Questran (Oral)
Questran (Oral) Uses, Dosage, Side Effects, Food Interaction and all others data.
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. Questran (Oral) 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.
Questran (Oral) binds bile in the gastrointestinal tract to prevent its reabsorption. The resin is a strong anion exchange resin, which means that it can exchange its chloride anions with anionic bile acids in the gastrointestinal tract and bind them strongly in the resin matrix. The functional group of the anion exchange resin is a quaternary ammonium group attached to an inert styrene-divinylbenzene copolymer.
Trade Name | Questran (Oral) |
Availability | Prescription only |
Generic | Cholestyramine |
Cholestyramine Other Names | Cholestyramine resin, Colestiramina, Colestyramine |
Related Drugs | atorvastatin, simvastatin, rosuvastatin, Lipitor, fenofibrate, Crestor, Questran, Prevalite, Cholestyramine Light, Questran Light |
Type | |
Groups | Approved, Investigational |
Therapeutic Class | Bile acid sequestrants |
Manufacturer | |
Available Country | USA |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
As an adjunct to dietary therapy & exercise to decrease elevated serum cholesterol in the management of type IIa & type IIb hyperlipoproteinaemia & reduce the risk of atherosclerotic coronary artery disease & MI. Symptomatic control of diarrhoea caused by increased bile acids due to short bowel syndrome. Relief of pruritus associated with partial biliary obstruction.
Questran (Oral) is also used to associated treatment for these conditions: Atherosclerosis, Primary Hypercholesterolemia, Pruritus
How Questran (Oral) works
Questran (Oral) forms a resin that acts as a bile acid sequestrant to limit the reabsorption of bile acids in the gastrointestinal tract. Questran (Oral) resin is a strong anion exchange resin, allowing it to exchange its chloride anions with anionic bile acids present in the gastrointestinal tract and form a strong resin matrix. Questran (Oral) consists of a functional group, which is a quaternary ammonium group attached to an inert styrene-divinylbenzene copolymer, in the anion exchange resin.
Dosage
Questran (Oral) dosage
Adult: Initially 4 gm 1 to 6 times daily. May be taken with or without food. Do not take in the dry form. Mix with 120-180 ml of water or fruit juice, stir to a uniform consistency before taking.
Side Effects
Constipation, faecal impaction &/or haemorrhoids with or without bleeding, steatorrhoea, hyperchloraemic acidosis, increased urinary calcium excretion, irritation of skin, tongue & perianal area.
Toxicity
Overdose may result in blockage of intestine or stomach.
Precaution
Prolonged use may increase bleeding tendency. Not to be used as monotherapy in patients with hyperlipidaemias associated with hypertriglyceridaemia. Folic acid, vit A & D supplement may be needed in long-term use. Lactation, pregnancy & elderly.
Interaction
Binds & may delay or reduce absorption of thyroid hormones, digitoxin, digoxin, warfarin, Fe salts, chenodiol, phenylbutazone, thiazide diuretics, phenobarb, tetracycline, loperamide, penicillin G, HMG-CoA reductase inhibitors. Admin other drugs 1 hr before or 4-6 hr after cholestyramine.
Food Interaction
- Take with fluids. Do not take with carbonated fluids.
- Take with food. Take with a meal unless this interferes with other medications.
Questran (Oral) multivitamins interaction
[Moderate] ADJUST DOSING INTERVAL: Bile acid sequestrants and the phosphate binder, sevelamer, can decrease the absorption of fat-soluble vitamins A, D, E, and K.
In non-clinical safety studies, rats administered colesevelam at doses greater than 30-fold the projected human clinical dose developed hemorrhage in association with vitamin K deficiency.
In a crossover study involving healthy subjects, coadministration of sevelamer with calcitriol resulted in a significant reduction in bioavailability for calcitriol (calcitriol with sevelamer vs calcitriol alone: AUC 137 pg*h
Oral vitamin supplements should be administered at least 4 hours before colesevelam and either 1 hour before or 4 to 6 hours after other bile acid sequestrants and sevelamer.
Questran (Oral) Drug Interaction
Moderate: levothyroxine, levothyroxine, cholecalciferol, cholecalciferolMinor: aspirin, aspirin, acetaminophen, acetaminophenUnknown: duloxetine, duloxetine, omega-3 polyunsaturated fatty acids, omega-3 polyunsaturated fatty acids, pregabalin, pregabalin, cyanocobalamin, cyanocobalamin, ascorbic acid, ascorbic acid, cetirizine, cetirizine
Questran (Oral) Disease Interaction
Major: biliary obstructionModerate: constipation, hyperchloremia, PKU, vitamin/folate deficiency
Elimination Route
Not absorbed from the gastrointestinal tract following oral administration.
Half Life
6 minutes
Elimination Route
Questran (Oral) resin adsorbs and combines with the bile acids in the intestine to form an insoluble complex which is excreted in the feces.
Pregnancy & Breastfeeding use
Pregnancy Category- Not Classified
Contraindication
Complete biliary obstruction.
Innovators Monograph
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