conventional measures, intensive lipid-lowering combination therapy significantly reduced the frequency of progression and cjolestyramine the frequency of regression of coronary atherosclerotic lesions in patients with or at risk for coronary artery disease. Cholestyramine for oral suspension USP light powder may be useful to lower LDL cholesterol in patients who also have hypertriglyceridemia, but it is not indicated where hypertriglyceridemia is the abnormality of most concern.

Therapy with lipid-altering agents should be a component of multiple risk factor intervention in those individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia. Treatment should begin and continue with dietary therapy specific for the type of hyperlipoproteinemia determined prior to initiation of drug therapy.

Excess body weight may be an important factor and caloric restriction for weight normalization should be addressed prior to drug therapy in the overweight. Prior to initiating therapy with cholestyramine for oral suspension USP light powder secondary causes of hypercholesterolemia e. In such cases cholestyramine for oral suspension USP light powder may not be indicated.

Serum cholesterol and triglyceride levels should be determined periodically based on NCEP guidelines shat confirm initial and adequate long-term response. A favorable trend in cholesterol reduction should occur during the first month of cholestyramine for oral suspension USP light powder therapy.

The therapy should be continued to sustain cholesterol reduction. If adequate cholesterol reduction is not attained, increasing the dosage of cholestyramine for oral suspension USP light powder or adding other lipid-lowering agents in combination with cholestyramine for oral suspension USP light powder should be considered.

A lipoprotein analysis including LDL-C determination should be carried out once a year. The NCEP treatment guidelines are summarized below.

Cholestyramine for oral suspension USP light powder monotherapy has been demonstrated to retard the rate of progression 2,3 and increase the rate of regression 3 of coronary atherosclerosis. Cholestyramine for oral suspension USP light powder has been shown to have a variable effect on serum cholesterol in these fot. Patients with primary biliary cirrhosis may exhibit an elevated cholesterol as part whats in a liquid cocaine their disease.

Cholestyramine for oral suspension USP light powder is contraindicated in patients with complete biliary obstruction where bile is not secreted into the intestine and in those individuals who have shown hypersensitivity to any of its components. Chronic use of cholestyramine for oral suspension USP light powder may be associated with increased bleeding tendency due to hypoprothrombinemia associated with Vitamin K deficiency. This will usually respond promptly to parenteral Vitamin K 1 and recurrences can be prevented by oral administration of Vitamin K 1.

Reduction of serum or red cell folate has been reported over long term administration of cholestyramine for oral suspension USP light powder. Supplementation with folic acid should be considered in these cases. There is a possibility that prolonged use of cholestyramine for oral suspension USP light powder, since it is a chloride form of anion exchange resin, may produce hyperchloremic acidosis. This would especially be true in younger and smaller patients where the relative dosage may be higher.

Caution should also be exercised in patients with renal insufficiency or volume depletion, and in patients receiving concomitant spironolactone. Cholestyramine for oral suspension USP light powder may produce or worsen pre-existing constipation.

The dosage should be increased gradually in patients to minimize the risk of developing fecal impaction. In patients with pre-existing constipation, the starting dose should be 1 pouch or 1 scoop once daily for 5 to7 days, increasing to twice daily with monitoring of constipation and of serum lipoproteins, at least twice, 4 to 6 weeks apart.

Increased fluid intake and fiber intake should be encouraged to alleviate constipation and a chloestyramine softener may occasionally be indicated. Particular effort should be made to avoid constipation in patients with symptomatic coronary artery disease.

Constipation associated with cholestyramine for oral suspension USP light powder may aggravate hemorrhoids. Inform your physician if you are pregnant or suspeension to become pregnant or are breastfeeding.

Drink plenty of fluids and mix each 5. Sipping or holding the suxpension suspension in the mouth for prolonged periods may lead to changes in the surface of the teeth resulting in discoloration, erosion of enamel or decay; good oral hygiene should be maintained.

Serum cholesterol levels should be determined frequently usef the first few months of therapy and periodically thereafter. Serum triglyceride levels should be measured periodically to detect whether significant changes have occurred.

