Which medications in the drug class Bile Acid Sequestrants are used in the treatment of Coronary Artery Atherosclerosis?

Updated: Apr 09, 2021
  • Author: Sandy N Shah, DO, MBA, FACC, FACP, FACOI; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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Answer

Bile Acid Sequestrants

The bile acid sequestrants block enterohepatic circulation of bile acids and increase the fecal loss of cholesterol. This results in a decrease in intrahepatic levels of cholesterol. The liver compensates by up-regulating hepatocyte LDL-receptor activity. The net effect is a 10-25% reduction in LDL-C, but no consistent effect on triglycerides or HDL-C exists. Bile acid sequestrants include cholestyramine (Questran, LoCholest, Prevalite) and colestipol (Colestid).

Cholestyramine can be used as an adjunct in primary hypercholesterolemia. It forms a nonabsorbable complex with bile acids in the intestine, which in turn inhibits enterohepatic reuptake of intestinal bile salts.

Colestipol forms a soluble complex after binding to bile acid, increasing fecal loss of bile acid–bound LDL-C.

Colestipol (Colestid)

Forms a soluble complex after binding to bile acid, increasing fecal loss of bile acid-bound LDL cholesterol.

Cholestyramine (Questran, LoCholest, Prevalite)

May use as adjunct in primary hypercholesterolemia. Forms a nonabsorbable complex with bile acids in the intestine, which, in turn, inhibits enterohepatic reuptake of intestinal bile salts.

May use as adjunct in primary hypercholesterolemia.


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