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    Bile Acid Sequestrants for High Cholesterol

    Bile Acid Sequestrants for High Cholesterol

    Examples

    Generic Name Brand Name
    cholestyramine Locholest, Prevalite
    colesevelam Welchol
    colestipol Colestid

    Sequestrants are sometimes called bile acid resins or gels.

    How It Works

    Sequestrants bind to bile acids in the intestine and prevent them from being reabsorbed into the blood. The liver then produces more bile to replace the bile that has been lost. Because the body needs cholesterol to make bile, the liver uses up the cholesterol in the blood, which reduces the amount of LDL cholesterol circulating in the blood.

    Why It Is Used

    These medicines may be prescribed, along with dietary therapy, to lower LDL cholesterol in people who have high cholesterol and known heart disease or in people who are at high risk for heart disease.

    For people who have very high cholesterol levels (over 240 mg/dL or 6.21 mmol/L), these drugs also may be prescribed in combination with medicines called statins .

    People who have the following conditions should not take sequestrants:

    How Well It Works

    Bile acid sequestrants:

    • Reduce LDL cholesterol by 15% to 30%. 1
    • Raise HDL cholesterol by 3% to 5%. 1
    • May increase triglycerides , so you should not take these medicines if your triglyceride levels are above 300 mg/dL. 1

    Side Effects

    All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

    Here are some important things to think about:

    • Usually the benefits of the medicine are more important than any minor side effects.
    • Side effects may go away after you take the medicine for a while.
    • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

    Call 911 or other emergency services right away if you have:

    • Trouble breathing.
    • Swelling of your face, lips, tongue, or throat.

    Call your doctor if you have:

    • Hives.

    Common side effects of this medicine include:

    • Constipation.
    • Stomach pain.
    • Nausea.
    • Heartburn.
    • Indigestion or gas.

    See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

    What To Think About

    Some of these medicines are a powder that you mix with water, fruit juice, or milk. The powder can also be mixed with foods such as applesauce, soup, cereal, canned fruits.

    These medicines can make it harder for your body to use other medicines or vitamins. Tell your doctor what other medicines you take, including over-the-counter medicine and vitamins. Your doctor might suggest that you take your other medicines 1 hour before or 4 hours after a bile acid sequestrant.

    Be active and eat a cholesterol-lowering diet in addition to taking this medicine. Ask your doctor for advice on a diet that can help lower cholesterol. An example is the Therapeutic Lifestyle Changes (TLC) diet . For more information, see:

    Click here to view an Actionset. High Cholesterol: Using the TLC Diet.

    Taking medicine

    Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

    There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

    Advice for women

    If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

    Checkups

    Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

    Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

    References

    Citations

    1. Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486?2497.

    Credits

    By Healthwise Staff
    Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
    Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
    Specialist Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
    Last Revised June 29, 2012

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