GI

Bile Acid Sequestrants

Gastrointestinal

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Examples

cholestyraminecolestipolcolesevelam

Prefix / Suffix: cole-

Physiology

Bile acids are made from cholesterol in the liver and recycled from the intestine. Binding bile acids forces the liver to use more cholesterol to make new ones, lowering blood cholesterol.

Mechanism of Action

They bind bile acids in the intestine, preventing reabsorption. The liver then uses circulating cholesterol to produce more bile acids, reducing LDL.

Indications

  • Hyperlipidemia (especially LDL)
  • Pruritus from biliary obstruction
  • Bile acid diarrhea

Side Effects / Adverse Effects

  • Constipation (very common)
  • Bloating, flatulence
  • Decreased absorption of fat-soluble vitamins (A, D, E, K)
  • Decreased absorption of other medications

Contraindications

  • Complete biliary obstruction
  • Bowel obstruction

Nursing Considerations

  • Give other medications 1 hour before or 4 hours after (prevents binding)
  • Mix powder with water or juice — never take dry (risk of esophageal obstruction)
  • Encourage fluids and fiber (counter constipation)
  • Monitor lipid panel (effectiveness)
  • Supplement fat-soluble vitamins if long-term use

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.