This fatal case of ischemic colitis showed abundant Kayexalate (arrow) and bile acid sequestrant
(BAS) resins (bracket, asterisks) at the perforation site.
Adding a bile acid sequestrant
to statin monotherapy does not appear to increase the risk of systemic toxicity.
Recommended pharmacologic interventions include HMG-CoA reductase inhibitors (statins), bile acid sequestrants
, nicotinic acid, and fibric acids (Reed et al.
Therefore, health care providers should be aware that other lipid-lowering medications, such as bile acid sequestrants
, fibric acids, and niacin have the advantageous effect of raising HDL-C level (Illingworth, 2001).
A bile acid sequestrant
should not be used by patients with high triglycerides; it will worsen the problem.
The statins, Vytorin and Zetia predominantly target LDL-C so patients with elevated triglycerides or decreased HDL even after treatment with one of these agents are often prescribed an add-on drug such as niacin, a fibrate, omega-3 fatty acid or bile acid sequestrant
to target these lipid abnormalities," said Decision Resources Analyst Christine Helliwell, Ph.
The internist will lose the case because he should have chosen a statin over a bile acid sequestrant
Because co-administration of bile acid sequestrants
may reduce the bioavailability of acidic medicinal products such as nicotinic acid, it is recommended that Tredaptive be administered > 1 hour before or > 4 hours after administration of a bile acid sequestrant
(see section 4.
University, examined the interaction of levothyroxine with two relatively new drugs--colesevelam (Welchol), the newest bile acid sequestrant
approved for hyperlipidemia and diabetes; and lanthanum carbonate (Fosrenol), a new phosphate binder used in end-stage renal disease.
Colesevelam hydrochloride (HCI) is a bile acid sequestrant
indicated alone or in combination with a statin, and as an adjunct to diet and exercise, for the reduction of elevated low-density lipoprotei n-cholesterol (LDL-C) in patients with primary hypercholesterolemia.