Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Kolestyramin

Klassificering: A

Preparat: Colestyramin, Kolestyramin Alternova, Lipocol-Mertz, Quantalan, Questran, Questran Light, Questran Loc, Questran®, Questran® Loc

ATC kod: C10AC01

Substanser: kolestyramin

Sammanfattning

Studier har visat att den lipidsänkande effekten av kolestyramin hos patienter med hyperlipoproteinemi är likvärdig för kvinnor och män.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing  cholestyramine have been found.

Effects

The lipid-lowering efficacy of cholestyramine 16 g/day in patients with hyperlipoproteinemia was analyzed in a randomized, double-blind, placebo-controlled study (29 men, 18 women). Despite that women had higher baseline cholesterol levels, the mean percentage fall in cholesterol levels induced by cholestyramine did not differ between men and women [1].

Cholestyramine therapy have been compared to lovastatin therapy in patients with severe primary hypercholesterolemia in a randomized, single-blind, placebo-controlled study (170 men, 94 women). Men and women taking cholestyramine 12 g twice daily had a similar mean reduction in the levels of LDL cholesterol, while women treated with lovastatin 20-40 mg twice daily had larger mean reductions LDL levels than men [2]. Another study has compared cholestyramine with pravastatin. Patients at increased risk for cardiovascular disease (1047 men, 989 women) were randomly assigned to one of four treatment groups: 16 g cholestyramine, 8 g cholestyramine and 20 mg pravastatin, 20 mg pravastatin, or 40 mg pravastatin. There was no difference in lipid-lowering effect between men and women (no data shown). Results for each treatment group were not stratified by sex [3].

No studies on sex differences in clinical outcomes such as morbidity and mortality have been found.

Adverse effects

No studies with a clinically relevant sex analysis regarding adverse effects of cholestyramine have been found.

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Försäljning på recept

Fler kvinnor än män hämtade ut läkemedel innehållande kolestyramin (ATC-kod C10AC01) på recept i Sverige år 2015, totalt 5 037 kvinnor och 3 100 män. Det motsvarar 1,0 respektive 0,6 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 70 år och äldre hos båda könen. I genomsnitt var läkemedel innehållande kolestyramin 1,5 gånger vanligare hos kvinnor [4].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2015-06-10

Referenser

  1. Levy RI, Fredrickson DS, Stone NJ, Bilheimer DW, Brown WV, Glueck CJ et al. Cholestyramine in type II hyperlipoproteinemia A double-blind trial. Ann Intern Med. 1973;79:51-8. PubMed
  2. The Lovastatin Study Group. A multicenter comparison of lovastatin and cholestyramine therapy for severe primary hypercholesterolemia The Lovastatin Study Group III. JAMA. 1988;260:359-66. PubMed
  3. Eriksson M, Hådell K, Holme I, Walldius G, Kjellström T. Compliance with and efficacy of treatment with pravastatin and cholestyramine: a randomized study on lipid-lowering in primary care. J Intern Med. 1998;243:373-80. PubMed
  4. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk

Författare: Linnéa Karlsson Lind, Desirée Loikas

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson