Bile Acid Sequestrants for High Cholesterol

Covers bile acid sequestrants drugs to treat high cholesterol. Includes generic and brand names such as cholestyramine and colesevelam (Welchol). Covers why they are used, how well they work, and side effects. Includes info on when to take.

Bile Acid Sequestrants for High Cholesterol


Generic Name Brand Name
cholestyramine Locholest, Prevalite
colesevelam Welchol
colestipol Colestid

Sequestrants are sometimes called bile acid resins or gels.

How It Works

Sequestrants bind to
bile acids in the intestine and prevent them from
being reabsorbed into the blood. The liver then produces more bile to replace
the bile that has been lost. Because the body needs
cholesterol to make bile, the liver uses up the
cholesterol in the blood, which reduces the amount of LDL cholesterol
circulating in the blood.

Why It Is Used

Your doctor may recommend these medicines if there is a reason you can't take a statin for high cholesterol.

People who have the following
conditions should not take sequestrants:

  • High
  • Familial dysbetalipoproteinemia (a rare form of
    lipid disorder)
  • Severe constipation
    (sequestrants make constipation worse)

How Well It Works

Bile acid sequestrants can improve cholesterol levels, but they have not been proved to lower the risk of a heart attack or a stroke.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.

Common side effects of this medicine include:

  • Constipation.
  • Stomach pain.
  • Nausea.
  • Heartburn.
  • Indigestion or gas.

See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)

What To Think About

Some of these medicines are a powder
that you mix with water, fruit juice, or milk. The powder can also be mixed with foods such as
applesauce, soup, cereal, canned fruits.

These medicines can make it harder for your body to use other medicines or vitamins. Tell your doctor
what other medicines you take, including over-the-counter medicine and vitamins. Your doctor might suggest that you take your other medicines 1 hour before or 4 hours after a bile acid sequestrant.

A heart-healthy lifestyle is important for lowering your risk whether you take medicine or not. This includes eating healthy foods, being active, staying at a healthy weight, and not smoking.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

Advice for women

If you are pregnant, breastfeeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) ( What is a PDF document? ) to help you understand this medication.


ByHealthwise StaffPrimary Medical Reviewer Kathleen Romito, MD - Family Medicine Specialist Medical Reviewer Adam Husney, MD - Family Medicine

Current as ofOctober 5, 2017