Cholestyramine--can you take one big dose?

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Pebbledash
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Cholestyramine--can you take one big dose?

Post by Pebbledash »

Hi all,

I have had some success recently going dairy free and taking cholestyramine. The problem I have with cholestyramine (apart from spelling the damn word each time I write it) is that it seems to work only when I take it as recommended, which is twice per day, but this really interferes with taking my daily meds as you're not meant to take a med 4-6 hours after.

Is it possible to get the same benefit by taking both doses in one big dose per day?

Or does it need to be distributed over time (twice per day) in order to impact the bile (or whatever it does in the gut)?

And would one big dose mean that he 4-6 hours wait time becomes 8-12?

Thanks guys.

Paul
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tex
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Post by tex »

Hi Paul,

Those are some good questions, but if they have a corresponding medical opinion, I'm not aware of it. So users would probably be the only ones who would know the correct answer. Hopefully someone who actually has some experience with this product will jump in here with their insight, because I have never used cholestyramine.

Here are my thoughts in the meantime:

Cholestyramine must be present in the ileum if it's going to be able to sequester the bile at any given moment. Therefore it would appear that if it were to be effective for 8 or 10 hours (or whatever), then it would also sequester other medications or supplements taken within that time frame. I don't know that for a fact, it just seems logical that it would be true, based on the pharmacological properties of the product.

Some people work around this by taking their meds or supplements 2 hours before they take the cholestyramine.

I had a similar problem recently when taking Cipro twice a day for a dental infection while also taking magnesium 3 times per day. Magnesium antagonizes/limits the effectiveness of Cipro so that a similar 2/4 time spacing interval is necessary. And since a magnesium deficiency is what causes all the serious side effect risks that prompt the dire black box warnings on Cipro, I had to be very careful with timing. But I managed to make it work (and I take about 4 or 5 meds and over half a dozen supplements daily).

I hope you can make it work.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Pebbledash »

Thanks, Tex.

It's a challenge working in the two daily doses, for the reasons you cite.

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Cholestyramine--can you take one big dose?

Post by EUROPEU »

Hi, Paul
Hi, Tex, how are you doing ,amigo?

About cholestyramine, Can you try taking it one hour before your meds?. Did you try to take only a pouch in the morning (4 grams)? For me taken this way worked ok. Even a smaller amount , 1 gram a day was enough later for beeing ok.

The best for you,

Enric
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Post by tex »

Hello Enric,

So far I'm doing well and feeling fine — probably better than I deserve, considering my age. My blood test results always make my doctor happy.

I hope you're staying safe and doing well, also.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Pebbledash »

Hi Europeu,

Based on my experience, cholestyramine only seems to work if I take two doses of 4 grams. For example, I took only one dose yesterday, probably about 6 grams, and this morning my stools weren't as solid (to be blunt).

The problem is that I take multiple meds that need to be spaced out during the day (I have addison's disease and neuropathy). For example, I take nortriptyline before I go to bed (and cholestyramine seems to particularly like to bind with this med from what I googled), so I need to take cholestyramine 6 hours before, but I also need to take meds in the morning and afternoon for my addisons.

The other problem with cholestyramine, it is hardly travel friendly--I have a large container of powder that isn't particularly portable. Can you get sachets?

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Paul
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Post by tex »

You should be able to get Sandoz brand cholestyramine in lots of 60 packets weighing 4 grams net each.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Pebbledash »

Thank you, sir!

Love the book, by the way.

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Paul
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Post by Pebbledash »

Is cholestyramine in the powder form the only kind of bile acid sequestrant that is effective?

I read online that they can also come in a pill form, and I wonder if these would work the same way for MC?

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Paul
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Post by tex »

I'm not very familiar with it, but it probably is available in other forms. Ultimately, though, probably it's all a powder or an encapsulated powder. To be honest, I don't know if anyone here has tried all the various forms, but the main reason for my recommendations is that (based on most of the posts here) it seems to be the only form that works for most of us (who use it). Most of the other brands, and especially the "Lite" versions, simply won't work for many of us, presumably because of the inactive ingredients.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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