Cholestyramine for oral suspension USP light powder may delay or reduce how to call mexico cell phone 044 absorption of concomitant oral medication such as phenylbutazone, warfarin, thiazide diuretics acidicor propranolol basicas well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins, and sspension.

Interference with the absorption of oral phosphate supplements has been observed with another positively-charged bile acid sequestrant. Cholestyramine for oral suspension USP light powder may interfere with the pharmacokinetics of drugs that undergo enterohepatic circulation. The discontinuance of cholestyramine for oral suspension USP light powder could pose a hazard to health if a potentially toxic drug such as digitalis has been titrated to a maintenance level while the patient was taking cholestyramine for oral suspension USP light powder.

Because cholestyramine binds bile acids, cholestyramine for oral suspension USP light powder may fr with normal fat digestion and absorption and thus may prevent absorption of fat-soluble vitamins such as A, D, E and K. When cholestyramine for oral suspension USP light powder is given for long periods of time, concomitant supplementation with water-miscible or parenteral forms of fat-soluble vitamins should be considered. In studies conducted in rats in which cholestyramine resin was used as a tool to investigate the role of various intestinal factors, such as fat, bile salts and microbial flora, in the development of intestinal tumors induced by potent carcinogens, the incidence of such tumors was observed to be greater in cholestyramine resin-treated rats than in control rats.

The relevance of this laboratory observation from studies in rats to the clinical use of cholestyramine for oral suspension USP light powder is not known. When the many different categories of tumors are examined, various alimentary system cancers were somewhat more prevalent in the cholestyramine group.

The small numbers and the multiple categories prevent conclusions from being drawn. Hcolestyramine, in view of the fact that cholestyramine resin is confined to the GI tract and not absorbed, and in light of what is the song paradise about animal experiments referred to above, a six-year post-trial follow-up of the LRC-CPPT5 patient population ysed been completed a total of There are no adequate and well controlled studies in pregnant women.

The use iz cholestyramine for oral suspension USP light powder in pregnancy or lactation or by women of childbearing age requires that the potential benefits of drug therapy be weighed against the possible hazards to the mother and child. Caution should be exercised when cholestyramine for oral suspension USP light powder is administered to a nursing mother. The possible lack of proper vitamin absorption described in the " Pregnancy " section may have an effect on nursing infants.

In calculating pediatric dosages, The effects of long-term administration, as well as its effect in maintaining lowered cholesterol levels in pediatric patients, are unknown. The most common adverse reaction is constipation. When used as a cholesterol-lowering agent predisposing factors for most complaints of constipation are high dose and increased age more than 60 years old. Most instances of constipation are mild, transient, and controlled with conventional therapy.

Some patients require a temporary decrease in dosage tor discontinuation of therapy. Rare reports of intestinal qhat, including two deaths, have been reported in pediatric patients. Occasional calcified material has been observed in the biliary tree, including calcification of the gallbladder, in patients to whom cholestyramine for oral suspension USP light powder has been given.

However, this may be a manifestation of the liver disease and not drug related. One patient experienced biliary colic on each of three occasions on which he took cholestyramine for oral suspension USP light powder. One patient diagnosed as acute abdominal symptom complex was found to have a "pasty mass" in the transverse colon on x-ray. Other events not necessarily drug related reported in patients taking cholestyramine for oral suspension USP light powder include.

GI-rectal bleeding, black stools, hemorrhoidal bleeding, bleeding from known duodenal ulcer, dysphagia, hiccups, ulcer attack, sour taste, pancreatitis, rectal pain, diverticulitis. Headache, anxiety, vertigo, dizziness, fatigue, tinnitus, syncope, drowsiness, femoral nerve pain, paresthesia. Weight loss, weight gain, increased libido, swollen glands, edema, dental bleeding, dental caries, erosion of tooth enamel, tooth discoloration.

No ill effects were reported. Euspension an overdosage occur, the chief potential harm would be obstruction of the gastrointestinal tract. The location of such potential obstruction, the degree uses obstruction, and the presence or absence of normal gut motility would determine treatment.

