Pharm

Colesevelam

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Colesevelam, Welchol

  • See Also
  1. Bile Acid Sequestrant
  2. Hyperlipidemia
  3. Hyperlipidemia Management
  4. Cholestyramine
  5. Colestipol
  • Indications
  1. Hyperlipidemia adjunctive management (rare use)
  • Contraindications
  1. See Bile Acid Sequestrant
  2. Serum Triglycerides >500 mg/dl
  • Mechanism
  1. See Bile Acid Sequestrant
  2. Binds bile salts
    1. Results in insoluble complexes that are excreted in the stool
  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
  • 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
  • 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]
  • Adverse Effects
  1. See Bile Acid Sequestrant
  2. Colesevelam may have less gastrointestinal intolerance than other bile acid resins
  • Safety
  1. Pregnancy Category B
  2. Considered Safe in Lactation
  • Metabolism
  1. Not absorbed
  • Resources
  1. Colesevelam (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8867edcf-0b56-4203-8269-90b3af4ede36
  • 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]