GALTIPEX 20mg/ml Price

Overview

Welcome to Dwaey, specifically on GALTIPEX 20mg/ml page.
This medicine contains an important and useful components, as it consists of
Glatiramer acetateis available in the market in concentration

Name

Cholestyramine

Precaution

Before using **Cholestyramine**, patients should consult their healthcare provider, especially in the following circumstances: - **Pregnancy and Breastfeeding**: While **Cholestyramine** is considered relatively safe during pregnancy, it should only be used when absolutely necessary. Pregnant or breastfeeding women should consult their healthcare provider before initiating treatment. Cholestyramine may reduce the absorption of fat-soluble vitamins (A, D, E, and K), so additional supplementation might be required. - **History of Bowel Obstruction**: Cholestyramine can cause or worsen bowel obstruction, particularly in patients with preexisting gastrointestinal issues. It should be used cautiously in individuals with a history of **bowel obstruction**, **severe constipation**, or **colorectal diseases**. - **Blood Clotting Disorders**: Cholestyramine may reduce the absorption of **vitamin K**, which is crucial for blood clotting. Patients on **anticoagulant** therapy (such as warfarin) should be closely monitored to avoid bleeding complications. - **Other Medications**: Cholestyramine may interact with other medications, affecting their absorption. Patients should inform their healthcare provider of all medications they are taking, including **thyroid medication**, **blood pressure medications**, **antidiabetic drugs**, or **fat-soluble vitamins**.

Indication

**Cholestyramine** is primarily used for the following conditions: - **Hyperlipidemia**: Cholestyramine is primarily prescribed to lower high **cholesterol levels** in patients with **hyperlipidemia**, particularly when **statins** or other first-line treatments are ineffective or not tolerated. It works by binding to bile acids in the intestine, preventing their reabsorption, and subsequently lowering **low-density lipoprotein (LDL)** cholesterol. - **Pruritus Associated with Bile Acid Sequestration**: Cholestyramine can also be used to treat **pruritus (itching)** associated with liver diseases such as **cholestasis** or **primary biliary cirrhosis**, where bile acid accumulation contributes to intense itching. - **Diarrhea Associated with Bile Acid Malabsorption**: It can help manage **diarrhea** caused by bile acid malabsorption, such as in **Crohn’s disease** or post-cholecystectomy syndrome. - **Digoxin Toxicity**: Cholestyramine may be used off-label to treat **digoxin toxicity** by binding to digoxin in the intestines and preventing its reabsorption, though this is not a standard use.

Contra indication

Cholestyramine should not be used in the following situations: - **Complete Biliary Obstruction**: Cholestyramine should not be used in patients with a **complete obstruction** of the bile duct. Since its primary action is to bind bile acids, it can exacerbate bile acid-related complications in these patients. - **Severe Constipation or Gastrointestinal Motility Disorders**: Due to its potential to cause or worsen **bowel obstruction**, Cholestyramine should be avoided in patients with a history of severe **constipation** or **gastrointestinal motility disorders**. - **Hypersensitivity to Cholestyramine**: Patients with a known **hypersensitivity** or **allergy** to cholestyramine or any of its ingredients should not use this medication. - **Phenylketonuria**: Some formulations of cholestyramine contain **phenylalanine**. This should be avoided in patients with **phenylketonuria (PKU)**, a rare metabolic disorder.

Side Effect

Common and severe side effects of **Cholestyramine** include: - **Gastrointestinal Distress**: The most common side effects of cholestyramine include **constipation**, **bloating**, **gas**, and **abdominal discomfort**. These are often dose-dependent and may improve with continued use or dose adjustments. - **Nausea and Vomiting**: Some patients may experience **nausea** or **vomiting**, especially if they have not gradually introduced cholestyramine into their regimen. - **Malabsorption of Nutrients**: Long-term use of cholestyramine may result in the **malabsorption** of certain nutrients, particularly **fat-soluble vitamins** (A, D, E, K), leading to **deficiencies** over time. Supplementation may be required. - **Fatigue**: Due to nutrient malabsorption, patients may experience **fatigue**, particularly if vitamin deficiencies occur. - **Biliary Complications**: Rarely, cholestyramine can cause issues with the **gallbladder**, such as **gallstone formation**, particularly in individuals with a history of gallbladder disease. - **Severe Constipation**: Rarely, cholestyramine can lead to **severe constipation** or bowel obstruction, especially in elderly patients or those with preexisting gastrointestinal conditions.

