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Cholestyramine

Drug Information

Cholestyramine is bile acid sequestrant—a class of drugs that binds bile acids, prevents their reabsorption from the digestive system, and reduces cholesterol levels. Cholestyramine is one of many drugs used to lower cholesterol levels in people with high cholesterol.

Bile acids are produced in the liver from cholesterol and secreted into the small intestine to help with the absorption of dietary fat and cholesterol. Bile acid sequestrants bind bile acids in the small intestine and carry them out of the body. This causes the body to use more cholesterol to make more bile acids, which are secreted into the small intestine, bound to bile acid sequestrants, and carried out of the body. The end result is lower cholesterol levels. Bile acid sequestrants also prevent absorption of some dietary cholesterol.

Common brand names:

Questran

Summary of Interactions with Vitamins, Herbs, & Foods

What Are Nutrient Interactions
Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Folic Acid

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.1 , 2 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.3 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.4

  • Vitamin A

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.5 , 6 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.7 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.8

  • Vitamin D

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.9 , 10 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.11 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.12

  • Vitamin E

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.13 , 14 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.15 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.16

  • Vitamin K

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.17 , 18 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.19 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.20

  • Beta-Carotene

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene.21

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Calcium

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.22 , 23 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.24 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.25

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Zinc

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A, D, E, and K.26 , 27 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.28 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.29

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required 

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

2. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

3. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

4. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

5. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

6. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

7. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

8. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

9. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

10. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

11. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

12. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

13. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

14. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

15. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

16. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

17. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

18. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

19. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

20. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

21. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88–91.

22. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

23. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

24. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

25. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

26. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 221–2 [review].

27. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

28. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 171i–l.

29. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

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