Questran

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How does it work?

This medicine contains the active ingredient colestyramine (previously spelt cholestyramine in the UK). It is not absorbed into the blood stream, but acts in the intestine, where it works by absorbing bile acids. Bile is a substance that is produced by the liver and released into the intestines through the bile duct as part of digestion. It contains chemicals called bile acids, which the liver makes from cholesterol in the blood. Bile acids aid the digestion of fats consumed in the diet and are normally reabsorbed from the intestine into the bloodstream following digestion. Colestyramine absorbs bile acids in the intestine and prevents them being reabsorbed into the bloodstream. Instead, they pass through the intestine with the colestyramine and are excreted in the faeces. Colestyramine therefore reduces the levels of bile acids in the blood. This in turn triggers the liver to produce more bile acids using the cholesterol in the blood, which therefore lowers the levels of cholesterol in the blood. High cholesterol levels are a risk factor for heart disease, and reducing cholesterol reduces the risk of a heart attack. Colestyramine is used for this purpose. Though cholesterol levels are reduced, colestyramine does not correct the underlying cause of raised cholesterol levels, so it is necessary to continue with a cholesterol-lowering diet and the medicine indefinitely. Stopping treatment usually leads to a return to high cholesterol levels. Colestyramine is also used to treat people who have an obstruction of the bile duct. These people often have itchy skin due to a build up of bile acids in the blood, which leads to excess being deposited in the skin. As colestyramine reduces the levels of bile acids in the blood, the amount of excess bile acids deposited in the skin is reduced and this stops the itching. Finally, colestyramine is used to bind unabsorbed bile salts in the intestine and hence provide symptomatic relief of diarrhoea due to various conditions described below.

What is it used for?

- Diarrhoea due to:- Crohn's disease; surgical removal of part of the intestine (ileal resection); removal of nerve supply to the gut (vagotomy); decreased nerve supply to the gut due to diabetes (diabetic vagal neuropathy); or radiation treatment
- High blood cholesterol levels
- Itching due to partial blockage of the bile duct (biliary obstruction), or a rare form of liver disease which damages the liver and bile ducts (primary biliary cirrhosis)
- Prevention of coronary heart disease, in men aged 35-59 with high blood cholesterol (hypercholesterolemia) which has not responded to diet or other measures

Warning!

- This medicine may interfere with the absorption of fat soluble vitamins such as A, D and K from the gut. Supplements of these vitamins may be required during prolonged high dose treatment.

Seek medical advice from your doctor.
- This medicine is not recommended for children under six years of age.
- This medicine should not be taken in its dry form. Mix with water or fruit juice before taking. Alternatively, the powder may be mixed with skimmed milk, thin soups or pulpy fruits with a high moisture content, eg apple sauce.
- People with diabetes should be aware that each sachet of Questran contains 3.79g of sucrose. Questran light contains the sweetener aspartame, which is a source of phenylalanine, instead of sucrose.

Use with caution in

.

- Children with inherited high blood cholesterol

Not to be used in

- Total blockage of the bile duct (total biliary obstruction)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The safety of this medicine in pregnancy has not been established. It is to be used with caution during pregnancy, bearing in mind it may reduce absorption of fat soluble vitamins. Seek medical advice from your doctor.
- The safety of this medicine during breastfeeding has not been established. Seek medical advice from your doctor.

Label warnings

- Dissolve or mix this medication with water before taking.

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