Pregnancy—Cholestyramine is not absorbed into the body and is not likely to cause problems. However, it may reduce absorption of vitamins into the body. Ask your doctor whether you need to take extra vitamins.

Breast-feeding—Questran is not absorbed into the body and is not likely to cause problems. However, the reduced absorption of vitamins by the mother may affect the nursing infant.

Children—Cholestyramine has been tested in a limited number of children. In effective doses, the medicine has not been shown to cause different side effects or problems than it does in adults.

Older adults—Side effects may be more likely to occur in patients over 60 years of age, who are usually more sensitive to the effects of Questran.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking Cholestyramine it is especially important that your health care professional know if you are taking any of the following:

Anticoagulants (blood thinners)—The effects of the anticoagulant may be changed and this may increase the chance of bleeding.
Digitalis glycosides (heart medicine) or
Diuretics (water pills) or
Penicillin G, taken by mouth or
Phenylbutazone or
Propranolol (e.g., Inderal) or
Tetracyclines, taken by mouth (medicine for infection) or
Thyroid hormones or
Vancomycin, taken by mouth—Questran may prevent Cholestyramine from working properly

Other medical problems—The presence of other medical problems may affect the use of Questran. Make sure you tell your doctor if you have any other medical problems, especially:
Bleeding problems or
Constipation or
Gallstones or
Heart or blood vessel disease or
Hemorrhoids or
Stomach ulcer or other stomach problems or
Underactive thyroid—Questran may make these conditions worse
Kidney disease—There is an increased risk of developing electrolyte problems (problems in the blood)
Phenylketonuria—Phenylalanine in aspartame is included in the sugar-free brand of Questran and should be avoided. Aspartame can cause problems in people with phenylketonuria. Therefore, it is best if you avoid using the sugar-free product.

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Proper Use of This Medicine

Take Cholestyramine exactly as directed by your doctor. Try not to miss any doses and do not take more medicine than your doctor ordered.

This medicine should never be taken in its dry form, since it could cause you to choke. Instead, always mix as follows:

Place Cholestyramine in 2 ounces of any beverage and mix thoroughly. Then add an additional 2 to 4 ounces of beverage and again mix thoroughly (it will not dissolve) before drinking. After drinking all the liquid containing the medicine, rinse the glass with a little more liquid and drink that also, to make sure you get all Cholestyramine.
You may also mix this medicine with milk in hot or regular breakfast cereals, or in thin soups such as tomato or chicken noodle soup. Or you may add it to some pulpy fruits such as crushed pineapple, pears, peaches, or fruit cocktail.
For patients taking this medicine for high cholesterol :

Importance of diet—Before prescribing medicine for your condition, your doctor will probably try to control your condition by prescribing a personal diet for you. Such a diet may be low in fats, sugars, and/or cholesterol. Many people are able to control their condition by carefully following their doctor's orders for proper diet and exercise. Medicine is prescribed only when additional help is needed. Follow carefully the special diet your doctor gave you, since the medicine is effective only when a schedule of diet and exercise is properly followed.
Also, Cholestyramine is less effective if you are greatly overweight. It may be very important for you to go on a reducing diet. However, check with your doctor before going on any diet.
Remember that Cholestyramine will not cure your cholesterol problem but it will help control it. Therefore, you must continue to take it as directed if you expect to lower your cholesterol level.

Dosing—

The dose of Questran will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Questran. If your dose is different, do not change it unless your doctor tells you to do so.

For oral dosage form (powder for oral suspension):
For high cholesterol or pruritus (itching) related to biliary obstruction:
Adults—At first, 4 grams one or two times a day before meals. Then, your doctor may increase your dose to 8 to 24 grams a day. This is divided into two to six doses.
Children—At first, 4 grams a day. This is divided into two doses and taken before meals. Then, your doctor may increase your dose to 8 to 24 grams a day. This is divided into two or more doses.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. Then go back to your regular dosing schedule. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store Cholestyramine:

Keep out of the reach of children.
Store away from heat and direct light.
Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Do not take any other medicine unless prescribed by your doctor since Questran may change the effect of other medicines.

Do not stop taking Cholestyramine without first checking with your doctor. When you stop taking this medicine, your blood cholesterol levels may increase again. Your doctor may want you to follow a special diet to help prevent this from happening.

Side Effects of This Medicine

In some animal studies, Questran was found to cause tumors. It is not known whether Questran causes tumors in humans.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
Black, tarry stools; stomach pain (severe) with nausea and vomiting

Check with your doctor as soon as possible if any of the following side effects occur:

More common
Constipation

Rare
Loss of weight (sudden)

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common
Heartburn or indigestion; nausea or vomiting; stomach pain

Less common
Belching; bloating; diarrhea; dizziness; headache

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Questran : Full Prescribing Information