What are bile acid sequestrants?

Donna Hill Howes, RN
Family Practitioner

Bile acid sequestrants are drugs that bind with bile acids in the intestine so that they can't be reabsorbed. To increase bile acid production, the liver has to convert more cholesterol to bile acid. This results in a lower blood level of cholesterol. Several bile acid sequestrants are available in the US. These include cholestyramine (Prevalite), colesevelam (Welchol), and colestipol (Colestid).

Current cholesterol management guidelines state that non-statin drugs are not first-line therapy. But they can be added to a statin if cholesterol goals are not being met. Bile acid sequestrants can be considered for people with triglycerides below 300 mg/dL. However, studies have shown no additional benefit when added to a statin. 

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