Sequestrants of fatty acids are drugs that are able to lower blood cholesterol. This is an auxiliary drug used in complex treatment. There is a certain classification of lipid-lowering drugs that do not allow cholesterol to be synthesized in the blood. Sequestrants are included in this classification. It is conditional, contains various means, the mechanism of action of which is similar. The most famous sequestrants of bile acids are the preparations "Kolestipol", "Kolestiramin", "Kolesevelam".
The risk of heart disease is reduced due to the properties of sequestrants, including ischemia. Clinical practice confirms the effectiveness of SCW in the following points:
- coronary complications slow down;
- deaths from myocardial infarction are reduced.
The chemical composition of these drugs allows them to be classified as ion-exchange resins. These are high molecular weight synthetic compounds, which, in essence, are solid insoluble polymers participating in the ion exchange with the aqueous medium. This is what bile acid sequestrants are.
The mechanism of action of drugs
The word "sequestrant" means "insulator", that is, bile acids are isolated in the human body. Cholesterol combines with bile acids, which use cholesterol from the liver to synthesize. Bile acids circulate in the digestive system, then enter the intestines, where they are not absorbed. As a result, many valuable substances remain in the body for life.
Effective results will be with lipoproteins, which have a low density. This is the so-called bad cholesterol.
This is how bile acid sequestrants work (we will describe the preparations in more detail below).
Sequestrants are not absorbed into the blood, therefore side effects, if any, are minimal and are extremely rare.
Pregnant and lactating women can use them for these reasons. Also, children and adolescents with familial hypercholesterolemia take these drugs to slow down the process. This is a hereditary condition of the body in which high cholesterol and the ensuing consequences are pronounced.
If the tolerance of FFA is normal, then they can be used for a fairly long time. But it is imperative to control cholesterol, liver enzymes and muscle tissue.
Statins in combination with FFA are more effective with a long course of therapy. Bad cholesterol is reduced by half. If combined hyperlipoproteinemia is present (when there is a lot of fat in the blood), then the results will be better by 70-75%. How do sequestrants of bile acids act on the body? Drugs are generally well tolerated.
What side effects are there?
Side effects are very rare. If they happen, then they don’t turn anything serious for the body. But still, some people may display the following rapidly passing symptoms:
- constipation
- digestive disorders (dyspepsia);
- nausea
- excess flatulence in the intestines (flatulence);
- bloating;
- heartburn, and this is the most common side effect of bile acid sequestrants.
In order to avoid negative reactions from the body, you need to drink plenty of fluids and use small doses of the medicine at first.
When using FFA, children need to prescribe iron and folic acid. Concomitant use with other drugs can provoke poor absorption of active components. Here it is necessary to observe the following rule: sequestrants drink an hour after drinking another drug and four hours before.
Very rarely, muscle pain (myalgia), inflammation of the pharynx (pharyngitis) is possible. Extremely rare is the appearance of cough, pain in the back, runny nose.
Contraindications
Do sequestrants of bile acids have contraindications? Drugs are not prescribed in the following cases.
With hyperlipoproteinemia of types 3 and 4 (which threaten pathologies of the cardiovascular system), sequestrants are not recommended. Triglycerides in the blood may increase. When the bile ducts are affected (biliary cirrhosis and complete biliary obstruction), these medications should not be prescribed. If a person suffers from frequent constipation, then medications can only aggravate the situation. Kidney disease, gastric ulcer, hemorrhoids, bleeding disorders - all these are contraindications to the intake of FFA.
They are prescribed with caution to people with gastrointestinal tract disorders, malabsorption syndrome (intestinal absorption is impaired, and it is difficult for valuable nutrients to linger in the body).
Possible individual intolerance.
Below we consider the most popular sequestrants of bile acids. The drugs (the list can also be checked with the doctor) will be arranged in order from the most popular to the less popular.
The drug "Colestyramine"
It is also called "Cholestyramine." It is an insoluble ion-exchange compound of polymers. It leads to a decrease in blood cholesterol by a quarter. Active binding to bile acids occurs, after which they are isolated from the human body. If this drug must be drunk for a long time, then you need to consume more water. Statins enhance the effect, but their concentration is reduced in the blood. At the age over 60 years appoint with caution.
Medication "Colestipol"
It is a high molecular weight insoluble copolymer. The properties of binding bile acids are somewhat worse for him than for Colestyramine.
Indications, side effects and contraindications are the same as for the entire group of drugs. The combination of "Colestepol" and statins give the best effect.
The medicine "Kolesevelam"
The absence of unpleasant taste in the drug contributes to the fact that it is more often used in comparison with other medicines.
Do these bile acid sequestrants have side effects?
Negative phenomena from the gastrointestinal tract are not noted. There are no reactions with other medicines. "Kolesevelam" can be used to treat pregnant and lactating women.