Patients should discuss with their physician the benefits and risks of taking bile acid resins if they have any of the following:

• Liver disease (history of disease or persistently high liver enzymes). Taking certain bile acid resins (colestipol) may result in an increase in cholesterol levels in patients with liver disease.
  
  
• Kidney disease. Cholestyramine and colestipol may increase the risk of developing electrolyte problems (blood disorders) in patients with kidney disease.

In addition, bile drug resins, cholestryamine and colestipol,  may worsen the following conditions:

• Gallstones
• Bleeding problems
• Stomach problems (e.g., heartburn, ulcers)
• Constipation and hemorrhoids
• Hypothyroidism (underactive thyroid gland)
• Phenylketonuria. A disorder that makes it difficult for the body to break down certain types of food. Certain bile acid resins (cholestyramine) are available in sugar–free form, which may contain phenylalanine, an ingredient in the artificial sweetener aspartame. Aspartame can cause problems in people with phenylketonuria. Patients with this condition may want to avoid sugar–free versions of bile acid resins.

Colesevelam may increase problems associated with severe gastrointestinal disorders, bowel obstruction, and swallowing problems. The drug may also increase the risk of post-surgical complications following major gastrointestinal surgery.