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Colesevelam Medication: Uses, Dosage, and Cholesterol Benefits
Summary of Key Points
Colesevelam is a medication used to lower cholesterol levels and manage blood sugar in individuals with type 2 diabetes. It belongs to a class of drugs known as bile acid sequestrants. Colesevelam is typically prescribed when diet and exercise alone are not enough to control cholesterol or blood sugar levels. Always consult your healthcare provider before starting or adjusting your Colesevelam dosage.
Names of Medication
US Brand Name: Welchol
Generic Name: Colesevelam
The generic name, Colesevelam, refers to the active ingredient, while Welchol is the brand name given by the manufacturer.
Pharmacologic Category
Colesevelam belongs to the pharmacologic category of bile acid sequestrants.
Other medications in this category include cholestyramine and colestipol.
Colesevelam Dosage
Colesevelam is prescribed for various conditions, with the dosage depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your Colesevelam dosage. If you need to speak with a provider, you can schedule a telemedicine appointment with us today.
Hyperlipidemia (High Cholesterol)
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: Long-term, as directed by your healthcare provider.
Type 2 Diabetes
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: Long-term, as directed by your healthcare provider.
Cholesterol Gallstones
Recommended Dose: 3.75 grams per day.
Frequency: Once daily with meals.
Length of Treatment: As directed by your healthcare provider.
Diarrhea Related to Bile Acid Malabsorption
Recommended Dose: 3.75 grams per day.
Frequency: Once daily with meals.
Length of Treatment: As directed by your healthcare provider.
Familial Hypercholesterolemia
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: Long-term, as directed by your healthcare provider.
Hypercholesterolemia (High Cholesterol)
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: Long-term, as directed by your healthcare provider.
Cardiovascular Disease Prevention
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: Long-term, as directed by your healthcare provider.
Metabolic Syndrome
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: Long-term, as directed by your healthcare provider.
Non-Alcoholic Fatty Liver Disease
Recommended Dose: 3.75 grams per day, either as 6 tablets once daily or 3 tablets twice daily.
Frequency: Once or twice daily with meals.
Length of Treatment: As directed by your healthcare provider.
Dosage Forms and Strengths
Tablets: 625 mg
Oral Suspension: 3.75 grams per packet
Administration Instructions for Colesevelam
Colesevelam should be taken with meals and a full glass of water. If you are taking other medications, take them at least 4 hours before or after Colesevelam to avoid potential interactions. Follow your healthcare provider’s instructions carefully. If you have any questions about how to take your Colesevelam medication, schedule a telemedicine appointment with one of our providers.
Contraindications for Colesevelam
A contraindication is a specific condition where a medication should not be used because it may be harmful. If you have any of the following conditions, you should not take Colesevelam. Be sure to discuss your medical history with your healthcare provider before starting any new medication, including Colesevelam.
Bowel Obstruction: Colesevelam is contraindicated in patients with a history of bowel obstruction, as it can worsen the blockage, leading to severe complications.
Hypertriglyceridemia (High Triglycerides): Colesevelam may increase triglyceride levels, so it is not recommended for patients with triglycerides above 500 mg/dL. Elevated triglycerides can raise the risk of pancreatitis.
History of Pancreatitis: If you have had pancreatitis, especially due to high triglycerides, Colesevelam may increase the risk of recurrence.
Allergy to Colesevelam: If you are allergic to Colesevelam or any of its ingredients, you should not take this medication, as it could cause a severe allergic reaction.
Drug-to-Drug Interactions
Colesevelam can interact with other medications, potentially affecting their effectiveness. It is important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Colesevelam:
Levothyroxine (Synthroid): Colesevelam may reduce the absorption of levothyroxine, a medication used to treat hypothyroidism, making it less effective.
Warfarin (Coumadin): Colesevelam can interfere with the absorption of warfarin, a blood thinner, potentially affecting blood clotting and increasing the risk of bleeding or clotting issues.
Phenytoin (Dilantin): Colesevelam may reduce the absorption of phenytoin, an anti-seizure medication, leading to decreased effectiveness and an increased risk of seizures.
Oral Contraceptives: Colesevelam can reduce the effectiveness of birth control pills, increasing the risk of unintended pregnancy.
