Bile acid sequestrants

Drag names and brand names: Cholestyramine (Questran Lite), colestipol (Colestid Granules).

How do bile acid sequestrants work? They bind with cholesterol containing bile acids in the intestines, and are then removed in bowel motions. These drugs typically lower LDL cholesterol by 10-20%. Sometimes a bile acid sequestrant is given with a statin drag in order to lower cholesterol levels more efficiently. Together, these two drags can lower LDL cholesterol by approximately 40%. Triglycerides are not lowered by bile acid sequestrants. These drags usually come as powders and are mixed with water or juice and consumed once or twice daily with meals.

Side effects of bile acid sequestrants: These drags reduce your ability to absorb other medications you take. They also inhibit the absorption of the fat soluble vitamins A, E, D and K, therefore long term use of bile acid sequestrants usually requires vitamin supplementation. Antacids impair the effectiveness of bile acid sequestrants, therefore the two drags should not be taken together. The most common side effects of these medications are digestive upsets such as gas, nausea, bloating and constipation.

Cholesterol absorption inhibitors

Drug name and brand name: Ezetimibe (Ezetrol).

How do cholesterol absorption inhibitors work? This is a new class of drugs which was first approved by the US FDA in late 2002. Ezetimibe inhibits the intestinal absorption of cholesterol found in bile and the diet. When given by itself, ezetimibe reduces LDL cholesterol by 18-20%. It is often given with a statin, especially in people who get side effects from high doses of statins. Ezetimibe can increase HDL cholesterol, but the way it does this is not yet known. It has no effect on the absorption of triglycerides, bile acids, fatty acids and fat soluble vitamins. This drug is taken in tablet form once daily.

Side effects of cholesterol absorption inhibitors: So far studies have shown that side effects in people taking ezetimibe were no greater than those taking a placebo. It is generally well tolerated if taken on its own.


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