Bile acid sequestrants bind with cholesterol-containing bile acids in the intestines and are then eliminated in the stool. The usual effect of these cholesterol medicines is to lower LDL cholesterol levels by about 10 percent to 20 percent. Small doses can produce useful reductions in LDL numbers.
Bile acid sequestrants are sometimes prescribed with a statin for people with heart disease to increase cholesterol reduction. When these two medications are combined, their effects lower bad cholesterol levels by over 40 percent.
These cholesterol 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 medicines come in either tablet or powder form. The powders must be mixed with water or fruit juice and taken once or twice (in rare cases, three times) daily with meals. The tablets must be taken with large amounts of fluids to avoid gastrointestinal symptoms. Bile acid sequestrants may produce a variety of side effects, including:
Bile acid sequestrants are not prescribed as the sole cholesterol medicine 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. Any other medications should be taken at least one hour before or four to six hours after the sequestrants. Talk to your healthcare provider about the best time to take these drugs, especially if you take other medications.