5 Food and Drinks to Avoid While Taking Cholestyramine

Cholestyramine is a medication that lowers cholesterol. It binds bile acids, which are breakdown products of cholesterol, in your intestines. Because cholestyramine isn’t absorbed, it carries the bile acid out of your body with it. Your body then converts cholesterol in the body into the bile acids that it needs. Cholestyramine also treats itching due to incomplete bile duct blockage. 

Cholestyramine is effective whether you take it before or during meals. Because it’s not absorbed into your body, you don’t have to worry about foods affecting the medication’s absorption and break down. 

However, some foods reduce the effectiveness of the medication. And some foods can worsen cholestyramine side effects, like heartburn, nausea, vomiting, constipation, and bloating. These can make it more difficult to take the medication properly. Here are five foods to avoid if you’re taking cholestyramine.

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1. High-fat foods

The most common reason people take cholestyramine is to reduce cholesterol. So it makes sense to cut back on high-fat foods while taking it. If you continue to eat cholesterol-rich foods while taking cholestyramine, you might not get the cholesterol-lowering results you need. Fatty foods can also worsen some cholestyramine side effects. 

Examples of high-fat foods include: 

• Fried foods like french fries, onion rings, fried chicken

• Pizza

• Full-fat dairy

• Processed meats like bacon or sausage

• Chips

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2. Dairy

Full-fat dairy may counteract the effectiveness of cholestyramine because it’s also higher in cholesterol. 

In addition, dairy foods are most likely to worsen common side effects like constipation and bloating. So, it’s best to avoid full-fat cheese, milk, and other dairy products while taking cholestyramine. 

3. Alcohol

There’s no evidence to suggest that alcohol interferes with how cholestyramine works. But alcohol can worsen liver disease. So, if you’re taking cholestyramine for liver-related reasons, it’s best to avoid alcohol altogether. 

Alcohol also makes you pee more often, which can lead to dehydration and worsen constipation. Alcohol also irritates your stomach, which can worsen side effects from cholestyramine like nausea and heartburn. 

4. High-sugar foods

It’s wise to limit or avoid sugary and artificially sweetened foods while taking cholestyramine. These foods don’t interfere with how the medication works, but they can worsen bloating and nausea, two common side effects of cholestyramine. 

Some sugars are obvious, like those in candy and cookies. But some sugars you may not know or think about. Examples include: 

• Condiments like ketchup and barbecue sauce

• Drinks like fruit juice and chocolate milk

• Low-fat yogurt

• Fat-free products

• Processed foods

5. Spicy foods

Spicy foods don’t interfere with how cholestyramine works. But they can worsen nausea, vomiting, and heartburn. You’ll want to avoid spicy foods if you’re experiencing these side effects while taking cholestyramine.

Examples of foods that contain spicy ingredients include: 

• Spicy peppers like habanero, serrano, jalapeno

• Curries

• Chilis

• Kimchi

• Hot sauce

• Horseradish

When should you take cholestyramine?

It’s best to take this cholestyramine in the morning if you’re taking it for itching related to bile-duct illness. This is because the chemicals that cause itching are stored in the gallbladder overnight when you aren’t eating. 

It’s also a good idea to wait 4 to 6 hours after taking cholestyramine to take vitamins or other medications. That’s because cholestyramine can interfere with the absorption of fat-soluble vitamins A, D, E, and K. It can also interfere with the absorption of certain medications, so be sure to let your healthcare team know about all medications and supplements you’re taking.

When in doubt, ask your prescriber or pharmacist about medication interactions and when to take them.

What else should you know about taking cholestyramine?

Always take cholestyramine with some food or liquid. Because it’s mixed with liquid, there’s often a substantial amount of cholestyramine left as residue on your glass. Rinse the cup and drink that as well to ensure you get all of the medicine. 

Some people find the taste and texture of cholestyramine more tolerable with these tips:

• Mix the whole day’s dose with food or liquid the night before and put it in the refrigerator overnight. 

• Mix it with heavy or pulpy fruit juice to make the consistency of the medication less noticeable.

• Instead of juice or water, mix it with applesauce or other crushed fruit. 

Finally, don’t hold cholestyramine in your mouth for too long because it can damage your teeth. 

Why trust our experts?

Written by:

Amy Walsh, MD, MDP

I have worked as an emergency physician for 15 years, including care at both rural hospitals and trauma centers. I am the former Global Emergency Medicine fellowship director at Health Partners.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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References

Associates in Gastroenterology. (n.d.). Biliary obstruction.

Drugs.com. (2024). Cholestyramine and alcohol/food interactions.

Fernández-Bañares, F., et al. (2006). Sugar malabsorption in functional abdominal bloating: A pilot study on the long-term effect of dietary treatment. Clinical Nutrition.

MedlinePlus. (2017). Cholestyramine resin. 

Odan Laboratories LTD. (2016). Cholestyramine-odan product monograph.

Penn State College of Medicine. (n.d.). Nausea or vomiting.

Riaz, S., et al. (2023). Cholestyramine resin. StatPearls.

Sirtori, M., et al. (1991). Efficacy of cholestyramine does not vary when taken before or during meals. Atherosclerosis.

Van Neil, C. M. (2010). Chronic constipation? Hold the milk! NEJM Journal Watch.