A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Questran Side Effects, and Drug Interactions - Cholestyramine
Questran Side Effects, and Drug Interactions - Cholestyramine
SIDE EFFECTS
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.
Less Frequent Adverse Reactions - Abdominal discomfort
and/or pain, flatulence, nausea, vomiting, diarrhea, eructation, anorexia,
steatorrhea, bleeding tendencies due to hypoprothrombinemia (Vitamin K
deficiency) as well as Vitamin A (one case of night blindness reported)
and D deficiencies, hypercholeremic acidosis in children, osteoporosis,
rash and irritation of the skin, tongue and perianal area. 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.
Laboratory test changes - Liver function abnormalities.
Hematologic - Prolonged prothrombin time, ecchymosis, anemia.
Hypersensitivity - Urticaria, asthma, wheezing, shortness
of breath.
Musculoskeletal - Backache, muscle and joint pains, arthritis.
Neurologic - Headache, anxiety, vertigo, dizziness, fatigue,
tinnitus, syncope, drowsiness, femoral nerve pain, paresthesia.
Eye - Uveitis.
Renal - Hematuria, dysuria, burnt odor to urine, diuresis.
Miscellaneous - Weight loss, weight gain, increased libido,
swollen glands, edema, dental bleeding, dental caries, erosion of tooth
enamel, tooth discoloration.
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.
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 filtrated
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.
SINCE CHOLESTYRAMINE RESIN MAY BIND OTHER DRUGS GIVEN CONCURRENTLY, IT
IS RECOMMENDED THAT PATIENTS TAKE OTHER DRUGS AT LEAST 1 HOUR BEFORE
OR 4 TO 6 HOURS AFTER CHOLESTYRAMINE RESIN (OR AT AS GREAT AN INTERVAL
AS POSSIBLE) TO AVOID IMPEDING THEIR ABSORPTION.
top