The recommended starting adult dose for cholestyramine for oral suspension USP light powder is one pouch or one level scoopful once or twice a day. The recommended maintenance dose for cholestyramine for oral suspension USP light powder is 2 to 4 pouches or scoopfuls daily 8 to 16 grams anhydrous cholestyramine resin divided into two doses.

Four grams of anhydrous cholestyramine resin is contained in each measured dose of cholestyramine for oral suspension USP light powder as follows:. The maximum recommended daily dose is six pouches or scoopfuls of cholestyramine for oral suspension USP light powder 24 grams of anhydrous cholestyramine resin. The suggested time of administration is at mealtime but may be modified to avoid interference with absorption of other medications.

Although the suspesion dosing schedule is twice daily, cholestyramine for what is the land registry fee suspension USP light powder may be administered in 1 to 6 doses per day.

Cholestyramine for oral suspension USP light powder should not be taken in its dry form. Always mix cholestyramine for oral suspension USP light powder with water or other fluids before ingesting.

Cholestyramine Description

Jul 19,  · Cholestyramine is used to reduce high cholesterol levels. It’s given to people with high cholesterol who haven’t been able to lower their cholesterol enough with diet changes. This drug is also. Cholestyramine for oral suspension USP, the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin is quite hydrophilic, but insoluble in water. The cholestyramine resin in cholestyramine for oral suspension, USP is not absorbed from the digestive tract. Cholestyramine for oral suspension USP light powder, the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin is quite hydrophilic, but insoluble in water.

Medically reviewed by Drugs. Last updated on March 1, Cholestyramine for Oral Suspension, USP, the chloride salt of a basic anion exchange resin, a cholesterol lowering agent, is intended for oral administration. Cholestyramine resin is quite hydrophilic, but insoluble in water. Cholestyramine resin is not absorbed from the digestive tract.

It is represented by the following structural formula:. Inactive ingredients: sucrose Cholesterol is probably the sole precursor of bile acids. During normal digestion, bile acids are secreted into the intestines. A major portion of the bile acids is absorbed from the intestinal tract and returned to the liver via the enterohepatic circulation.

Only very small amounts of bile acids are found in normal serum. Cholestyramine resin adsorbs and combines with the bile acids in the intestine to form an insoluble complex which is excreted in the feces.

This results in a partial removal of bile acids from the enterohepatic circulation by preventing their absorption. The increased fecal loss of bile acids due to Cholestyramine resin administration leads to an increased oxidation of cholesterol to bile acids, a decrease in beta lipoprotein or low density lipoprotein plasma levels and a decrease in serum cholesterol levels.

Although in man, Cholestyramine resin produces an increase in hepatic synthesis of cholesterol, plasma cholesterol levels fall. In patients with partial biliary obstruction, the reduction of serum bile acid levels by Cholestyramine resin reduces excess bile acids deposited in the dermal tissue with resultant decrease in pruritus.

In a large, placebo-controlled, multi-clinic study, LRC-CPPT 1 , hypercholesterolemic subjects treated with Cholestyramine resin, had mean reduction in total and low-density lipoprotein cholesterol LDL-C which exceeded those for diet and placebo treatment by 7. Two controlled clinical trials have examined the effects of Cholestyramine monotherapy upon coronary atherosclerotic lesions using coronary arteriography.

In the St. The mean absolute width of coronary segments decreased in the usual care group, increased slightly 0. Thus in these randomized controlled clinical trials using coronary arteriography, Cholestyramine resin monotherapy has been demonstrated to slow progression 2,3 and promote regression 3 of atherosclerotic lesions in the coronary arteries of patients with coronary artery disease.

The effect of intensive lipid-lowering therapy on coronary atherosclerosis has been assessed by arteriography in hyperlipidemic patients. In these randomized, controlled clinical trials, patients were treated for two to four years by either conventional measures diet, placebo or in some cases low dose resin or intensive combination therapy using diet plus colestipol an anion exchange resin with a mechanism of action and an effect on serum lipids similar to that of Cholestyramine for Oral Suspension, USP plus either nicotinic acid or lovastatin.

When compared to conventional measures, intensive lipid-lowering combination therapy significantly reduced the frequency of progression and increased the frequency of regression of coronary atherosclerotic lesions in patients with or at risk for coronary artery disease.

