What Is Prevalite? Uses, Dosage, and What You Need to Know in 2026

Prevalite is the brand name for cholestyramine, a prescription medication that has been used to lower high cholesterol for over 50 years. While the Prevalite brand itself has been discontinued, generic cholestyramine remains an important medication for managing high LDL cholesterol and certain bile acid conditions. Here's everything you need to know about it in 2026.

What Is Cholestyramine (Prevalite)?

Cholestyramine is a bile acid sequestrant — a type of medication that works in your digestive tract to bind bile acids and prevent them from being reabsorbed into your bloodstream. Unlike most other medications, cholestyramine is not absorbed into your body; it works entirely in your gut.

It comes as a powder that you mix with water, juice, applesauce, or a brothy soup before drinking. It was originally sold under brand names including Prevalite, Questran, and LoCholest — all of which have been discontinued. All cholestyramine on the market today is generic.

What Is Cholestyramine Used For?

Cholestyramine has two FDA-approved uses:

• High LDL cholesterol (primary hypercholesterolemia): Cholestyramine is prescribed as an adjunct to diet to lower elevated LDL ("bad") cholesterol in patients who don't achieve adequate reduction through diet alone. It is particularly useful for patients who cannot tolerate statins.
• Pruritus from partial biliary obstruction: Itching caused by too much bile acid in the body due to a liver or bile duct problem. Cholestyramine relieves itching by binding excess bile acids in the intestine.

Common off-label uses include:

• Bile acid diarrhea (BAD/BAM): Chronic diarrhea caused by bile acid malabsorption in the small intestine. Often seen in patients with Crohn's disease, ileal resection, or idiopathic bile acid malabsorption.
• Familial hypercholesterolemia: Hereditary high cholesterol; often used in combination with statins or other lipid-lowering agents.

Who Should NOT Take Cholestyramine?

Cholestyramine is not appropriate for everyone. Do not take it if you have:

• Complete biliary obstruction (total blockage of bile ducts)
• Fasting triglyceride levels of 300 mg/dL or higher
• Type III hyperlipoproteinemia
• Allergy to cholestyramine or any component of the formulation
• Phenylketonuria (PKU) if using the aspartame-containing light formulation

Dosage and How to Take Cholestyramine

Each packet or level scoop of cholestyramine contains 4 grams of anhydrous cholestyramine resin (5.5 grams of Prevalite powder contains 4 grams of active ingredient).

• Starting dose: 1 packet or scoop once or twice daily
• Maintenance dose: 2–4 packets or scoops daily (8–16 grams), divided into two doses
• Maximum dose: Up to 6 packets or scoops daily in some cases

How to take it correctly:

1. Mix with 2–6 ounces (60–180 mL) of water, juice, or another non-carbonated liquid.
2. You can also mix it with applesauce, brothy soups, or pulpy fruits like crushed pineapple.
3. Never take it dry — this can cause choking or GI obstruction.
4. Don't hold it in your mouth — rinse your glass with additional liquid and drink that too.
5. Take other medications at least 1 hour before or 4–6 hours after cholestyramine.

How Long Does It Take to Work?

For high cholesterol, it may take several weeks of regular use to see the full benefit. A lipid panel is typically checked 4–6 weeks after starting therapy to assess response. For bile acid diarrhea, some patients notice improvement within days to a few weeks of starting treatment.

For a more detailed explanation of how cholestyramine works in your body, read our guide on

how Prevalite works.