Bile acid sequestrant drugs (drug interactions)
Bile acid sequestrant drugs are medications primarily used to lower cholesterol levels in the body. While effective, they can interact with a variety of nutrients and medications, which is important for patients to consider. These drugs may impair the absorption of essential nutrients such as calcium, iron, and fat-soluble vitamins, particularly affecting long-term users. It has been noted that supplementation with folate may be necessary for those on prolonged therapy, although other nutrient levels often remain within normal ranges.
In terms of drug interactions, bile acid sequestrants can narrow the therapeutic effects of blood thinners like warfarin, reduce the effectiveness of thyroid medications, and hinder the absorption of birth control pills and certain antibiotics. Interestingly, when used alongside statins, their cholesterol-lowering effects can be significantly enhanced. However, they may also interfere with medications for diabetes and organ transplant recipients. Given these complexities, individuals taking bile acid sequestrants should consult healthcare providers to manage potential nutrient deficiencies and medication interactions effectively.
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Subject Terms
Bile acid sequestrant drugs (drug interactions)
DEFINITION: A drug used to lower levels of cholesterol.
INTERACTION: Many nutrients, blood thinners, thyroid medications, birth control pills, antibiotics, sulfonylureas, statins
DRUGS IN THIS FAMILY: Colestipol hydrochloride (Colestid), cholestyramine resin (Questran, Questran Light)
Nutrients
Effect: Supplementation Likely Helpful
Bile acid sequestrants have been reported to impair the absorption of numerous nutrients and fat-soluble vitamins, including calcium, folate, iron, vitamin A, vitamin B12, and vitamin E. It appears, however, that only folate supplementation may be needed by persons on long-term therapy with bile acid sequestrants. Although the bile acid sequestrant used in the studies interfered with the absorption of the other nutrients, their levels remained in the normal range. To be safe, though, one should be sure to get enough vitamin E and A (in the form of beta-carotene).
Bile acid sequestrants have also been reported to interact with numerous medications. They have been shown to narrow the therapeutic index of blood thinners, such as Warfarin, and lower the availability of thyroid medications like levothyroxine. Bile acid sequestrants interfere with the effectiveness of birth control pills and prevent the absorption of certain antibiotics. Bile acid sequestrants may also interfere with various medications in the categories of antibiotics, antifungal medications, and cholesterol-lowering medications. However, when used in combination with statins, the effectiveness of bile acid sequestrants was greatly enhanced. Finally, bile acid sequestrants have been shown to interact with sulfonylurea medication used to treat type 1 diabetes and interfere with the medication that prevents organ rejection post-transplant from being effective.
Bibliography
"Bile Acid Sequestrants for Cholesterol." MedlinePlus, 27 Feb. 2024, medlineplus.gov/ency/patientinstructions/000787.htm. Accessed 5 Sept. 2024.
Lent-Schochet, Daniella, Ishwarlal Jialal. "Antilipemic Agent Bile Acid Sequestrants - StatPearls." NCBI, 23 Jan. 2023, www.ncbi.nlm.nih.gov/books/NBK549906. Accessed 5 Sept. 2024.
West, R. J., and J. K. Lloyd. "The Effect of Cholestyramine on Intestinal Absorption." Gut, vol. 16, 1975, pp. 93-98.