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Exchange resins

Authoring team

Drugs include:

  • cholestyramine and colestipol

Actions:

  • sequester bile acids in the gut and so reduce their reabsorption after biliary excretion - this prevents their reabsorption and promotes hepatic conversion of cholesterol into bile acids
    • causes an up-regulation of LDL receptors to maintain cholesterol pool
  • reduces cholesterol and LDL concentrations
  • may increase plasma triglyceride concentration by increasing VLDL - this is particularly the case where triglyceride levels are already raised when exchange resin therapy can result in a substantial increase in plasma triglycerides
  • note that exchange resins may decrease folate levels and folate supplementation should be considered in some groups (e.g children, pregnancy)

Contraindications:

  • complete biliary obstruction

Side effects include:

  • bloating, constipation, heartburn

The summary of product characteristics should be consulted before prescribing either of these drugs.

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