Internal and Emergency Medicine

, Volume 8, Issue 3, pp 205-210

First online:

Use and indications of cholestyramine and bile acid sequestrants

  • Franco ScaldaferriAffiliated withCatholic University of Rome Email author 
  • , Marco PizzoferratoAffiliated withCatholic University of Rome
  • , Francesca Romana PonzianiAffiliated withCatholic University of Rome
  • , Giovanni GasbarriniAffiliated withFondazione Ricerca in Medicina ONLUS
  • , Antonio GasbarriniAffiliated withCatholic University of Rome

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Cholestyramine is a bile acid sequestrant, like colestipol and colesevelam. These molecules are positively charged non-digestible resins that bind to bile acids in the intestine to form an insoluble complex, which is excreted in the feces. They are used mainly for the treatment of primary hypercholesterolemia and hypercholesterolemia associated with mild hypertriglyceridemia, in patients not responding to dietary treatment as well as a second line-treatment for pruritus associated with cholestatic disease, in patients with incomplete biliary obstruction. Several data indicate that modulation of bile acid homeostasis has a good clinical effect in managing diabetes mellitus and the diarrhea from bile acid malabsorption. In this review, we present the “in label” use and indication for these compounds, revisiting the other clinical applications that may benefit from the use of bile acid sequestrants in the near future.


Cholestyramine Bile acid sequestrants Colestipol Colesevelam