Questran

Generic name: Cholestyramine

What is Questran?

Questran is used to lower cholesterol levels in the blood of people with primary hypercholesterolemia (too much LDL cholesterol). Hypercholesterolemia is a genetic condition characterized by a lack of the LDL receptors that remove cholesterol from the bloodstream. This drug can be used to lower cholesterol levels in people who also have hypertriglyceridemia, a condition in which an excess of fat is stored in the body. This drug may also be prescribed to relieve itching associated with gallbladder obstruction.

It is available in two forms: Questran and Questran Light. The same instructions apply to both.

What is the most important information I should know about Questran?

It's important to remember that Questran is a supplement to—not a substitute for—diet, exercise, and weight loss. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because together they may lower your risk of heart disease.

If you are being treated for any disease that contributes to increased blood cholesterol, such as hypothyroidism (reduced thyroid function), diabetes, nephrotic syndrome (kidney and blood vessel disorder), dysproteinemia, obstructive liver disease, or alcoholism, or if you are taking any drugs that may raise cholesterol levels, consult your doctor before taking this medication. Caution is also in order if your kidney function is poor.

The use of this medication may produce or worsen constipation and aggravate hemorrhoids. If this happens, inform your doctor. To prevent constipation, the doctor may increase your dosage very slowly, and ask you to drink more fluids, take more fiber, or take a stool softener. If severe constipation develops anyway, the doctor may switch to a different drug.

The prolonged use of Questran may change acidity in the bloodstream, especially in younger and smaller individuals in whom the doses are relatively higher. It is important that you or your child be checked by your doctor on a regular basis.

Who should not take Questran?

If you are sensitive to or have ever had an allergic reaction to Questran or similar drugs, you should not take this medication. Make sure that your doctor is aware of any drug reactions that you have experienced. Unless you are directed to do so by your doctor, do not take this medication if you are being treated for gallbladder obstruction.

What should I tell my doctor before I take the first dose of Questran?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with this drug. Also, talk to your doctor about your complete medical history, especially if you have reduced thyroid function, diabetes, nephrotic syndrome (kidney and blood vessel disorder), obstructive liver disease, or if you drink a lot of alcohol or take any drugs that may raise cholesterol levels.

If you have phenylketonuria, a genetic disorder, check with your doctor before taking Questran Light because this product contains phenylalanine.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The recommended starting dose is 1 single-dose packet or 1 level scoopful, 1 to 2 times daily. The usual maintenance dosage is a total of 2 to 4 packets or scoopfuls daily divided into 2 doses preferably at mealtime (usually before meals). The maximum daily dose is 6 packets or scoopfuls. Although the recommended dosing schedule is 2 times daily, your doctor may ask you to take Questran in up to 6 smaller doses per day.

Children: The dosage will be based on your child's weight. Follow your doctor's recommended dosing schedule.

How should I take Questran?

Never take Questran in its dry form. Always mix it with water or other liquids before taking it. For Questran, use 2 to 6 ounces of liquid per packet or level scoopful; for Questran Light, use 2 to 3 ounces. Soups or fruits with a high moisture content, such as applesauce or crushed pineapple, can be used in place of beverages.

What should I avoid while taking Questran?

Avoid sipping Questran or holding it in your mouth for a long period, as this can lead to tooth discoloration, enamel erosion, or decay. Be sure to brush and floss regularly.

What are possible food and drug interactions associated with Questran?

If Questran is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before taking questran with the following: digitalis, estrogens and progestins, oral diabetes drugs, penicillin G, phenobarbital, phenylbutazone, propranolol, spironolactone, tetracycline, thiazide-type diuretic pills, thyroid medication, and warfarin.

Your doctor may recommend that you take other medications at least 1 hour before or 4 to 6 hours after you take Questran.

If you are taking a drug such as digitalis, stopping Questran could be hazardous, since you might experience exaggerated effects of the other drug. Consult your doctor before discontinuing Questran.

This drug may interfere with normal digestion and absorption of fats, including fat-soluble vitamins such as A, D, E, and K. If supplements of vitamins A, D, E, and K are essential to your health, your doctor may prescribe an alternative form of these vitamins.

What are the possible side effects of Questran?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: constipation, heartburn, nausea, vomiting, abdominal pain, flatulence, diarrhea, loss of appetite, osteoporosis, rash, vitamin A and D deficiency, vitamin K deficiency

Can I receive Questran if I am pregnant or breastfeeding?

The effects of Questran during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Because this medication can interfere with vitamin absorption, you may need to increase your vitamin intake before the baby is born and while nursing an infant.

What should I do if I miss a dose of Questran?

Take the forgotten dose as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never double the dose.

How should I store Questran?

Store at room temperature. Protect from moisture and high humidity.