Prevalite (Cholestyramine) - Oral

What Is Prevalite?

Prevalite (cholestyramine) is a prescription drug commonly used to lower cholesterol. It is also used to reduce itching related to a bile duct blockage. Prevalite belongs to a drug class called bile acid sequestrant.

Cholestyramine binds to bile acid in your intestine. Bile acids are made from cholesterol. Binding to bile acids allows cholestyramine to prevent the reabsorption of bile acids in the body. To make more, the body removes cholesterol from the bloodstream. This process helps lower cholesterol. It also eases itching by decreasing the amount of bile acid in the skin.

Prevalite is available as an individual packet of powder and a canister of powder for suspension in a liquid. It may also contain artificial sweeteners (aspartame or phenylalanine). Do not take it if you have phenylketonuria (PKU) disease.

What Is Prevalite Used For?

Prevalite (cholestyramine) is a prescription drug used to:

• Lower cholesterol levels in your body
• Reduce the risk of arteriosclerosis (hardening of blood vessels)
• Treat itching due to bile duct blockage

How to Take Prevalite

Prevalite comes in a dry powder that must be mixed with at least 2 to 3 ounces of liquid per packet or scoopful before taking it. You may also combine it with soups or foods with high moisture content, such as applesauce or crushed pineapple. Do not sip on the mixture for too long or leave it in your mouth, as this can decay your tooth enamel or cause tooth discoloration.

The recommended dosing schedule is twice a day, but you can take this drug as a single dose or as divided doses up to six times a day. Prevalite works best when you take it during meals. Carefully follow your healthcare provider's instructions on how to take it.

If used to treat high cholesterol, you may take it with your evening meal (preferably a single dose). However, if you're taking it for a bile duct blockage, you may take it before breakfast.

Do not take Prevalite together with other drugs. Taking it with other medications reduces how well your body absorbs it. Take other oral medicines at least one hour before or four to six hours after Prevalite.

If you are using this medication long-term, you may need to take supplements that contain fat-soluble vitamins (vitamins A, D, E, and K), iron, and folic acid.

Storage

Store at room temperature (77 degrees Fahrenheit) in a dry place. You may store it between cool and mildly hot temperatures (59 F to 86 F) during short periods. Do not store it in your bathroom.

Keep the powder away from and out of reach of children and pets.

Toss all expired and unused medicines. Do not pour down the drain, sink, or toilet. Ask your pharmacist about the best ways to dispose of your medication. Check out drug take-back programs in your area.

Off-Label Uses

Cholestyramine is used off-label to:

• Treat chronic diarrhea due to bile acid malabsorption
• ​Treat hyperthyroidism (Graves’ disease)
• Remove Arava (leflunomide) quickly from the system (in people having side effects, who are pregnant, or plan to be pregnant)
  

What Are the Side Effects of Prevalite?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The common side effect of Prevalite is constipation.

You may be able to manage constipation by drinking fluids, exercising, or eating high-fiber foods (e.g., beans, whole grains, bran cereals, and fruits and vegetables).

Tell your healthcare provider if this side effect does not go away or becomes bothersome. Your healthcare provider may order a stool softener or laxative for you.

Severe Side Effects

Call your healthcare provider promptly if you have serious side effects. Call 911 if you have a medical emergency or if your symptoms feel life-threatening. Serious side effects may include:

• Bleeding
• Severe abdominal pain
• Severe constipation
• Signs of an allergic reaction, like hives or swelling

Long-Term Side Effects

Long-term use and chronic use of Prevalite could lead to:

• Bleeding problems (mainly in high doses)
• Worsening hemorrhoids
• Change in color or erosion of tooth enamel 
• Hypochloremic acidosis (a type of acid imbalance in your body)

To prevent tooth enamel discoloration, avoid sipping on your medicine. Do not leave it sitting in your mouth for a long time. Practice good dental hygiene during your treatment.

If you are on long-term cholestyramine, your healthcare provider may prescribe vitamin K to help prevent bleeding problems.

Dosage: How Much Prevalite Should I Take?

Modifications

Other oral drugs affect how well your body absorbs Prevalite. Therefore, it is recommended to take other oral medicines at least one hour before or four to six hours after Prevalite.

Prevalite is safe to use through a feeding tube in people who cannot swallow by mouth.

Missed Dose

Take the missed dose once you think of it. If it is too close to your next dose, skip the missed dose. Go back to your regular dosing frequency. Do not take extra doses or double the amount.

Overdose: What Happens If I Use Too Much Prevalite?

Prevalite has no overdose symptoms reported. If there is an overdose, it may cause a bowel blockage.

Precautions

What Are Reasons I Shouldn't Take Prevalite?

Avoid taking cholestyramine if you:

• Have a complete bile duct block
• Are allergic to bile acid sequestering resins or any part of the formulation
• Have hypertriglyceridemia (abnormal blood cholesterol)

What Other Medications Interact With Prevalite?

Cholestyramine may lower the level of CellCept (mycophenolate) in your body. Do not take it with mycophenolate.

What Medications Are Similar?

Medications similar to Prevalite used to lower cholesterol include:

• Welchol (colesevelam) 
• Colestid (colestipol)
• Lipitor (atorvastatin)

Welchol and Colestid are also bile acid sequestrants and have similar safety profiles as Prevalite.

Lipitor belongs to a different drug class, HMG-CoA reductase inhibitors (statins). It has more side effects than Prevalite, including serious side effects like rhabdomyolysis (muscle breakdown).

Fish oil (omega-3 fatty acids) is also sometimes used in conjunction with other treatments to help promote better heart health.

This is a list of drugs also used similarly to Prevalite. It is not necessarily a list of medications recommended to take together. You should not take these drugs together unless your healthcare provider tells you to. Talk to your pharmacist or healthcare provider if you have questions.

How Can I Stay Healthy While Taking Prevalite?

Managing your cholesterol is a lifelong journey that may require extended use of some medications like Prevalite. Long-term supplementing with fat-soluble vitamins (vitamins A, D, E, and K), iron, and folic acid will help lessen your chances of having certain side effects like bleeding.

Medication is often prescribed after lifestyle changes alone fail to lower cholesterol numbers. Even if you are on medication, you should follow your healthcare provider's recommendations for healthier lifestyle choices. These changed behaviors can help lower cholesterol and improve overall heart health, usually involving a well-balanced, nutritious diet and regular physical activity. If you are overweight or obese, bringing your weight down to a healthier range can also be beneficial. Consider working with your healthcare provider and a registered dietitian nutritionist on an appropriate weight loss plan, if needed.

Talk to your healthcare provider about any concerns or questions, no matter how small. They are there to help.