Cholestyramine

Ion exchange resin.

Indications

Hypercholesterolaemia, hyperlipidaemia, pruritis←partial biliary obstruction, diarrhoea due to bile acids, diarrhoea associated with Crohn's disease, hyperoxaluria, overdose of digitalis, thyroxine, warfarin or tetracycline.

How taken

Mixed with water or fruit juice.

Mechanism

Increases loss of bile acids, causing more cholesterol to be converted to bile acid. Does not work in patients with homozygous familial hypercholesterolaemia←works by ↑ expression of hepatocyte LDL receptors. It is not absorbed and remains in the intestine.

Adverse effects

Bloating, severe constipation or diarrhoea, N&V, heartburn.