A client newly prescribed cholestyramine (Questran). Which statement indicates a need for further instruction?

• A. I will continue taking vitamin supplements.
• B. This medication will help lower my cholesterol.
• C. This medication should only be taken with water.
• D. A high-fiber diet is important while taking this medication.

Answer: (C)

Cholestyramine is a bile acid sequestrant that lowers LDL cholesterol by binding bile acids in the intestine, forming a complex that is excreted in the stool. Because it binds substances in the gut, including fat-soluble vitamins and some medications, proper administration is important. It should be mixed with a liquid and taken with meals, then followed by a full glass of water to help prevent constipation. It can be mixed with water, juice, or milk (not carbonated beverages), and the dose should be spaced from other medications to avoid interference. Vitamin supplements should still be taken, but usually at a different time than the resin to prevent binding.

Saying it should only be taken with water suggests an incomplete instruction, because other noncarbonated liquids can be used to mix the suspension. That indicates a need for further instruction on proper administration.