Although statins are often the first line of treatment for individuals with high LDL cholesterol, familial hypercholesterolemia (FH), or high lipoprotein(a), also known as Lp(a), not all patients reach their LDL Safe Zone with statins.

In those cases, your healthcare provider may recommend the use of bile acid sequestrants.

This medication works with bile in the liver. The liver secretes bile to help with digestion and carrying waste out of the body. Since bile is made largely of cholesterol, bile acid sequestrants bind bile acids in the intestine to keep them (and the cholesterol) from getting back into the blood stream. Then they are passed in your stool.

Bile acid sequestrants other than colesevelam (Welchol), may bind other medications. It is important to take your other medications one hour before or 4 hours after taking your bile acid sequestrant.

This medication helps reduce LDL cholesterol by 10 to 30%.

• Cholestyramine (Questran, Prevalite)
• Colestipol (Colestid, Flavored Colestid)
• Colesevelam (Welchol)

Some people may be prescribed bile acid sequestrants alone, or in combination with other drugs to maximize its effectiveness.

Bile acid sequestrants are also the only approved LDL-lowering medication to take during pregnancy.