Olestar Suspension
Cholestyramine
4 g
Everest Pharmaceuticals Ltd.
| Pack size | 10 Sachet in box |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 130.00/Sachet AED |
Indications
Olestar Suspension is used for:
Bile acid-induced diarrhoea; Hyperlipidaemia, Combined hypercholesterolemia and hypertriglyceridemia, Pruritus associated w/ partial biliary obstruction or primary biliary cirrhosis
Adult Dose
Oral
Hyperlipidaemia, Bile acid-induced diarrhoea
Adult: 4 g once 12-24 hourly; increase gradually over >1 month intervals
Maintenance: 8-16 g/day PO divided 12 hourly; not to exceed 24 g/day
Oral suspension/Sachet
USP powder is 1 sachet (contains 4 grams of anhydrous cholestyramine) once or twice a day.
The recommended maintenance dose for cholestyramine for oral suspension, USP powder, is 2 to 4 sachets divided into two doses.
It is recommended that increases in dose be gradual with periodic assessment of lipid/lipoprotein levels at intervals of not less than 4 weeks.
The maximum recommended daily dose is 6 sachets (24 grams of anhydrous cholestyramine).
Although the recommended dosing schedule is twice daily, cholestyramine for oral suspension, USP powder may be administered in 1 to 6 doses per day.
Pruritus associated with partial biliary obstruction or primary biliary cirrhosis
Adult: 4-8 g daily.
Child Dose
Oral
Hyperlipidaemia, Bile acid-induced diarrhoea
Child: >6 yr: 240 mg/kg/day divided 8-12 hourly; generally not to exceed 8 g/day
Pruritus associated with partial biliary obstruction or primary biliary cirrhosis
Child: >6 yr: 240 mg/kg daily in divided doses.
Renal Dose
Administration
May be taken with or without food.
Do not take in the dry form.
Mix w/ 150 mL of water or fruit juice, stir to a uniform consistency before taking.
Reconstitution: Mix the powder w/ 60-180 mL of water or another noncarbonated beverage (e.g. fruit juice) and stir to a uniform consistency. Alternatively, it may also be mixed w/ skimmed milk, thin soup or a pulpy fruit w/ high moisture content (e.g. applesauce or crushed pineapple).
Take other drugs at least 1 hour before or 4-6 hours after taking cholestyramine to minimize possible interference with absorption
Contra Indications
Complete biliary obstruction; hypersensitivity.
Precautions
Use with caution in renal impairment
Volume depletion
Concomitant spironolactone therapy
Not for use with baseline fasting triglyceride levels ≥300 mg/dL or type III hyperlipoproteinemia; use with caution in patients with triglyceride levels 250-299 mg/dL; perform fasting lipid panel in 4-6weeks after initiation; discontinue use if triglycerides are >400 mg/dL; secondary causes of hyperlipidemia must be ruled out before therapy is initiated
Not to be used as monotherapy in hypertriglyceridemia
With prolonged use, increased risk of bleeding because of hypoprothrombinemia from vitamin K deficiency
May interfere with fat absorption and decrease absorption of fat-soluble vitamins (A, D, E, K)
May exacerbate preexisting constipation (initiate therapy at lower dosage in patients with history of constipation)
Special care must be taken to avoid constipation in patients with symptomatic coronary heart disease
Always mix with water or fluids; never ingest dry powder
Some formulations contain phenylalanine
Because of large quantities of chloride ion released from resin (which may lead to hyperchloremic acidosis and increase urinary calcium excretion on prolonged use), it may be advisable to reduce chloride intake
Pregnancy-Lactation
Pregnancy category: C
Lactation: Drug does not enter breast milk; use with caution because of potential vitamin loss in mother
Interactions
Delayed or reduced absorption of folic acid, thiazide diuretics, propranolol, digoxin and related glycosides, loperamide, phenylbutazone, barbiturates, oestrogens, progestogens, thyroid hormones, warfarin and other coumarin-derivative anticoagulants, iron salts, deferasirox and some antibacterials (e.g. tetracycline, penicillin G).
May prevent absorption of fat-soluble vit.
Slightly decreased rate of absorption of clofibrate.
May interfere w/ absorption of oral phosphate supplements.
Contraindicated (1)
mycophenolate
Serious (1)
warfarin
Adverse Effects
Side effects of Cholestyramine :
Frequency Not Defined
Belching
Constipation
Dental erosion
Diarrhea
Duodenal ulcer bleeding
Flatulence
Gallstones
Heartburn
Hypoprothrombinemia
Malabsorption of fat-soluble vitamins
Nausea and vomiting
Pancreatitis
Perianal irritation
Rectal pain
Steatorrhea
Stomach pain
Weight gain or loss
Mechanism of Action
Colestyramine binds with bile acids to form an insoluble complex which is excreted in the feces, resulting in increased loss of bile acid, thus increasing the oxidation of cholesterol to bile acids.
Note
Olestar 4 g Suspension manufactured by Everest Pharmaceuticals Ltd.. Its generic name is Cholestyramine. Olestar is availble in Bangladesh.
Farmaco BD drug index information on Olestar Suspension is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.