II. Indications
- Hyperlipidemia adjunctive management (rare use)
III. Contraindications
- See Bile Acid Sequestrant
- Serum Triglycerides >500 mg/dl
IV. Mechanism
- See Bile Acid Sequestrant
- Binds bile salts
- Results in insoluble complexes that are excreted in the stool
V. Dosing: Hyperlipidemia
- Approved for children age 10 years and older (postmenarche girls)
- Take with food and 8 ounces of water, fruit juice (e.g. orange juice) or diet soft drink
- One Dose: Six 625 mg tablets or one chewable bar (3.75 g) orally daily
- Two Doses: Three 625 mg tablets (1.875 g) orally twice daily
VI. Drug Interactions
- See Bile Acid Sequestrant
- May decrease levels of other medications
- Cyclosporine
- Glyburide
- Levothyroxine
- Oral Contraceptives (containing Ethinyl Estradiol and Norethindrone)
- Phenytoin
- Warfarin
- Fat Soluble Vitamins (Vitamin A, Vitamin D, Vitamin E, Vitamin K)
VII. Efficacy
- See Bile Acid Sequestrant
- Most expensive agent of the class
- May be preferred agent of class
- Lower adverse effect profile (see above)
- May be taken concurrently with Statin
- Lowers A1C by 0.5%
- Zieve (2007) Clin Ther 29(1):74-83 [PubMed]
VIII. Adverse Effects
- See Bile Acid Sequestrant
- Colesevelam may have less gastrointestinal intolerance than other bile acid resins
IX. Safety
- Pregnancy Category B
- Considered Safe in Lactation
X. Metabolism
- Not absorbed
XI. Resources
XII. References
- (2022) Non-StatinLipid Lowering Agents, Presc Lett, Resource #380202
- (2022) Med Lett Drugs Ther 64(1659): 145-52
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- (2000) Med Lett Drugs Ther 42:102-4 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
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 |
Ontology: colesevelam (C0541155)
Definition (NCI) | A non-absorbed polymer that binds bile acids in the intestine, impedes their reabsorption and lowers serum lipids. In patients with type 2 diabetes mellitus, colesevelam also lowers blood glucose levels by an unknown mechanism. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C107058 |
SnomedCT | 442510005, 441851004 |
English | Colesevelam, Colesevelam (substance), Colesevelam (product), colesevelam [Chemical/Ingredient], colesevelam, Allylamine Polymer with 1-chloro-2,3-epoxypropane, (6-(allylamino)hexyl)trimethylammonium Chloride and N-allyldecylamine, COLESEVELAM |
Spanish | colesevelam, colesevelam (sustancia), colesevelam (producto) |
Ontology: Welchol (C0939530)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C107058 |
English | Welchol, welchol |