Bile acid sequestrant
Colestyramine
Brand names: Questran, Questran Light
Adult dose
Dose: 4–8g sachet OD initially, increase to 12–24g/day in 1–4 divided doses
Route: PO
Frequency: divided
Clinical pearls
- Bile-acid diarrhoea (post-cholecystectomy, ileal disease); pruritus of cholestasis
- Mix powder with water/juice
Contraindications
- Complete biliary obstruction
Side effects
- Constipation
- Steatorrhoea
- Vitamin A/D/E/K malabsorption
- GI discomfort
Interactions
- Reduces absorption of many drugs — give other drugs ≥1h before or 4–6h after
- Warfarin, digoxin, levothyroxine, mycophenolate
Monitoring
- Vitamin levels if prolonged
- INR if on warfarin
Reference: BNF; https://bnf.nice.org.uk/drugs/colestyramine/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021