Cholestyramine for Oral Suspension, USP may be useful to lower LDL cholesterol in patients who also have hypertriglyceridemia, but it is not indicated where hypertriglyceridemia is the abnormality of most concern. Therapy with lipid-altering agents should be a component of multiple risk factor intervention in those individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia.

Treatment should begin and continue with dietary therapy specific for the type of hyperlipoproteinemia determined prior to initiation of drug therapy. Excess body weight may be an important factor and caloric restriction for weight normalization should be addressed prior to drug therapy in the overweight.

Prior to initiating therapy with Cholestyramine resin, secondary causes of hypercholesterolemia e. In such cases Cholestyramine resin, may not be indicated.

Serum cholesterol and triglyceride levels should be determined periodically based on NCEP guidelines to confirm initial and adequate long-term response. A favorable trend in cholesterol reduction should occur during the first month of Cholestyramine resin therapy. The therapy should be continued to sustain cholesterol reduction. If adequate cholesterol reduction is not attained, increasing the dosage of Cholestyramine resin or adding other lipid-lowering agents in combination with Cholestyramine resin should be considered.

A lipoprotein analysis including LDL-C determination should be carried out once a year. The NCEP treatment guidelines are summarized below. Cholestyramine resin monotherapy has been demonstrated to retard the rate of progression 2,3 and increase the rate of regression 3 of coronary atherosclerosis. Cholestyramine resin has been shown to have a variable effect on serum cholesterol in these patients. Patients with primary biliary cirrhosis may exhibit an elevated cholesterol as part of their disease.

Cholestyramine for Oral Suspension, USP is contraindicated in patients with complete biliary obstruction where bile is not secreted into the intestine and in those individuals who have shown hypersensitivity to any of its components. Chronic use of Cholestyramine resin may be associated with increased bleeding tendency due to hypoprothrombinemia associated with Vitamin K deficiency.

This will usually respond promptly to parenteral Vitamin K 1 and recurrences can be prevented by oral administration of Vitamin K 1. Reduction of serum or red cell folate has been reported over long term administration of Cholestyramine resin.

Supplementation with folic acid should be considered in these cases. There is a possibility that prolonged use of Cholestyramine resin, since it is a chloride form of anion exchange resin, may produce hyperchloremic acidosis. This would especially be true in younger and smaller patients where the relative dosage may be higher.

Caution should also be exercised in patients with renal insufficiency or volume depletion and in patients receiving concomitant spironolactone. Cholestyramine resin may produce or worsen preexisting constipation. The dosage should be increased gradually in patients to minimize the risk of developing fecal impaction. In patients with preexisting constipation, the starting dose should be 1 pouch or 1 scoop once daily for 5 to 7 days, increasing to twice daily with monitoring of constipation and of serum lipoproteins, at least twice, 4 to 6 weeks apart.

Increased fluid intake and fiber intake should be encouraged to alleviate constipation and a stool softener may occasionally be indicated. Particular effort should be made to avoid constipation in patients with symptomatic coronary artery disease. Constipation associated with Cholestyramine resin may aggravate hemorrhoids. Inform your physician if you are pregnant or plan to become pregnant or are breast-feeding. Drink plenty of fluids and mix each 8. Sipping or holding the resin suspension in the mouth for prolonged periods may lead to changes in the surface of the teeth resulting in discoloration, erosion of enamel or decay, good oral hygiene should be maintained.

Serum cholesterol levels should be determined frequently during the first few months of therapy and periodically thereafter. Serum triglyceride levels should be measured periodically to detect whether significant changes have occurred. 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.

Interference with the absorption of oral phosphate supplements has been observed with another positively-charged bile acid sequestrant. Cholestyramine resin may interfere with the pharmacokinetics of drugs that undergo enterohepatic circulation. The discontinuance of Cholestyramine resin could pose a hazard to health if a potentially toxic drug such as digitalis has been titrated to a maintenance level while the patient was taking Cholestyramine resin.

