Bile acid sequestrants are drugs that are generally used to decrease cholesterol levels in those who have excessive levels of LDL cholesterol, sometimes known as "bad cholesterol." They function within the digestive system by binding to bile acids, which are generated by the liver from cholesterol and play an important role in dietary fat breakdown and absorption. Bile acid sequestrants are not taken into the bloodstream and instead function in the gastrointestinal tract. These drugs bind to bile acids, generating a compound that hinders resorption. As a result, the body compensates for this loss by increasing cholesterol utilization to make more bile acids, resulting in a decrease in total cholesterol levels in the blood. Bile acid sequestrants are commonly used to treat high cholesterol levels, particularly in those who cannot tolerate statins or in combination with statin therapy when statins alone do not reduce cholesterol levels satisfactorily. They can significantly reduce LDL cholesterol by 15-30%. Bile acid sequestrants that are commonly recommended include cholestyramine, colestipol, and colesevelam. These drugs are often taken orally in powder or tablet form, commonly mixed with water or other liquids. They must be taken with meals to have the greatest cholesterol-lowering effect. While bile acid sequestrants are generally regarded safe, they can cause constipation, bloating, gas, and stomach pain. These adverse effects are frequently manageable by changing the dosage or taking the drug with plenty of water and fiber. It's also worth noting that bile acid sequestrants can impair the absorption of certain drugs and fat-soluble vitamins. To avoid interactions, take them separately from other prescriptions and consult with a healthcare provider or pharmacist about the scheduling of other medications. Overall, bile acid sequestrants provide an alternate or complementary treatment option for people with high cholesterol, especially those who may not be candidates for other cholesterol-lowering drugs. As with any drug, it's critical to stick to the dosage and instructions given by a healthcare practitioner. Regular monitoring and follow-ups are also advised to ensure efficacy and reduce the risk of side effects.
