Cholestyramine
Classification: AATC code: C10AC01
Summary
Studies have shown that the lipid-lowering effect of cholestyramine in patients with hyperlipoproteinemia is similar for men and women.
The present evidence concerning differences between men and women is limited and do not motivate differentiation in dosing or treatment.
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).
Updated: 2019-02-26
Date of litterature search: 2015-06-10
References
- 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
- 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
- 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
- Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk
Reviewed by: Mia von Euler
Approved by: Karin Schenck-Gustafsson