Pregnancy Category ID

3

Mode of Action

Cholestyramine works by binding to **bile acids** in the intestines, forming an insoluble complex that is excreted in the stool. This action: - **Prevents Bile Acid Reabsorption**: Normally, bile acids are reabsorbed in the intestines and recycled by the liver. Cholestyramine binds to these bile acids, preventing their reabsorption, thereby lowering the pool of bile acids available for digestion. - **Reduces Cholesterol Levels**: As a result, the liver converts **more cholesterol** into bile acids to make up for the lost bile acids, leading to a reduction in the overall **cholesterol levels** in the blood, particularly **LDL cholesterol**. - **Increases Excretion of Cholesterol**: Since bile acids are essential for digesting fats, the reduction in bile acids also causes the body to excrete more cholesterol, lowering overall lipid levels.

Interaction

Cholestyramine can interact with several other drugs, leading to altered absorption and efficacy: - **Thyroid Medications**: Cholestyramine can bind to thyroid medications, such as **levothyroxine**, decreasing their effectiveness. Patients should take thyroid medications at least **4 hours before or after** cholestyramine. - **Fat-Soluble Vitamins**: Cholestyramine may reduce the absorption of **vitamins A, D, E, and K**, leading to deficiencies over time. Supplementation may be necessary, and patients should discuss this with their healthcare provider. - **Antidiabetic Drugs**: Cholestyramine can reduce the absorption of **antidiabetic medications**, such as **metformin** and **glibenclamide**, potentially affecting blood glucose control. - **Blood Thinners**: Cholestyramine may interfere with the absorption of **warfarin**, a blood thinner, leading to an altered anticoagulation effect. Patients on warfarin should be monitored for changes in their **INR (International Normalized Ratio)**. - **Digoxin and Other Cardiac Drugs**: Cholestyramine can also reduce the absorption of **digoxin**, a drug used to treat heart failure. It should be administered several hours apart to avoid reduced efficacy.

Pregnancy Category Note

Information not available

Adult Dose

The typical dose of **Cholestyramine** for adults is: - **Hyperlipidemia**: The usual starting dose is **4 grams** once or twice daily. The dose may be increased gradually to a maximum of **24 grams per day**, depending on the patient's response and tolerability. - **Pruritus Due to Cholestasis**: A common dose for treating pruritus is **4-8 grams daily**, which can be adjusted as needed. - **Bile Acid Malabsorption**: The usual dose for treating diarrhea from bile acid malabsorption is **4 grams** once or twice daily.

Child Dose

For pediatric patients, **Cholestyramine** is generally used in the treatment of **hyperlipidemia** and **bile acid malabsorption**: - **Hyperlipidemia**: The usual dose is **2-4 grams** once or twice daily, and the dose can be adjusted depending on the child’s age and weight. - **Bile Acid Malabsorption**: The typical starting dose is **1 gram** per day, gradually increased based on response. Children should be closely monitored for any adverse effects, particularly **gastrointestinal distress**. Patients should always consult a healthcare provider before beginning **Cholestyramine**, especially when considering the appropriate dosage for children or individuals with other underlying health conditions.

Renal Dose

Cholestyramine is not primarily excreted through the kidneys; however, in patients with **severe renal impairment**, it is important to monitor for any gastrointestinal side effects like constipation, as these may worsen in patients with kidney dysfunction. **Renal dose adjustments** are generally not required for cholestyramine, but healthcare providers should use caution when prescribing it to patients with significant kidney disease.

Administration

Information not available