Also indexed as: Cholestyramine, Prevalite®,
Questran®
Cholestyramine (Questran®) and colestipol
(Colestid®) are bile acid sequestrants—a class of drugs that binds bile acids,
prevents their reabsorption from the digestive system, and reduces cholesterol levels.
Cholestyramine and colestipol are two of many drugs used to lower cholesterol levels in people
with high cholesterol.
Bile acids are produced in the liver from cholesterol and secreted into the small intestine
to help with the absorption of dietary fat and cholesterol. Bile acid sequestrants bind bile
acids in the small intestine and carry them out of the body. This causes the body to use more
cholesterol to make more bile acids, which are secreted into the small intestine, bound to
bile acid sequestrants, and carried out of the body. The end result is lower cholesterol
levels. Bile acid sequestrants also prevent absorption of some dietary cholesterol.
The information in this article pertains to bile acid sequestrants in general. The
interactions reported here may not apply to all the Also Indexed As terms. Talk to your doctor
or pharmacist if you are taking any of these drugs.
Summary of
Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)
 May be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them. |
Beta-carotene and other carotenoids
Calcium*
Folic acid
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Zinc*
|
| Side effect reduction/prevention |
None known
|
| Supportive interaction |
None known
|
| Reduced drug
absorption/bioavailability |
None known
|
| Adverse interaction |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Vitamins and Minerals
Bile acid sequestrants may prevent absorption of folic
acid and the fat-soluble vitamins A, D, E, and K.1 2 Other medications and vitamin
supplements should be taken one hour before or four to six hours after bile acid sequestrants
for optimal absorption.3 Animal studies suggest
calcium and zinc may also be depleted by taking
cholestyramine.4
Carotenoids
Use of colestipol for six months has been shown to significantly lower blood levels of
carotenoids including beta-carotene.5
Interactions with Foods and Other Compounds
Food
Bile acid sequestrants should be taken with plenty of water before meals.6
References
1. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA:
Third Line Press, 1997, 221–2 [review].
2. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic
Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis,
MO: Facts and Comparisons, Feb 1997, 171i–l.
3. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic
Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis,
MO: Facts and Comparisons, Feb 1997, 171i–l.
4. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc
balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed
Proc 1983;42:819.
5. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and
vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism
1985;34:88–91.
6. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic
Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis,
MO: Facts and Comparisons, Feb 1997, 171i–l.
Copyright © 2004 Healthnotes, Inc. All rights reserved.
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Learn more about the authors of Using
Medicines with Vitamins and Herbs
The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over-the-counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires March 2005.
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