Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

colesevelam (Rx)Brand and Other Names:WelChol

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 625mg

powder for oral suspension

  • 3.75g
more...

Hyperlipidemia

Reduction of elevated low-density lipoprotein (LDL) cholesterol (LDL-C) in adults with primary (Fredrickson type IIa) hyperlipidemia as adjunct to diet and exercise, either alone or in combination with a statin

Tablet: 1.875 g (3 tablets) PO q12hr with meals or 3.75 g (6 tablets) PO once daily with a meal

Oral suspension: 1.875 g (½ packet) PO q12hr or 3.75 g (1 packet) PO once daily, mixed with liquid

Overdose: Symptoms include gastrointestinal (GI) obstruction; treatment is supportive

Type 2 Diabetes Mellitus

Improvement of glycemic control in adults; taken in combination with insulin or oral antidiabetic agents

Tablet: 1.875 g (3 tablets) PO q12hr with meals or 3.75 g (6 tablets) PO once daily with a meal

Oral suspension: 1.875 g (½ packet) PO q12hr or 3.75 g (1 packet) PO once daily, mixed with liquid

Overdose: Symptoms include GI obstruction; treatment is supportive

Administration

Tablet: Take with meals and plenty of liquid

Oral suspension: Empty packet in 4-8 oz of water, fruit juice, or diet soft drink and stir; drink with meal(s)

May be coadministered with statins or administered at separate times

Dosage Forms & Strengths

tablet

  • 625mg

powder for oral suspension

  • 3.75g
more...

Heterozygous Familial Hypercholesterolemia

Indication

  • Reduction of LDL-C levels in boys and postmenarchal girls aged 10-17 years as adjunct to diet and exercise, either alone or in combination with statin after failure of adequate trial of diet therapy
  • Diet therapy failure defined as either (a) LDL-C ≥190 mg/dL or (b) LDL-C ≥160 mg/dL with positive family history of premature cardiovascular disease (CVD) or ≥2 other CVD risk factors present

<10 years: Safety and efficacy not established

>10 years: 3.75 g/day PO once daily or divided q12hr

Next

Interactions

Interaction Checker

colesevelam and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            >10%

            Constipation (9-11%)

            1-10%

            Dyspepsia (4.8%)

            Myalgia (2%)

            Asthenia (1.7%)

            Accidental injury (1%)

            Nausea (1%)

            Flu syndrome (1%)

            Hypertension (1%)

            Hypoglycemia (1%)

            Pharyngitis (1%)

            Rhinitis (1%)

            Postmarketing Reports

            Increased seizure activity or decreased phenytoin levels in patients receiving phenytoin; administer phenytoin 4 hours before colesevelam

            Reduced international normalized ratio (INR) in patients receiving warfarin; monitor INR

            Elevated thyroid-stimulating hormone (TSH) level in patients receiving thyroid hormone replacement therapy; administer thyroid hormones 4 hours before colesevelam

            GI: Bowel obstruction, dysphagia, esophageal obstruction, fecal impaction, pancreatitis, increased transaminase levels

            Previous
            Next

            Warnings

            Contraindications

            Current bowel obstruction or risk of bowel obstruction

            Serum triglyceride (Tg) >500 mg/dL (5.65 mmol/L)

            History of hypertriglyceridemia-induced pancreatitis

            Cautions

            Dysphagia (use oral suspension; large tablets can obstruct esophagus)

            Not recommended in gastroparesis (constipating effects)

            Not for glycemic control in type I diabetes mellitus or diabetic ketoacidosis

            May reduce absorption of some drugs and nutrients; administer drugs with known interactions or narrow therapeutic index 4 hours before colesevelam

            Not studied in Fredrickson I, III, IV, or V hyperlipidemia

            May exacerbate preexisting constipation (initiate therapy at lower dosage in patients with history of constipation)

            Oral suspension contains phenylalanine

            Secondary causes of hyperlipidemia must be ruled out before therapy is initiated

            Can increase Tg level, particularly when used with insulin or sulfonylureas; marked hypertriglyceridemia can cause acute pancreatitis

            Bile acid sequestrants may decrease absorption of fat-soluble vitamins

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy category: B

            Lactation: Drug not expected to be excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Forms complex with bile acids that is not absorbed through intestine; inhibits enterohepatic reuptake of intestinal bile salts, and this, in turn, increases fecal loss of bile salt-bound LDL and consequently reduces serum cholesterol in patients with primary hypercholesterolemia

            Absorption

            Absorbed only to insignificant extent

            Onset: 2 wk (lipid-lowering effect)

            Elimination

            Excretion: Feces, urine (trace amounts [0.05%])

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.