Because Cholestyramine binds bile acids, Cholestyramine resin may interfere with normal fat digestion and absorption and thus may prevent absorption of fat-soluble vitamins such as A, D, E and K. When Cholestyramine resin is given for long periods of time, concomitant supplementation with water-miscible or parenteral forms of fat-soluble vitamins should be considered.

In studies conducted in rats in which Cholestyramine resin was used as a tool to investigate the role of various intestinal factors, such as fat, bile salts and microbial flora, in the development of intestinal tumors induced by potent carcinogens, the incidence of such tumors was observed to be greater in Cholestyramine resin-treated rats than in control rats. The relevance of this laboratory observation from studies in rats to the clinical use of Cholestyramine resin is not known.

When the many different categories of tumors are examined, various alimentary system cancers were somewhat more prevalent in the Cholestyramine group. The small numbers and the multiple categories prevent conclusions from being drawn. However, in view of the fact that Cholestyramine resin is confined to the GI tract and not absorbed and in light of the animal experiments referred to above, a six-year post-trial follow-up of the LRC-CPPT 5 patient population has been completed a total of There are no adequate and well controlled studies in pregnant women.

The use of Cholestyramine in pregnancy or lactation or by women of childbearing age requires that the potential benefits of drug therapy be weighed against the possible hazards to the mother and child. Caution should be exercised when Cholestyramine resin is administered to a nursing mother. The possible lack of proper vitamin absorption described in the "Pregnancy" section may have an effect on nursing infants.

In calculating pediatric dosages, The effects of long-term drug administration, as well as its effect in maintaining lowered cholesterol levels in pediatric patients, are unknown. The most common adverse reaction is constipation. When used as a cholesterol-lowering agent predisposing factors for most complaints of constipation are high dose and increased age more than 60 years old. Most instances of constipation are mild, transient and controlled with conventional therapy. Some patients require a temporary decrease in dosage or discontinuation of therapy.

Rare reports of intestinal obstruction, including two deaths, have been reported in pediatric patients. Occasional calcified material has been observed in the biliary tree, including calcification of the gallbladder, in patients to whom Cholestyramine resin has been given. However, this may be a manifestation of the liver disease and not drug related. One patient experienced biliary colic on each of three occasions on which he took a Cholestyramine for oral suspension product.

One patient diagnosed as acute abdominal symptom complex was found to have a "pasty mass" in the transverse colon on x-ray. Other events not necessarily drug related reported in patients taking Cholestyramine resin include:. Gastrointestinal: GI-rectal bleeding, black stools, hemorrhoidal bleeding, bleeding from known duodenal ulcer, dysphagia, hiccups, ulcer attack, sour taste, pancreatitis, rectal pain, diverticulitis. Hypersensitivity: Urticaria, asthma, wheezing, shortness of breath.

Neurologic: Headache, anxiety, vertigo, dizziness, fatigue, tinnitus, syncope, drowsiness, femoral nerve pain, paresthesia. Miscellaneous: Weight loss, weight gain, increased libido, swollen glands, edema, dental bleeding, dental caries, erosion of tooth enamel, tooth discoloration. No ill effects were reported. Should an overdosage occur, the chief potential harm would be obstruction of the gastrointestinal tract. The location of such potential obstruction, the degree of obstruction and the presence or absence of normal gut motility would determine treatment.

The recommended maintenance dose for Cholestyramine for Oral Suspension, USP is 2 to 4 pouches or scoopfuls daily 8 to 16 grams anhydrous Cholestyramine resin divided into two doses. The maximum recommended daily dose is 6 pouches or scoopfuls of Cholestyramine for Oral Suspension, USP 24 grams of anhydrous Cholestyramine resin.

The suggested time of administration is at mealtime but may be modified to avoid interference with absorption of other medications. Although the recommended dosing schedule is twice daily, Cholestyramine for Oral Suspension, USP may be administered in 1 to 6 doses per day. Always mix the dry powder with water or other fluids before ingesting.

See Preparation Instructions. Preliminary evidence suggests that the lipid-lowering effects of Cholestyramine on total and LDL-cholesterol are enhanced when combined with a HMG-CoA reductase inhibitor, e.



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