Glyburide (Diabeta): Colesevelam may reduce the absorption of glyburide, a medication used to control blood sugar in people with type 2 diabetes, potentially leading to higher blood sugar levels.
Colesevelam in Pregnancy
Is it safe to take Colesevelam during pregnancy? Colesevelam is classified as a Category B medication by the FDA, meaning that animal studies have not shown harm to the fetus, but there are no well-controlled studies in pregnant women. While it is generally considered safe during pregnancy, it’s essential to discuss the potential risks and benefits with your healthcare provider. If you are pregnant or planning to become pregnant, consult one of our telemedicine providers before starting or continuing this medication.
Colesevelam While Breastfeeding
Is it safe to take Colesevelam while breastfeeding? Colesevelam is not absorbed into the bloodstream in significant amounts, making it unlikely to pass into breast milk. However, due to limited data on its use during breastfeeding, it’s recommended to consult your healthcare provider before taking Colesevelam while nursing. Our telemedicine providers can assist you in making an informed decision.
Estimated Cost of Colesevelam Medication
The estimated cost of a 30-day supply of Colesevelam without insurance can vary depending on the pharmacy and location. With a GoodRx coupon, the average cost for a 30-day supply (180 tablets of 625 mg) typically ranges from $150 to $200. Prices may differ, so it’s a good idea to check with your pharmacy for the most accurate pricing.
Possible Alternatives to Colesevelam
If Colesevelam is not the right medication for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these alternatives.
Alternatives for Hyperlipidemia
Alternatives include statins (e.g., atorvastatin, simvastatin), ezetimibe, or fibrates. Lifestyle changes, such as adopting a heart-healthy diet, engaging in regular exercise, and managing your weight, can also help lower cholesterol levels.
Alternatives for Type 2 Diabetes
Other medications include metformin, sulfonylureas, or GLP-1 receptor agonists. In addition, dietary changes, regular physical activity, and weight loss are key lifestyle interventions that can help manage blood sugar levels.
Alternatives for Cholesterol Gallstones
Ursodiol (Actigall) is an alternative medication for cholesterol gallstones. In more severe cases, surgery to remove the gallbladder may be considered.
Alternatives for Diarrhea
For diarrhea related to bile acid malabsorption, alternatives include cholestyramine or dietary modifications. For other causes of diarrhea, over-the-counter medications like loperamide (Imodium) may provide relief.
Alternatives for Bile Acid Malabsorption
Cholestyramine or dietary adjustments, such as following a low-fat diet, may be effective alternatives for managing bile acid malabsorption.
Alternatives for Familial Hypercholesterolemia
Statins, PCSK9 inhibitors (e.g., alirocumab), or lifestyle changes like a low-cholesterol diet and regular exercise may be recommended for managing familial hypercholesterolemia.
Alternatives for Hypercholesterolemia
Common alternatives include statins, ezetimibe, or fibrates. Lifestyle changes, such as maintaining a healthy diet, losing weight, and exercising regularly, can also be beneficial in managing cholesterol levels.
Alternatives for Cardiovascular Disease
Medications such as statins, ACE inhibitors, or beta-blockers may be used to manage cardiovascular disease. Additionally, lifestyle changes, including quitting smoking, eating a heart-healthy diet, and engaging in regular physical activity, are crucial for heart health.
Alternatives for Metabolic Syndrome
Weight loss, increased physical activity, and a diet rich in fruits, vegetables, and whole grains can help manage metabolic syndrome. In some cases, medications like metformin may also be prescribed.
Alternatives for Non-Alcoholic Fatty Liver Disease (NAFLD)
Weight loss, dietary changes, and regular exercise are the primary treatments for NAFLD. In certain cases, medications such as pioglitazone or vitamin E may be considered.
Recent Updates on Colesevelam Research
Recent research on Colesevelam has explored its potential benefits beyond cholesterol management. Studies suggest that Colesevelam may help improve blood sugar control in patients with type 2 diabetes, making it a dual-purpose medication for those managing both high cholesterol and diabetes. Ongoing research is also investigating its role in managing bile acid malabsorption and its potential benefits for patients with non-alcoholic fatty liver disease (NAFLD). While these findings are promising, more studies are needed to confirm these benefits. Always consult your healthcare provider before making any changes to your treatment plan.
