Colesevelam

Aka: Colesevelam, Welchol

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II. Indications

  1. Hyperlipidemia adjunctive management (rare use)

III. Contraindications

  1. See Bile Acid Sequestrant
  2. Serum Triglycerides >500 mg/dl

IV. Mechanism

  1. See Bile Acid Sequestrant
  2. Binds bile salts
    1. Results in insoluble complexes that are excreted in the stool

V. Dosing: Hyperlipidemia

  1. Approved for children age 10 years and older (postmenarche girls)
  2. Take with food and 8 ounces of water, fruit juice (e.g. orange juice) or diet soft drink
  3. One Dose: Six 625 mg tablets or one chewable bar (3.75 g) orally daily
  4. Two Doses: Three 625 mg tablets (1.875 g) orally twice daily

VI. Drug Interactions

  1. See Bile Acid Sequestrant
  2. May decrease levels of other medications
    1. Cyclosporine
    2. Glyburide
    3. Levothyroxine
    4. Oral Contraceptives (containing Ethinyl Estradiol and Norethindrone)
    5. Phenytoin
    6. Warfarin
    7. Fat Soluble Vitamins (Vitamin A, Vitamin D, Vitamin E, Vitamin K)
      1. Colesevelam does not appear to affect Vitamin Absorption as much as other bile acid resins
      2. However, package insert recommends taking Vitamins at least 4 hours before colesevalam

VII. Efficacy

  1. See Bile Acid Sequestrant
  2. Most expensive agent of the class
  3. May be preferred agent of class
    1. Lower adverse effect profile (see above)
    2. May be taken concurrently with Statin
    3. Lowers A1C by 0.5%
    4. Zieve (2007) Clin Ther 29(1):74-83 [PubMed]

VIII. Adverse Effects

  1. See Bile Acid Sequestrant
  2. Colesevelam may have less gastrointestinal intolerance than other bile acid resins

IX. Safety

  1. Pregnancy Category B
  2. Considered Safe in Lactation

X. Metabolism

  1. Not absorbed

XI. Resources

  1. Colesevelam (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8867edcf-0b56-4203-8269-90b3af4ede36

XII. References

  1. (2022) Non-StatinLipid Lowering Agents, Presc Lett, Resource #380202
  2. (2022) Med Lett Drugs Ther 64(1659): 145-52
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  4. (2000) Med Lett Drugs Ther 42:102-4 [PubMed]

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Related Studies

Cost: Medications

colesevelam (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
COLESEVELAM 625 MG TABLET Generic $0.38 each
COLESEVELAM HCL 3.75 G PACKET Generic $3.37 each
welchol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
WELCHOL 625 MG TABLET Generic $0.38 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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