Colesevelam hydrochloride powder for oral suspension versus cholestyramine powder for oral suspension: comparison of acceptability and tolerability.
OBJECTIVE
To compare tolerability of colesevelam hydrochloride powder versus a cholesterol-lowering equivalent dose of generic cholestyramine powder, each mixed in water, by means of the validated Bile Acid Sequestrant Acceptability (BASA) Scale.


METHODS
We conducted a randomized, single-blind, single-visit, single-site study, comparing doses of 2 different bile acid sequestrant powders for oral suspension that produce similar cholesterol lowering: colesevelam hydrochloride (3.75 g) and generic cholestyramine (12 g), each mixed in a transparent cup with tap water.


RESULTS
The study sample consisted of 42 participants-12 men and 30 women. The study subjects were non-Hispanic white (64%) or black (36%), with a mean age of 50 years and a mean body mass index of 32.2 kg/m2. The components of the BASA Scale included taste, texture, appearance, and mixability. Colesevelam hydrochloride and cholestyramine did not differ significantly when assessed by both the unweighted and the weighted global BASA Scale. Although study participants indicated that the colorless or whitish colesevelam hydrochloride powder tasted better (P<.0001), they thought that the orange-colored cholestyramine had a more appealing appearance (P<.0001). Regarding the potential for taking the drug "for the rest of your life," 71.4% of study participants rated taste as "very important," and 11.9% rated appearance as "very important."


CONCLUSIONS
Although study participants thought that the orange-colored generic cholestyramine powder had a better appearance, they also reported that colesevelam hydrochloride for oral suspension tasted better. A minority of study participants thought appearance was "very important"; a substantial majority thought taste was "very important" for potential long-term compliance.
Louisville Metabolic and Atherosclerosis Research Center, Louisville, Kentucky, USA. HBaysMD@aol.com
Harold E
HE
Bays
Kevin C
KC
Maki
Kathy
K
Schmitz
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000499:Allylamine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology*; D000069472:Colesevelam Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D055815:Young Adult
D000924:Anticholesteremic Agents; D000499:Allylamine; D000069472:Colesevelam Hydrochloride