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Prevalite
Prevalite (cholestyramine) is a bile acid sequestrant used primarily to lower cholesterol levels in patients with hyperlipidemia. It works by binding to bile acids in the intestine, preventing their reabsorption and promoting their excretion. This mechanism stimulates the liver to convert cholesterol into bile acids, thus reducing the overall cholesterol levels in the body. Prevalite is also used to manage itching associated with liver disease and as an adjunct therapy in patients with certain types of diarrhea.
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Frequently Asked Questions
How long does it take for Prevalite to lower cholesterol levels?
Cholesterol levels may begin to improve within 4 to 6 weeks of starting treatment, with continued improvement over time.
Can I stop taking Prevalite suddenly?
It is advisable to consult your healthcare provider before stopping any medication, including Prevalite, to ensure continued management of cholesterol levels.
Are there any dietary restrictions while taking Prevalite?
While there are no specific dietary restrictions, following a heart-healthy diet is recommended to maximize the benefits of cholesterol-lowering medications.
What should I do if I miss a dose of Prevalite?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Is Prevalite safe for long-term use?
Prevalite can be used long-term under medical supervision, but regular monitoring is important to assess effectiveness and potential side effects, including vitamin deficiencies.
Comprehensive Drug Guide
How Does Prevalite Work?
Cholestyramine binds to bile acids in the gastrointestinal tract, forming a complex that cannot be absorbed. This binding decreases the enterohepatic circulation of bile acids, leading to their excretion. As a result, the liver must utilize cholesterol to produce more bile acids, which decreases the level of cholesterol in the bloodstream.
Common Dosages
- Powder for oral suspension: 4 g per packet
Typical Dosing
- The usual starting dose for lowering cholesterol is 4 g taken orally once or twice daily, with the option to increase to a maximum dose of 24 g per day based on patient response and tolerability.
- For managing pruritus, dosing may vary based on individual needs and should be directed by a healthcare provider.
Typical Dosing
FDA Approved Indications
- Management of primary hyperlipidemia to reduce elevated levels of LDL cholesterol
- Relief of pruritus associated with partial biliary obstruction
- Adjunctive therapy for patients with certain types of diarrhea
Who Shouldn't Take Prevalite?
- Known hypersensitivity to cholestyramine or any of its components
- Complete biliary obstruction
- Patients with certain gastrointestinal disorders that affect motility
Advice From The Pharmacist
- Mix the powder with water, juice, or non-carbonated beverages before taking it. Do not take it dry, as it can cause choking.
- Separate dosing from other medications and supplements by at least 1 hour before or 4 to 6 hours after taking cholestyramine, as it can interfere with their absorption.
- Regular monitoring of lipid levels is important to assess the effectiveness of the therapy.
Side Effects of Prevalite
Common Side Effects
- Constipation
- Nausea
- Abdominal discomfort or bloating
- Flatulence
Uncommon/Severe Side Effects
- Gastrointestinal obstruction (in rare cases)
- Malabsorption of fat-soluble vitamins (A, D, E, K)
Risks and Warnings of Prevalite
- Gastrointestinal Issues: Caution should be used in patients with a history of bowel obstruction or severe constipation.
- Vitamin Deficiency: Prolonged use may lead to malabsorption of fat-soluble vitamins, so patients should be monitored for vitamin deficiencies.
- Drug Interactions: Cholestyramine can bind to other medications, reducing their effectiveness. It’s important to space doses of other drugs accordingly.
Interactions with Prevalite
Common Drug Interactions
- Warfarin: Cholestyramine can interfere with the absorption of warfarin, requiring careful monitoring of INR levels.
- Thyroid Medications: Can reduce the absorption of levothyroxine and other thyroid medications.
- Diuretics: Certain diuretics may have altered effectiveness when taken with cholestyramine.
Alternatives to Prevalite
- Statins: Such as atorvastatin or simvastatin, which are commonly used for lowering cholesterol.
- Fibrates: Such as fenofibrate, which can also help lower triglyceride levels.
- Niacin: A vitamin that can improve cholesterol levels but should be used under medical supervision due to potential side effects.
