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Resins (Bile acid sequestrants)

Your body uses cholesterol to make bile, an acid used in digestion. Resins or bile acid sequestrants bind to bile, preventing it from being used during digestion. In response, your liver makes more bile, and the more bile it makes, the more LDL-cholesterol (the bad cholesterol) it needs.  This means there is less LDL-cholesterol circulating through your blood. These drugs, such as cholestyramine (Questran) and colestipol (Colestid), can reduce total cholesterol and may even raise "good" HDL cholesterol.

What does this medication do?
These medications work by binding to bile acids, which prevents bile acids from being absorbed by the intestine. Bile acids then pass in your stool, which forces the body to break down more bad cholesterol to make more bile acids. This results in decreased cholesterol levels.

How should I take it?
Cholestyramine is only available as granules (a coarse powder), while colestipol is available as both granules or tablets. They are usually taken once or twice a day with meals. Questran granules or Colestid granules must be mixed with liquids – do not take the powder dry. You can mix the granules with water, milk, a flavoured drink, juice, soda or foods such as cereals, thin soups, yogurt, pudding, cottage cheese or fruit cocktail.

Make sure you always take your other medications at least one hour before, or four hours after you take cholestyramine or colestipol, because they may bind other medications, making them less effective.

Always talk to your doctor or pharmacist about how and when to take your medication.

What if I am taking other medicines?
Always tell your doctor about any other medication including prescription, non-prescription, over-the-counter or natural health products (vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics and other products such as amino acids and essential fatty acids). Make sure you always take your other medications at least 1 hour before or 4 hours after you take cholestyramine or colestipol, because they may bind other medications, making them less effective.

What are some common side effects?
The most common side effects are stomach or intestinal problems: constipation, abdominal pain or cramping, bloating, flatulence (gas), heartburn, nausea, vomiting and diarrhea.

Lifestyle changes
Eating a healthy diet that is lower in fat, especially saturated and trans fats, being smoke free, limiting alcohol use, being physically active and reducing stress are also important in lowering the risk of heart disease. Talk to your healthcare practitioner about how you can achieve these lifestyle changes.

For more information
Health Canada provides health and medical information to help Canadians maintain and improve their health. Learn more about Safe Use of MedicinesSafety and Effectiveness of Generic Drugs and Buying Drugs over the Internet.

Drug Product Database provides information about drugs approved for use in Canada.

MedEffect Canada provides safety alerts, public health advisories, warnings and recalls.

Your ministry of health also provides useful health resources in your province or territory. For example, Ontario has a MedsCheck program providing free pharmacist consultations on safety use of drugs. British Columbia has a Senior Healthcare webpage providing information about important health programs.  

Last modified: July 2011
Last reviewed: July 2011