Cholestrom is indicated as an adjunct to a suitable diet
– to lower elevated total cholesterol (total-C), LDL cholesterol (LDL-C), apolipoprotein B and triglycerides in patients with primary hypercholesterolemia, when the response to diet and other non-pharmacological measures is inadequate
– to lower total-C and LDL-C levels in adults with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering therapies or when such therapies are not available.
– for the prevention of cardiovascular events in patients estimated to be at high risk of developing a first cardiovascular event, in addition to the correction of other risk factors.
The patient should be placed on a standard cholesterol-lowering diet before receiving Cholestrom and should continue on this diet during treatment with Cholestrom.
The dose should be individualised according to baseline LDL‑C levels, the goal of therapy, and patient response.
The usual starting dose in 10 mg once a day.
Adjustment of dose should be made at intervals of 4 weeks or more. The maximum dose is 80 mg once a day.
Primary hypercholesterolemia and combined (mixed) hyperlipidaemia
The majority of patients are controlled with Cholestrom 10 mg once a day. A therapeutic response is evident within 2 weeks, and the maximum therapeutic response is usually achieved within 4 weeks.
The response is maintained during chronic therapy.
Patients should be started with Cholestrom 10 mg daily. Doses should be individualised and adjusted every 4 weeks to 40 mg daily. Thereafter, either the dose may be increased to a maximum of 80 mg daily or a bile acid sequestrant may be combined with 40 mg atorvastatin once daily.
Prevention of cardiovascular disease
In the primary prevention trials, the dose was 10mg/day. Higher doses may be necessary in order to attain (LDL-) cholesterol levels according to current guidelines.
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