Bile Acid Sequestrants

This class of drug, in use for more than 40 years with no major problems, acts like super glue, binding with bile acids in the intestines so that the acids are removed with the stool. Bile acids (which help your body digest fatty foods) are made from cholesterol in the liver. Ordinarily, as they pass through the intestines they are reabsorbed into the bloodstream and carried back to the liver. This “recycles” the cholesterol component as well. But bile acid sequestrants interrupt this pathway, causing the bile acids to exit the body. This causes a loss of cholesterol as well. In response, the liver removes more LDL from the bloodstream. And—voila—your blood cholesterol levels drop.

The most common drugs include cholestyramine, sold under the brand names Questran, Prevalite, and LoCholest, and colestipol (Colestid). These drugs generally lower LDL about 15 to 30 percent with relatively low doses while increasing HDL slightly (up to 5 percent). They may be prescribed with a statin if you already have heart disease. Together the two drugs can lower LDL more than 40 percent.

Side effects: These drugs may cause bloating, heartburn, constipation, i and abviominl path anton ene.,triglycerides, particularly if levels are already high.

Warnings: Bile acid sequestrants may delay or reduce your ability to absorb oral medications and vitamins, so you shouldn’t take them along with other medications or supplements.

Recommended dose: Bile acid  sequestrants generally come as tablets  or as a powdered resin that you mix with liquids or foods. A typical dose is about 10 grams per day.

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