How much cholestyramine (Prevalite) should I take?

Closely follow your healthcare provider's dosing instructions. Generally, cholestyramine (Prevalite) is taken once or twice per day. [Mix](https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=9269d9ba-d791-4865-8a39-abd1733d79bd&type=display) the powder with at least 2 to 6 ounces of water or another non-carbonated beverage.

Is there a pill form of cholestyramine (Prevalite)?

Cholestyramine (Prevalite) is currently only available as a powder form. There are other bile acid type medications, such as [colestipol (Colestid)](https://www.goodrx.com/colestipol) and [colesevelam (Welchol)](https://www.goodrx.com/colesevelam), that are available in a pill form.

cholestyramine

Generic Prevalite

Used for High Cholesterol

Cholestyramine (Prevalite) is used to help lower cholesterol. It can also be used to treat itching caused by bile duct blockage. The medication can cause stomach-related side effects, like constipation, gas, and stomach discomfort.

Reviewed by:

Sean Moshrefi, PharmD

Allison Gourley, PharmD

Last reviewed on July 26, 2021

What is Cholestyramine (Prevalite)?

What is Cholestyramine (Prevalite) used for?

High cholesterol (in combination with diet)
Itching caused by bile duct blockage

How Cholestyramine (Prevalite) works

Cholestyramine (Prevalite) is a bile acid sequestrant. It works by binding to bile acid in your intestines. Once it attaches to the bile acid, it forms a complex and is removed from your body. When bile acid levels are lowered, your liver converts more cholesterol into bile acid in order to replace what was lost. This lowers the amount of cholesterol in your body. It also helps with itching by lowering the extra bile acid found in the skin tissues.

When does Cholestyramine (Prevalite) start working?Time passed since treatment started:

HOURS

DAYS

WEEKS

Full effect

MONTHS

Drug facts

Common Brands	Prevalite
Drug Class	Bile acid sequestrant
Controlled Substance Classification	Not a controlled medication
Generic Status	Lower-cost generic available
Availability	Prescription only

Common Brands

Prevalite

Drug Class

Bile acid sequestrant

Controlled Substance Classification

Not a controlled medication

Generic Status

Lower-cost generic available

Availability

Prescription only

Side effects of Cholestyramine (Prevalite)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Mild constipation
Stomach discomfort
Nausea
Vomiting
Diarrhea
Bloating or gas

Cholestyramine (Prevalite) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Allergic reaction
Severe constipation
Severe stomach pain
Easy bruising or unusual bleeding
Bloody, black, or tarry stools

When do Cholestyramine (Prevalite) possible side effects begin and end?

Time passed since treatment started:

HHOURS

DDAYS

WWEEKS

MMONTHS

Mild constipation

Stomach discomfort, bloating, or gas

Nausea or vomiting

Diarrhea

If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following Cholestyramine (Prevalite) side effects have also been reported

In some animal studies, cholestyramine was found to cause tumors. It is not known whether cholestyramine causes tumors in humans.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Black, tarry stools

stomach pain (severe) with nausea and vomiting

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Constipation

Rare

Loss of weight (sudden)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Heartburn or indigestion

nausea or vomiting

stomach pain

Less common

Belching

bloating

diarrhea

dizziness

headache

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Avg retail price

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GoodRx discount

$5.34

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Pros and cons of Cholestyramine (Prevalite)

Pros

Can help lower cholesterol in people who haven't been able to lower it with diet or exercise
Available as an easy-to-use powder formulation that can be mixed with soups, applesauce, crushed pineapple, or pureed fruit
Available as a lower-cost, generic medication

Cons

Can make you feel constipated
Need to get your blood checked frequently during the first few months of treatment and periodically thereafter
Doesn't lower cholesterol as well as other drugs like statins
Can cause tooth discoloration or tooth decay
May need to take vitamins A, D, E, K, folic acid, or iron if you're taking this medication for a long time
Might not be a good option if you have a blockage in your stomach or intestines

Pharmacist tips for Cholestyramine (Prevalite)

Take cholestyramine (Prevalite) with meals.
Take other medications at least 1 hour before or 4 to 6 hours after taking cholestyramine (Prevalite).
Make sure you use the measuring cup or scoop that was provided to you with your medication. Using household spoons may not be accurate.
Don't take the powder alone (in its dry form); always dissolve it in liquid before taking it. Place contents of 1 single dose packet or 1 scoopful of medication in a cup (2 to 6 ounces) of water or non-carbonated drink and mix well.
Drink plenty of fluids and eat foods high in fiber to prevent constipation.
Don't sip or hold this medication in your mouth for a long time, because it can make your teeth turn a different color, wear away your tooth enamel, or cause your teeth to decay.
Let your healthcare provider know if you are pregnant, plan on getting pregnant, or are breastfeeding. This medication may lower the amount of daily vitamins that your body needs during pregnancy.
The packets of powder contain phenylalanine. Phenylalanine can be harmful to patients with phenylketonuria (PKU).

Common questions about Cholestyramine

You should take this medication at mealtime. Make sure you also space out your other medications by at least 1 hour before or 4 to 6 hours after you take Cholestyramine to avoid any potential absorption issues.

