Beyond Cholesterol: Exploring the Versatile Potential of Compounded Cholestyramine

Cholestyramine is a commonly known medication used for cholesterol management. Although its primary function is to reduce LDL cholesterol, an FDA approved indication for the use of cholestyramine, there is also a significant amount of information about cholestyramine that integrative and functional medicine practitioners use in other areas of health and wellness. At Allure Compounding Pharmacy, we provide customized medications that are customized to each individual patient to go beyond cholesterol-lowering medication.

As a bile acid sequestrant, cholestyramine binds bile acids in the gastrointestinal tract and prevents reabsorption. This single action produces many effects on biological processes, many of which are not related to lipid metabolism. Since cholestyramine does not get absorbed into the circulatory system, it works directly in the gastrointestinal tract providing a novel mechanism for addressing systemic conditions.

Cholestyramine has many literature-based and clinical applications that are considered off-label uses. The primary off-label applications are listed in the table below, with reference to clinical studies that support their use.

Bile Acid Diarrhea (BAD) – Cholestyramine may be used for the treatment of bile acid diarrhea (BAD) caused by excessive levels of bile salts in the intestines, resulting in severe watery stools and an increase in urgency. It is frequently used for diarrhea caused by sabra gallbladder surgery and for diarrhea caused by problems within the ileum.

Support for Blood Glucose Levels in Patients with Type 2 Diabetes – Cholestyramine can enhance the secretion of an important insulin-regulating hormone (GLP-1) and thereby improve the metabolism of glucose: diabetes patients have been shown to have lower glucose levels in their plasma while being treated with cholestyramine than before being treated.

Refractory Thyrotoxicosis- In patients with refractory thyrotoxicosis, this therapy has been used to bind thyroid hormones that are being excreted into bile, interrupting their absorption and improving their clearance. Generally used as part of a short-term strategy to help achieve a more rapid reduction of thyroid hormone concentrations while taking standard antithyroid medications.

Pruritus associated with liver disease- There are various causes of pruritus or itching. One cause is the accumulation of bile salts on the skin due to reduced flow of bile. This treatment is the first-line agent as recommended in the gastroenterology guidelines for the management of a very distressing symptom as a result of cholestatic liver disease.

Specific Pediatric GI Disorders- For selected pediatric gastrointestinal disorders (Hirschsprung’s disease), this therapy can be helpful in binding bile acids and improving bowel function. Pediatric gastroenterology specialists will prescribe this for optimal management.

Specialized compounding pharmacies help facilitate this process for complicated medications like Cholestyramine. Cholestyramine purchased from pharmacies is usually available as a gritty powder that has an extremely unpleasant taste/texture that can prevent patients from being compliant when taking the drug, especially in young children or people who are very sensitive to flavors and textures. In addition to the inconvenience associated with taking the medication, many of the commercially available formulations of Cholestyramine will also include inactive ingredients such as color/sweeteners/preservatives that some patients may want/need to avoid altogether.

With Allure Compounding Pharmacy, these issues can be addressed. Allure Compounding Pharmacy collaborates closely with your physician to provide an individualized formulation of cholestyramine. Allure Compounding Pharmacy is able to create a unique liquid suspension, with added flavors if desired, for patients who may not be able to swallow pills or capsules as well as compounding cholestyramine to meet patient’s specific dose needs that cannot be made commercially. We also provide an individual formulation of cholestyramine which does not contain inactive ingredients such as dyes, gluten, or sugars that may cause adverse reactions to patients. This type of personalisation helps to make sure patients are able to take their medication and have a positive impact on the patient’s overall health.

Cholestyramine may bind to other medications (including frequently used medications, such as thyroid hormone (levothyroxine), some cardiovascular medications, and other supplements) and prevent their absorption. As a general rule of thumb, you should take other medications at least 1 hour before or 4-6 hours subsequent to taking a dose of cholestyramine. Consult your physician, as well as the staff at Allure Pharmacy, about how to build a safe and efficient dosing plan for yourself with respect to your medications.

If you’re considering an off-label use of cholestyramine with your healthcare provider, compound it. Please reach out to us at Allure Compounding Pharmacy today to learn how we can provide a customized cholestyramine preparation for your specific wellness needs.

The FDA does not review any compounded drugs to evaluate their safety, effectiveness, or quality before they reach patients.