Cholestyramine (Questran, Prevalite)
Cholestyramine is a bile-acid binding powder that lowers LDL cholesterol without being absorbed into the bloodstream. In LRC-CPPT, it produced a 10.4% greater LDL reduction than placebo over an average 7.4 years. Study results
How much does cholestyramine lower LDL cholesterol?
Cholestyramine produced a 10.4% greater LDL reduction than placebo in LRC-CPPT, a long-term prevention trial using a prescribed dose of up to 24 g daily. Read the evidence.
| Dose and treatment context | LDL result |
|---|---|
| LRC-CPPT regimen, up to 24 g daily | 10.4% greater reduction than placebo |
This long-term result includes the realities of adherence and dose tolerance. It is not a short-term dose-response estimate for a single 4 g packet.
Individual responses vary. LDL and ApoB measure different things; these LDL percentages should not be used as ApoB estimates. Compare ApoB-lowering treatments.
How is cholestyramine taken?
Cholestyramine is supplied as powder, commonly with 4 g of active resin per dose. Usual maintenance dosing is 8–16 g daily in divided doses, with a maximum of 24 g. Mix it with liquid or an appropriate moist food; never swallow the powder dry. Prescribing information.
How does cholestyramine compare with other medications?
Cholestyramine has older cardiovascular prevention evidence but is less convenient than once-daily Ezetimibe. Colesevelam offers tablets or a once-daily packet, although constipation and medication absorption remain considerations.
Which medications can be combined with cholestyramine?
Cholestyramine can be used with a statin, but it binds many oral medicines. Other medicines generally need to be taken at least one hour before or four to six hours after it. Long-term use can reduce absorption of fat-soluble vitamins.
How much does cholestyramine cost?
Cost Plus Drugs lists cholestyramine 4gm, 30 packets, at $25.70 before shipping ($30.95 with standard shipping). Prices were checked October 6, 2026; the quantity is not necessarily a month’s supply.
Cost Plus Drugs
Cholestyramine 4gm, 30 packets: $25.70 including the dispensing fee, or $30.95 with standard shipping.
GoodRx
Compare local coupon prices for the same 4gm strength and 30 packets. The pharmacy, ZIP code, and coupon can change the price; this is a live comparison, not a second fixed quote.
Compare the cash price with your plan’s out-of-pocket quote for the same strength and quantity. Coupon purchases may not count toward your insurance deductible.
Does insurance cover cholestyramine?
Coverage for cholestyramine varies by plan and formulation. These named formularies and medical policies were checked October 6, 2026; your plan’s rules and cost sharing may differ.
| Insurer | Coverage policy |
|---|---|
| UnitedHealthcare | Regular and light formulations are Tier 1, with no prior authorization, step therapy, or quantity limit listed. Commercial PDL, September 2026. |
| Aetna | Aetna lists cholestyramine as a preferred generic; some powder manufacturers are excluded. Advanced Control, October 2026. |
| Cigna | Cigna lists generic cholestyramine and light formulations at Tier 1, with possible home delivery and no prior authorization, step therapy, or quantity limit listed. California Standard 4-Tier (DMHC), July 2026. |
| Anthem | No listing for cholestyramine was located in this named pharmacy formulary. This does not establish a denial; ask the plan about its current drug list, exceptions, and medical-benefit coverage. California Individual Select, October 2026. |
| Blue Shield of California | Blue Shield of California lists cholestyramine at Tier 1 for the listed regular and light formulations. Standard Formulary. |
| BCBS of Texas | BCBS of Texas lists cholestyramine as a nonpreferred generic, with no prior-authorization, step-therapy, or quantity-limit marker listed. Performance Annual, 2026. |
What are the side effects of cholestyramine?
Constipation, bloating, and abdominal discomfort can limit treatment. Triglycerides may increase. It is contraindicated in complete biliary obstruction; review severe constipation, high triglycerides, and medication timing before use. Full safety information.
Does cholestyramine reduce heart attacks or strokes?
In LRC-CPPT, cholestyramine reduced coronary heart disease death or nonfatal heart attack by 19% relative to placebo over an average 7.4 years. Participants were middle-aged men with high LDL; the trial predates modern statin-based care. Read the supporting evidence.
Is cholestyramine right for you?
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