Colestyramine is an active ingredient used in the treatment of hypercholesterolemia. Too high LDL cholesterol levels in the blood can increase the risk of arteriosclerosis and thus of heart attacks and similar diseases. Colestyramine binds the bile acids in the intestines and prevents their reabsorption into the body. As a result, the body needs more cholesterol to produce new bile acids and blood levels fall. Colestyramine can be used alone or in combination with statins and other drugs.
Manufacturer’s name
Many medicines containing the active ingredient colestyramine have the active ingredient name directly in their name. These include Colestyramin-Ratiopharm® or Colestyramin-Hexal®. But the drugs Vasosan®, Quantalan® and Lipocol-merz® chewable tablets also contain colestyramine as the active ingredient. These include both powders for suspensions and chewable tablets. Since other manufacturers are constantly developing different names for what is actually the same drug, it is possible to change the preparation in the course of a therapy without changing the therapy.
Indication
Colestyramine can be used as a supplement to a change in diet and a planned diet to lower cholesterol levels and thus reduce cardiovascular risk. Colestyramine can also be used in cases of familial hypercholesterolemia, i.e. high cholesterol levels without being overweight. Especially if a statin, the most widely used drug for high LDL cholesterol, does not have sufficient effect, colestyramine can be used additionally.
Colestyramine can also be used as a monotherapy without a statin if patients with primary hypercholesterolemia do not tolerate statins or reject them for other reasons. Another reason for taking colestyramine is bile acid loss syndrome. Those affected have severe diarrhea due to the loss of bile acids, which are normally reabsorbed by the body.
Colestyramine can relieve the symptoms for those affected. Colestyramine can also be helpful in closing bile ducts and the associated itching and jaundice. The use of colestyramine should always be discussed with the treating family doctor.
Active substance/effect
The active ingredient colestyramine belongs to the anion exchange resins. As it is strongly water-loving, but insoluble in water and cannot ferment, colestyramine cannot be absorbed in the gastrointestinal tract. A chloride is bound in colestyramine and this is exactly what is exchanged on contact with bile acids.
The bile acids, which are normally reabsorbed to a large extent by the intestine, can then no longer be absorbed and are excreted with the stool. The amount of bile acids present in the body decreases and the body tries to produce more bile acids. These bile acids are built from cholesterol and therefore cholesterol is consumed.
This consumption leads on the one hand to lower cholesterol levels and on the other hand to a greater number of receptors for LDL and thus to a reduction in LDL cholesterol. It is precisely this LDL that is responsible for the high risk of cardiovascular disease and the reduction can therefore protect against cardiovascular disease. The colestyramine itself is not absorbed during the process, but is also excreted again through the intestines. It is therefore almost impossible to reach a toxic level.
