The most common side effect of bile acid resins is constipation. Some patients find that increasing their activity level (e.g., walking) eases this symptom. Patients are advised to consult with their physician about beginning an exercise program. Stool softeners or laxatives may also be prescribed.

In addition, these medications may inhibit the absorption of certain nutrients (vitamins A, D, K and folate). Patients are encouraged to talk to their physicians about taking additional supplements and/or adding green leafy vegetables and skim milk to their diets.

Bile acid resins are usually administered in a chewable bar or in powder form, except colesevelam, which is usually in pill form. Powdered medication should never be taken in dry form because it could cause choking.

If a powder is prescribed, it should be mixed thoroughly in two ounces of any beverage except grapefruit juice. Once mixed, patients drink the medication, fill the glass again with more liquid and then drink that as well. This process ensures that none of the medication is left in the glass. Not all bile acid resins will completely dissolve. The powder may also be mixed with milk in hot or regular breakfast cereals, in thin soups (e.g., tomato or chicken), or with some pulpy fruits (e.g., crushed pineapple, peaches, pears or fruit cocktail).

Patients should carefully follow the directions for taking their medication provided by their physician and pharmacy. Those who miss a dose of this medication should take it as soon as possible, unless it is nearly time for the next dose. In that case, the missed dose should be skipped. Double doses of this medication should NOT be taken.

Bile acid resins may be less effective in people who are significantly overweight. Therefore, in addition to lifestyle changes recommended to reduce blood fat levels, patients may be placed on a weight loss program. In many cases, the lifestyle changes needed to manage blood fats will be similar to those in a weight loss program (e.g., diet, exercise, stress management).

All patients taking bile acid resins should inform their physician immediately of any side effects or concerns. Patients should not abruptly stop taking their medications without first consulting their physicians. It is also important that patients notify all physicians (including dentists) that they are taking bile acid resins before undergoing any surgical procedure.

Most patients on medication to treat high cholesterol (hypercholesterolemia) will take it for the rest of their lives, provided no serious side effects occur. Patients should remember that medications may control high cholesterol, but they do not cure it. Even if all their symptoms are relieved, patients should continue to take their medication exactly as directed, eat a heart-healthy diet that is low in saturated fats and keep all scheduled follow-up appointments with their physician.