Bile acid sequestrants (anion exchange resins).

Colestyramine [cholestyramine] - diarrhoea

Questran Light: low sugar powder in sachets. Questran: powder in sachets.

Questran Light: Colestyramine 4g. Questran: Colestyramine 4g.

Questran is used for:

1. Primary prevention of coronary heart disease in men between 35 and 59 years of age and with primary hypercholesterolaemia who have not responded to diet and other appropriate measures.
2. Reduction of plasma cholesterol in hypercholesterolaemia, particularly in those patients who have been diagnosed as Fredrickson's Type II (high plasma cholesterol with normal or slightly elevated triglycerides).
3. Relief of pruritus associated with partial biliary obstruction and primary biliary cirrhosis.
4. Relief of diarrhoea associated with ileal resection, Crohn's disease, vagotomy and diabetic vagal neuropathy.
5. Management of radiation-induced diarrhoea.

Adults:

As a precautionary measure, where concurrent drug therapy exists then such drugs should be administered at least one hour before or 4-6 hours after Questran.

Questran should not be taken in its dry form.

Questran should be administered mixed with water or a suitable liquid, such as fruit juice, and stirred to a uniform consistency.

Questran may also be mixed with skimmed milk, thin soups, pulpy fruits with high moisture content, e.g. apple sauce, etc..

1. For primary prevention of coronary heart disease and to reduce cholesterol: After initial introduction over a three to four week period, 3 to 6 Questran sachets per day, administered either as a single daily dose or in divided doses up to four times daily, according to dosage requirements and patient acceptability. Dosage may be modified according to response and can be increased to 9 sachets per day if necessary.

Occasional slight gastro-intestinal upsets, e.g. constipation, may occur when starting Questran. These usually pass with continued usage of Questran and are minimised by starting therapy gradually.

2. To relieve pruritus: One or two sachets daily are usually sufficient.

3. To relieve diarrhoea: As for reduction of cholesterol but it may be possible to reduce this dosage. In all patients presenting with diarrhoea induced by bile acid malabsorption, if a response is not seen within 3 days, then alternative therapy should be initiated.

Children 6 - 12 years:

The initial dose is determined by the following formula:

Subsequent dosage adjustment may be necessary where clinically indicated.

Children under 6 years: The dose has not been established in infants and children under 6 years.

Elderly:

No dosage adjustment is necessary.

Under 6 years, not recommended; over 6 years, in proportion to dose for 70 kg adult.

Questran is contra-indicated in patients who have shown hypersensitivity to any of the product ingredients.

In patients with complete biliary obstruction, since Questran cannot be effective where bile is not secreted into the intestine.

Reduction of serum folate concentrations has been reported in children with familial hypercholesterolaemia. Supplementation with folic acid should be considered in these cases.

Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.

Take all drugs 1 hour before or 4 - 6 hours after Questran.

Increased bleeding tendency on long term therapy due to vitamin K deficiency. Constipation.

Bristol-Myers Squibb

(POM)

04 October 2010