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Uses

What is colesevelam used for?

Colesevelam is commonly used to lower bad cholesterol (LDL-C) in people with high cholesterol.

It is also used to help improve management of blood sugar levels in people with type 2 diabetes.

Colesevelam may also be used for other conditions as determined by your healthcare provider.

How does colesevelam work (mechanism of action)?

Colesevelam works by binding bile acid and increasing its removal from your body. Bile acid is a liquid substance your liver produces that helps with food digestion. Because bile acid is made from cholesterol, your body will use cholesterol to replace the bile acid that was removed. As a result, your cholesterol levels will also decrease.

It is unknown how colesevelam works to manage blood sugar levels in people with type 2 diabetes.

How is colesevelam supplied (dosage forms)?

Brands and other names

  • Welchol

Dosage forms and strengths

  • 625 mg oral tablets
  • 1.875 g/packet of powder for oral suspension
  • 3.75 g/packet of powder for oral suspension

How should I store colesevelam?

Colesevelam should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of colesevelam?

The most common side effects of colesevelam are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Constipation
  • Upset stomach (or indigestion)
  • Nausea

There may be other side effects of colesevelam that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of colesevelam?

While less common, the most serious side effects of colesevelam are described below, along with what to do if they happen.

Severe Allergic Reactions. Colesevelam may cause allergic reactions, which can be serious. Stop using colesevelam and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

High Triglyceride Levels. Some people taking colesevelam have had high triglyceride levels. Be sure you are getting your triglyceride levels checked before and during your colesevelam treatment. High triglyceride levels can lead to pancreatitis. 

Inflammation of the Pancreas (Pancreatitis). Colesevelam may cause inflammation of the pancreas, which is called pancreatitis. Stop taking colesevelam and call your healthcare provider right away if you have symptoms of pancreatitis including vomiting or severe pain in the upper part of your belly that travels to your back.

Bowel obstruction. Colesevelam may cause bowel obstruction, which is a serious side effect. This is when your small or large intestine is fully or partly blocked. Call your healthcare provider right away if you have any of the following symptoms of bowel obstruction.

  • Loss of appetite
  • Nausea and vomiting
  • Constipation
  • A hard, swollen belly
  • Inability to pass gas

Vitamin Deficiency. Colesevelam may decrease the absorption of vitamins A, D, E, and K.  Take your vitamin at least 4 hours before taking colesevelam to decrease this risk. Talk with your healthcare provider if your symptoms are continuing to worsen.

Warnings & Precautions

Who should not use colesevelam?

Allergies to Ingredients. People who are allergic to any of the following should not take colesevelam.

  • Welchol
  • Colesevelam
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific colesevelam products they stock.

High Triglyceride Levels. Do not take colesevelam if you have  high triglyceride levels. Your doctor will check your triglyceride levels before starting colesevelam. 

History of Pancreatitis. Do not take colesevelam if you have a history of pancreatitis due to high triglyceride levels.

History of Bowel Obstruction. Do not take colesevelam if you have a history of bowel obstruction. 

What should I know about colesevelam before using it?

Do not take colesevelam unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share colesevelam with other people, even if they have the same condition as you. It may harm them.

Keep colesevelam out of the reach of children.

Colesevelam powder should not be taken as a dry powder. Always mix dry powder with water or other fluids before consuming as directed. 

Take colesevelam with a meal.

What should I tell my healthcare provider before using colesevelam?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if colesevelam is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Other Medicines and Supplements. Colesevelam may interact with other medicines and supplements. Before using colesevelam, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Colesevelam is not absorbed by the body and is not expected to reach the baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take colesevelam while you are pregnant or trying to get pregnant.

Breastfeeding. Colesevelam is not absorbed by the body and is not expected to pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take colesevelam while you are breastfeeding. 

Interactions

Does colesevelam interact with foods or drinks?

There are no known interactions between colesevelam and foods or drinks.

It is unknown if drinking alcohol will affect colesevelam, but alcohol may affect blood sugar levels in people with diabetes. Alcohol consumption can also affect your cholesterol levels. It is best to limit the amount of alcohol you drink.

Does colesevelam interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking colesevelam.

  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Warfarin (Coumadin, Jantoven), which is a blood thinner
  • A birth control pill that contains ethinyl estradiol and norethindrone (Aranelle and others)
  • A thyroid medicine, such as levothyroxine, which is used to raise thyroid hormone levels
  • Olmesartan (Benicar), a medicine used for high blood pressure
  • A sulfonylurea, which is a medicine for diabetes
  • Metformin extended release (ER), which is a medicine used for diabetes
  • Vitamins A, D, E, and K
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system

You should take other drugs at least 4 hours before you take colesevelam.

This may not be a complete list of medicines that can interact with colesevelam. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much colesevelam?

If you or someone else has used too much colesevelam, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of colesevelam?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.