You shouldn't stop taking this medication unless told to stop by a healthcare provider. If you stop taking this medication suddenly, your blood cholesterol levels might go back up again.

Closely follow your healthcare provider's dosing instructions. Generally, Cholestyramine is taken once or twice per day. Mix the powder with at least 2 to 6 ounces of water or another non-carbonated beverage.

Constipation is a very common side effect of Cholestyramine because of the way the medication works. Normally, bile acids in the intestine help control how much water is in your stool. By binding to extra bile acid in the intestines, this medication may remove some water in your stool, causing constipation. As a result, it's important to drink plenty of water and include fiber in your diet in order to lower your chances of becoming constipated.

Cholestyramine is currently only available as a powder form. There are other bile acid type medications, such as colestipol (Colestid) and colesevelam (Welchol), that are available in a pill form.

Risks and warnings for Cholestyramine (Prevalite)

Cholestyramine (Prevalite) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

BOWEL OBSTRUCTION OR BLOCKAGE

Risk factors: Blockage in your digestive tract (stomach or intestines)

Cholestyramine (Prevalite) can lead to constipation. This can lead to serious problems, like bowel obstruction, in people with digestive tract issues, such as bile duct, stomach, or intestinal blockage. Let your healthcare provider know if you experience really bad stomach pain or constipation while taking this medication.

GREATER RISK OF BLEEDING

Using cholestyramine (Prevalite) for a long time can cause bleeding. Report any signs of bleeding to your healthcare provider right away. Some examples include throwing up blood, blood in your urine, black, tarry stools, bleeding gums, or bruises without a reason.

CONSTIPATION

Risk factors: Heart disease | High dose | Older than 60 years

Cholestyramine (Prevalite) can cause or worsen constipation. Drinking more liquids, exercising, or adding fiber to your diet may help. Talk with your healthcare provider about taking a stool softener or laxative if constipation is a concern for you.

TEETH PROBLEMS

Sipping this medication or holding it in your mouth for a long time can make your teeth turn a different color, wear away your tooth enamel, or cause your teeth to decay. Make sure you brush your teeth and see a dentist often.

INTERACTIONS WITH OTHER MEDICATIONS

Because cholestyramine (Prevalite) works by binding bile acid in the gut, it may also affect how other medications get absorbed. It's recommended that you take your other medications at least 1 hour before or 4 to 6 hours after taking cholestyramine (Prevalite) to avoid any potential absorption issues. Check with your provider or pharmacist if you need to space any of your medications apart from each other when taking cholestyramine (Prevalite).

LOW FOLIC ACID LEVELS

Using cholestyramine (Prevalite) for a long time can lead to low levels of folic acid in your blood. Folic acid helps form red and white blood cells. Signs of low folic acid levels include feeling tired, weakness, pale skin, loss of appetite, fast heartbeat, and shortness of breath. You may need to take folic acid supplements to help prevent this. Talk to your healthcare provider if you have concerns.

VITAMIN INTERACTIONS

Because cholestyramine (Prevalite) works by binding to bile acid in the gut, it can also lead to less absorption of fat-soluble vitamins, like vitamins A, D, E, and K. Talk to your healthcare provider about taking vitamin supplements or seeing if any of your doses need to be adjusted. If you take a daily vitamin, it's recommended to take it 1 hour before or at least 4 hours after cholestyramine (Prevalite).

PHENYLKETONURIA (PKU)

Risk factors: History of phenylketonuria

Cholestyramine (Prevalite) contains phenylalanine. If you have phenylketonuria (PKU), this drug may not be right for you, since it can cause dangerous complications. Talk to your healthcare provider to see if there are safer options for you.

Cholestyramine (Prevalite) dosage

The average cost for 1 carton of 60 packets of 9g of Cholestyramine (Prevalite) is $46.25 with a free GoodRx coupon. This is 29.35% off the average retail price of $65.46.

Can of powder

Dosage	Quantity	Price as low as	Price per unit
378g of 4g/dose	1 can	$29.89	$29.89
348.6g of 4g/dose	1 can	$26.61	$26.61
368.76g of 4g/dose	1 can	$29.27	$29.27
239.4g of 4g/dose	1 can	$30.19	$30.19

Carton

Dosage	Quantity	Price as low as	Price per unit
60 packets of 9g	1 carton	$46.25	$46.25
60 packets of 8.3g	1 carton	$46.25	$46.25

Packet

Dosage	Quantity	Price as low as	Price per unit
9g of 4g/dose	30 packets	$27.65	$0.92

Typical dosage for Cholestyramine (Prevalite)

The recommended starting dose is 1 pouch or 1 level scoopful by mouth once or twice a day with a meal. Each pouch or scoopful is 4 grams.

You may slowly raise your dose up to 2 to 4 pouches or scoopfuls a day divided into two doses. The maximum daily dose is 6 pouches or scoopfuls in one day. Doses are based on how you respond to the medication.

Interactions between Cholestyramine (Prevalite) and other drugs

Cholestyramine (Prevalite) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Cholestyramine (Prevalite). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.