Bile acid sequestrants, also known as bile acid resins or BARs, are a class ofmedications used to help lower your cholesterol levels. If your cholesterol is high, your healthcare provider may decide to add a bile acid sequestrant to your cholesterol-lowering regimen. Because they tend to cause gastrointestinal symptoms, these drugs aren’t the first-line treatment for high cholesterol.
Currently, three bile acid sequestrant drugs are available in the United States:
Welchol (colesevelam) and Colestid (colestipol) are available as tablets or resin powder. Prevalite (cholestyramine) is available only as resin powder. All are also available as generic drugs.
This article discusses how bile acid sequestrants work, the common side effects, and who shouldn’t take them.
PhotoAlto / Alix Minde / Getty Images
How They Work
In response to lowered bile acids in the body, your liver will convert cholesterol into more bile acids. Additionally, LDL receptors will also be increased in the liver. These actions help lower cholesterol levels in the blood.
As a result, bile acid sequestrants mainly lowerLDLcholesterol between 15% to 30% and only slightly raiseHDLcholesterol.
These drugs do not appear to affect triglyceride levels but, in some cases, bile acid sequestrants may actually raise your triglycerides if taken for a long period of time. Because they have not been proven to lower the risk of a heart attack or stroke, bile acid sequestrants are not as commonly prescribed as other cholesterol-lowering medications, especially statins. However, they can be taken alone or combined with other cholesterol-lowering medications to help you manage your lipid levels.
Common Side Effects
Side effects from taking bile acid sequestrants mostly consist of gastrointestinal problems, including:
Some people may find it difficult to consistently take their bile acid sequestrant. For instance, some individuals might find the resins to be too gritty to taste—especially if they have to take them more than one time a day.
Although there are ways to improve the taste of the resins, some taking the drug still cannot tolerate their taste. Additionally, the Welchol tablet is large and may be difficult to swallow for some people. If you have been prescribed a bile acid sequestrant and are having difficulty taking your medication, you should let your healthcare provider know of this.
Who Should Not Take a Bile Acid Sequestrant
Some people shouldn’t take a bile acid sequestrant. Tell your healthcare provider if you have any of these other medical conditions below:
Your healthcare provider will weigh the benefits and risks of prescribing a bile acid sequestrant for you in these instances to help you manage your lipids.
Frequently Asked Questions
Bile acid sequestrants block bile acid in the stomach from being absorbed in the bloodstream. Bile acids are formed in the liver from cholesterol. By blocking their absorption, the liver draws cholesterol out of the blood, which in turn lowers cholesterol levels.
Bile acid sequestrants are primarily prescribed to lower LDL cholesterol levels. They are also prescribed to treat:
How you eat can have an impact on the amount of bile acid your body produces. Avoid high-fat foods, including deep-fried food, fatty cuts of meat, and full-fat dairy, which increase bile acid production.Eat food rich in soluble fiber, which helps to absorb bile acids. Soluble fiber is found in barley, beans, lentils, nuts, oat bran, peas, seeds, and some fruits and vegetables.Eating small but more frequent meals can also help to reduce bile acids naturally.
How you eat can have an impact on the amount of bile acid your body produces. Avoid high-fat foods, including deep-fried food, fatty cuts of meat, and full-fat dairy, which increase bile acid production.
Eat food rich in soluble fiber, which helps to absorb bile acids. Soluble fiber is found in barley, beans, lentils, nuts, oat bran, peas, seeds, and some fruits and vegetables.
Eating small but more frequent meals can also help to reduce bile acids naturally.
2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625National Library of Medicine.Bile acid sequestrants for cholesterol.
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625National Library of Medicine.Bile acid sequestrants for cholesterol.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625National Library of Medicine.Bile acid sequestrants for cholesterol.
Grundy SM, Stone NJ, Bailey AL, et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625
National Library of Medicine.Bile acid sequestrants for cholesterol.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
