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Questran
Questran (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. This process reduces the levels of cholesterol in the bloodstream, as the liver uses cholesterol to produce more bile acids, effectively lowering overall cholesterol levels.
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Frequently Asked Questions
How quickly does Questran start to work?
Cholestyramine may take several weeks to achieve its maximum effect on cholesterol levels, and patients should have their lipid profiles monitored regularly.
Can I stop taking Questran suddenly?
It is generally safe to stop taking Questran, but patients should discuss any changes in their treatment regimen with their healthcare provider, especially if they have underlying health issues.
Are there any specific dietary restrictions while using Questran?
While there are no specific dietary restrictions, patients are encouraged to follow a low-fat diet to enhance the effectiveness of cholesterol-lowering therapy.
What should I do if I miss a dose of Questran?
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 Questran safe for long-term use?
Questran can be used long-term; however, regular monitoring for side effects, especially gastrointestinal issues and nutritional deficiencies, is important for ensuring patient safety and effectiveness of treatment.
Comprehensive Drug Guide
How Does Questran Work?
Cholestyramine works by binding to bile acids in the intestine, forming an insoluble complex that is excreted in the feces. This binding reduces the pool of bile acids available for reabsorption, prompting the liver to convert more cholesterol into bile acids. As a result, this lowers the levels of cholesterol in the blood.
Common Dosages
- Powder for oral suspension: Commonly 4 g packets.
Typical Dosing
- The usual starting dose for adults is 4 grams taken once or twice daily, which may be adjusted based on the patient's cholesterol levels and response to therapy. The maximum recommended dose is 24 grams per day.
Typical Dosing
FDA Approved Indications
- Primary hyperlipidemia to reduce elevated cholesterol levels in adults.
- Pruritus associated with partial biliary obstruction.
Adjunct to dietary therapy in patients with elevated cholesterol levels.
Who Shouldn't Take Questran?
- Known hypersensitivity to cholestyramine or any components of the formulation.
- Complete biliary obstruction.
- Phenylketonuria (in some formulations).
Advice From The Pharmacist
- Instruct patients to take Questran exactly as prescribed and to mix the powder with enough liquid to ensure proper administration.
- Advise patients about the importance of maintaining a low-fat diet while on Questran for optimal cholesterol management.
- Discuss the need to take other medications at least 1 hour before or 4-6 hours after taking Questran, as it may interfere with the absorption of certain drugs.
Side Effects of Questran
Common Side Effects
- Constipation
- Bloating
- Gas
- Nausea
- Abdominal discomfort
Uncommon/Severe Side Effects
- Severe gastrointestinal obstruction
- Vitamin deficiencies (especially fat-soluble vitamins)
Risks and Warnings of Questran
- Gastrointestinal Effects: Monitor for signs of constipation or bowel obstruction, and encourage patients to maintain adequate fluid intake and dietary fiber.
- Nutritional Deficiencies: Long-term use may lead to deficiencies in fat-soluble vitamins (A, D, E, and K); patients should be monitored for signs of deficiency.
Interactions with Questran
Common Drug Interactions
- Other Medications: Cholestyramine can reduce the absorption of various medications, including digoxin, warfarin, and certain diuretics. Patients should be advised to separate the administration of these medications from Questran.
Alternatives to Questran
- Other Lipid-Lowering Agents: Such as statins (e.g., atorvastatin, simvastatin) or other classes of cholesterol-lowering medications may be considered based on individual patient needs and cholesterol levels.
