Bile Acid Sequestrants - Uses and BenefitsType of Drug:Drugs used as adjunctive therapy to diet and exercise to lower the level of LDL cholesterol and total cholesterol in the blood. How the Drug Works:Bile acid sequestrants increase the removal of bile acids from the body. As the body loses bile acids, it replaces them by converting cholesterol from the blood to bile acids. This causes the blood level of cholesterol to decrease. High blood levels of cholesterol may increase the risk of developing heart, coronary artery, or other vascular disease. Uses:To lower high levels of cholesterol in the blood alone or in conjunction with proper diet, exercise, and possibly other lipid-lowering drugs. Cholestyramine: To relieve itching associated with partial biliary obstruction. Unlabeled Uses: Occasionally doctors may prescribe cholestyramine to bind the toxins produced by Clostridium edificial, the organism which causes antibiotic-induced pseudomembranous colitis. Choloslyrnrnine has also been used for treatment of chlordecone (Kopone)pesticide poisoning, bile salt-mediated and postvagotomy darrhea,and thyriod hormone overdose. Cholestyramine and colestipol ihave both been used to treat digitials toxicty. Precautions:Before treatment: Before treatment with a bile acid sequestrant, a vigorous attempt should be made to control cholesterol with appropriate diet, exercise, and weight reduction (in obese people). Diseases that may increase cholesterol and must be treated before beginning treatment with bile acid sequestrants include: Phenylketonuria: Some of these products contain phenylalanine. Consult your doctor or pharmacist. Supplementation: Treatment with bile acid sequestrants may require supplementation with vitamins A, E, and D, oral vitamin K, or folic acid. Pregnancy: Safety for use during pregnancy has not been established. These agents are not absorbed systemically, and are not expected to cause fetal harm when administered during pregnancy in recommendod doses. Use only when clearly needed the potential benefits to the mother outweigh the possible hazards to the fetus. Breastfeeding: Use caution when breastfeeding. The possible lack of proper vitamin absorption may have an effect on nursing infants. Consult your doctor. Children: Dosage schedules have not been established. The effects 01 long-term use and effectiveness in maintaining lowered cholesterol levels are unknown. Lab Tests: Lab tests will be required periodically during treatment with bile acid sequestrates. Tests may include blood counts, triglycerides, and cholesterol levels. Drug Interactions:Tell your doctor or pharmacist if you are taking or planning to take any overthe-counter or prescription medications or dietary supplements while taking bile acid sequestrants. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with bile acid sequestrants:
Side Effects: Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include: Digestive Tract: Severe constipation or other persistent stomach problems; gastrointestinal bleeding or irritation; fatty or black stools; loose stools; occasional stomach pain; gas; indigestion; ulcer attack; bloating; belching; nausea; vomiting; heartburn; aggravated hemorrhoids; appetite loss; difficulty swallowing; diarrhea. Nervous System: Headache; leg pain; anxiety; feeling of whirling motion; dizziness; fatigue; insomnia; drowsiness; fainting. Respiratory System: Asthma; wheezing; shortness of breath. Skin: Rash; itching; hives; abnormal skin sensations. Other: Unusual bruising or bleeding (eg, gums, rectum); hiccups; sour taste; weight loss or gain; difficulty swallowing; muscle pain; anemia, backache; chest pain; arthritis; ringing in the ears; blood in urine; painful urination; increased urination; burnt urine odor; fluid retention; tingling or numbness in legs and arms; swelling of hands or feet; inflammation of the uveal tract; inflammation of the pancreas or gall bladder; gallstones; increased libido; deficiencies of fat-soluble vitamins (eg, A and D). Guidelines for Use:
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