Bile acid sequestrants bind with cholesterol-containing bile acids in the intestines and are then eliminated in the stool. The usual effect of bile acid sequestrants is to lower LDL cholesterol levels by about 10 percent to 20 percent. Small doses of bile acid sequestrants can produce useful reductions in LDL numbers.
Bile acid sequestrants are sometimes prescribed with a statin for patients with heart disease to increase cholesterol reduction. When these two cholesterol medications are combined, they lower bad cholesterol levels by over 40 percent.
These drugs are not absorbed from the gastrointestinal tract, and 30 years of experience with the sequestrants indicate that their long-term use is safe.
Examples of bile acid sequestrants used to treat high cholesterol include:
These drugs come in either powder or tablet forms. Bile acid sequestrant powders must be mixed with water or fruit juice and taken once or twice (rarely three times) daily with meals. Tablets must be taken with large amounts of fluids to avoid gastrointestinal symptoms. Sequestrant therapy may produce a variety of symptoms, including:
Bile acid sequestrants are not prescribed as the sole medicine to reduce cholesterol if you have high triglycerides or a history of severe constipation.
Although sequestrants are not absorbed, they may interfere with the absorption of other medicines if taken at the same time. Therefore, other medications should be taken at least 1 hour before or 4 to 6 hours after the sequestrants. Talk to your doctor about the best time to take these cholesterol drugs, especially if you take other medications.