B12 injections/Questran

[butterflyEi]

I have had PBC for more than 10 years. I recently noticed a return of some of the unpleasant symptoms I suffered prior to being diagnosed with Pernicious Anaemia last year and mentioned this to the GP last week but unfortunately she could not answer the question relative to Colestyramine (Questran) timings and having an intra muscular injection, she suggested I ask the specialist who I do not see for another month at least. Hidden helped me out on my last question and I took the leaflets that she had suggested may help.

So here I am asking if anyone has any experience of colestyramine reducing the efficacy of an intra muscular injection. When taking Questran a window of 4-6 hours has to be left before taking any other medication in tablet form.

I cannot believe that intramuscular injections would be affected by the Questran but I do not know what else to think of and of course the GP could only suggest asking the specialist.

Thanks in advance for any light that you can shed on this for me and hoping that I have explained myself coherently.

[Skypony]

Hi butterfly, I'm so sorry that you've been feeling more unwell lately.

A few things I was wondering; would a blood test show whether your PA had in fact worsened, before you see the specialist next? Are fluctuations in PA symptoms quite common? I'm also doubtful that Questran would interfere with absorption of an intra muscular injection, but that's not based on any scientific knowledge.

I'm a fan of the saying, 'when you hear hooves, think horses, not zebras', in other words, think of the most likely reason first for a change in your symptoms.

Wish I had answers, especially as you're always so kind and supportive to others.

Best wishes.

[butterflyEi in reply to Skypony]

Hi Skypony

I thought I had sent you a reply yesterday but I cannot see it here. So hope you are not getting a duplicate. I wanted to say thank you for your kind words and especially for your saying - I have not heard it before - I will pass this to my granddaughter she loves words and I think this saying will amuse her.

best wishes

[Skypony in reply to butterflyEi]

Glad you like it. I think medical students are encouraged to keep this principle in mind, also called 'common things occur commonly'. I try to remember not to put too many symptoms down to PBC when I'm not really sure, so I don't miss something else. I guess PA might be one of those variable diseases too, but at least more widely known.

Let us know how you get on. x

[Lilacfi161]

I have B12 injections every 9 weeks and also take Questran for PBC. As the Questran affects the absorption of oral meds, I avoid taking it on the day of my B12 until a few hours after. I couldn't afford to take a chance on the B12 not being absorbed as the symptoms are to debilitating. This is a personal choice, you may want to ask your pharmacist/practice nurse or even ring the haematology dept at your local hospital for researched advice, would be grateful to learn what they advise 👍

[butterflyEi in reply to Lilacfi161]

Hi Lilacfi161

Great idea to ring the haematology department, if they have an answer I will post it but if the GP cannot answer the question I am not sure the pharmacist or practice nurse would know.

When you delay taking the Questran does the itch come back?

My "itch" is still breaking through with questran and rifampicin but no where near as bad as it was and I have not been brave enough to not take the medication.

If I garner any information I will get back to you.

best wishes

[Lilacfi161 in reply to butterflyEi]

Aw thanks Hun. The itching will be a bit worse until you take the next dose, but for me, I couldn't do with a double wammy of tiredness and joint pain for weeks if the Questran blocked the B12 from working. I had sepsis last year, it caused my liver and spleen to enlarge and my liver started to fail. I thought after 6wks in hospital been pumped full of steroids I would recover quickly but it's been a slow process as it caused my PBC to become active😬 While I was in hospital they started me on piriton up to 4 times a day. Now I just take it at night and it really helps with the itching, might be worth a try for you👍x

[butterflyEi in reply to Lilacfi161]

thank you Lilacfi161 - brain fog got me today and I forgot to ring the hospital, tomorrow is another day hey ho!

Sorry to read about the sepsis and steroids - shame it set off the PBC. Piriton does not work for me unfortunately.

[Lilacfi161]

Have you tried hydroxyzine (atarax) ? They're stronger than piriton and even stop the itching when I get prickly heat👍x

[butterflyEi in reply to Lilacfi161]

Thank you I will investigate atarax.