Colestyramine

A high molecular weight resin-polymer that decreases the intestinal absorption of bile acids and cholesterol.
Oral administration twice a day.

Since the last update we have not found data published in relation to breastfeeding.

The intestinal absorption of the drug is zero (AEMPS 2013, New Zealand Data Sheet 2010), so it can not transfer to breastmilk, nor to the infant’s plasma via breastmilk. Its high molecular weight makes it unlikely that it will transfer into breastmilk in significant amounts.

It is unlikely that it can alter the lipid composition of milk. Infants need to ingest large amounts of cholesterol, as it is essential for the proper development of the nervous system, cell membranes and is a precursor of several hormones and vitamins.

Prolonged use can cause plasma deficiency, due to lack of absorption of fat-soluble vitamins (A, D, E, K) so it may be advisable to supplement to avoid deficiency of these vitamins in breastmilk.

Various medical associations, experts and expert consensus consider the use of this medication safe during breastfeeding (Hale 2017 p195, Lawrence 2016 p393, Serrano 2015, Briggs 2015, Heetun 2007, Mahadevan 2006).

It is advisable to follow a lipid-lowering diet.
Halting the pharmacological treatment of hypercholesterolemia during the period of breastfeeding is not likely to significantly alter the long-term outcome of the disease.

Alternatives

We do not have alternatives for Colestyramine since it is relatively safe.