Resins (Bile acid sequestrants)

Your body uses cholesterol to make bile an acid used in digestion. Bile acid sequestrants bind to bile, preventing it from being used during digestion. In response, your liver makes more bile and the more it makes, the more LDL-cholesterol (the bad cholesterol) it needs which means there is less LDL-cholesterol circulating through your blood. These drugs such as cholestyramine (Questran)and colestipol (Colestid) can reduce total cholesterol by 20%, and may even raise "good" cholesterol.

What does this medication do?
These medications work by preventing bile acids from being taken up into the intestine. Bile acids are formed when the body breaks down cholesterol. By binding the bile acids, they pass out in your stool. This forces the body to break down more cholesterol to make more bile acids and the result is your cholesterol is decreased.

How should I take it?
Cholestyramine is only available as granules (a course powder), while colestipol is available as both granules or tablets. They are usually taken once or twice a day, with meals. For Questran granules or Colestid granules, you must mix these with liquids do not take the powder dry. You can mix the granules with water, milk, flavoured drink, juice, soda or foods such as cereals, thin soups, yogurt, pudding, cottage cheese or fruit cocktail.

Make sure you always take your other medications at least one hour before, or four hours after you take cholestyramine or colestipol, because they may bind other medications, making them less effective.

Always talk to your doctor or pharmacist about how and when to take your medication.

What if I am taking other medicines?
Always tell your doctor about any other medication including prescription, non-prescription, over-the-counter or natural health products (vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics and other products like amino acids and essential fatty acids). Make sure you always take your other medications at least 1 hour before, or 4 hours after you take cholestyramine or colestipol, because they may bind other medications, making them less effective.

What are some common side effects?
The most common side effects are stomach or intestinal problems: constipation, addominal pain or cramping, bloating, flatulence (gas), heartburn, nausea, vomiting and diarrhea.

Lifestyle changes
Eating a healthy diet that is lower in fat, especially saturated and trans fats, being smoke free, limiting alcohol use, being physically active and reducing stress are also important in lowering the risk of heart disease. Talk to your health-care practitioner about how you can achieve these lifestyle changes.

Where can I get more information?
For warnings, recalls and other clinical drug information:

  1. Health Canada Drugs and Health Products http://www.hc-sc.gc.ca/dhp-mps/prodpharma/index_e.html
  2. Drugs and Health Products: Advisories, Warnings and Recalls http://www.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/index_e.html

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