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colesevelam
Used for Diabetes Type 2, High Cholesterol
Used for Diabetes Type 2, High Cholesterol
Colesevelam (Welchol) is a bile acid sequestrant used to lower "bad" cholesterol in adults. It's also used in children ages 10 and older with an inherited type of high cholesterol. Colesevelam (Welchol) can also help lower blood sugar in adults with Type 2 diabetes. The medication comes as tablets and a powder that's mixed with liquid. The dosage is taken by mouth, usually once or twice a day. Common side effects include constipation and indigestion. Eating a balanced diet and getting regular exercise can help the medication work better.
What is Colesevelam (Welchol)?
What is Colesevelam (Welchol) used for?
- High cholesterol in adults
- Heterozygous familial hypercholesterolemia (HeFH) in certain children 10 to 17 years old
- Type 2 diabetes in adults
How Colesevelam (Welchol) works
Colesevelam (Welchol) is a bile acid sequestrant. It works by attaching to bile acid in your gut. This causes your body to get rid of them in your stool.
For high cholesterol: Your liver uses the cholesterol in your body to replace the lost bile acids. This helps lower the amount of cholesterol in your blood.
For Type 2 diabetes: It's not exactly known how colesevelam (Welchol) lowers blood sugar. But it's thought to raise levels of a hormone called glucagon-like peptide 1 (GLP-1). This hormone helps your body release insulin, which helps lower your blood sugar.
Drug facts
| Common Brands | Welchol |
|---|---|
| Drug Class | Bile acid sequestrant |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Colesevelam (Welchol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Constipation (11%)
- Indigestion (8%)
- Nausea (4%)
- Weakness (4%)
Less Common Side Effects
- Sore throat
- Flu-like symptoms
- Runny or stuffy nose
- Muscle aches
- Accidental injury
Colesevelam (Welchol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Swelling of the pancreas (pancreatitis): nausea, vomiting, severe stomach pain that spreads to your back
- Stomach or intestinal blockage: severe constipation, severe stomach pain
The following Colesevelam (Welchol) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bowel blockage—stomach cramping, unable to have a bowel movement or pass gas, loss of appetite, vomiting
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Colesevelam (Welchol)
Pros
- Can be useful for people with both high cholesterol and Type 2 diabetes
- An option for people who can't tolerate statins for cholesterol
- Comes as tablets or a powder that can be mixed with a drink
Cons
- Might not lower cholesterol or blood sugar as much as some other medications
- Can raise triglyceride levels
- Might not be safe for people with certain stomach or intestinal problems
Pharmacist tips for Colesevelam (Welchol)
- Take colesevelam (Welchol) with a meal and some liquid. Try to take it around the same time each day.
- For colesevelam (Welchol) tablets: Swallow the tablets whole. If you have trouble swallowing them, ask your prescriber about switching to the powder that you mix with a drink.
- For colesevelam (Welchol) powder packets: Empty the full packet into a cup. Add 4 to 8 ounces (half a cup to 1 cup) of water, fruit juice, or a diet soft drink. Mix well and drink it all. Don't take the powder dry.
- Colesevelam (Welchol) can cause constipation. Eat more fiber and drink enough water to help prevent and manage constipation. If you get constipated, tell your prescriber if it doesn't get better or if it gets worse.
- Check with your prescriber or pharmacist before taking other medications or vitamins with colesevelam (Welchol). It can make some medications work less well. These include glipizide, birth control pills, and levothyroxine (Synthroid). It can also make it harder for your body to absorb certain vitamins. Because of this, you might need to take certain medications and vitamins at least 4 hours before colesevelam (Welchol). Ask your prescriber or pharmacist when to take each medication.
- Keep your appointments for your blood tests while taking colesevelam (Welchol). Your prescriber will check your cholesterol or blood sugar regularly to see how well the medication is working. They'll also check your triglyceride levels to make sure it's safe for you.
- Tell your prescriber if you're pregnant, plan to become pregnant, or are breastfeeding. Colesevelam (Welchol) isn't absorbed into your blood. But it can make it harder for your body to absorb certain vitamins, which are important for your baby. Your prescriber can help decide if colesevelam (Welchol) is right for you.
More on Colesevelam (Welchol) tips
Risks and warnings for Colesevelam (Welchol)
Colesevelam (Welchol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
High triglycerides and risk of pancreatitis
- Risk factors: High triglyceride levels (e.g., 300 mg/dL or greater) | History of pancreatitis caused by high triglyceride levels
Colesevelam (Welchol) can raise your triglyceride levels. Triglycerides are a type of fat in your blood. Very high levels can cause pancreatitis, or swelling of the pancreas.
Your prescriber will check your triglyceride levels before and during treatment. You can't take colesevelam (Welchol) if your triglycerides are very high or you've had pancreatitis caused by high triglycerides before.
Stop taking colesevelam (Welchol) and get medical help right away if you have severe stomach pain, especially if it spreads to your back. You might also have nausea or vomiting. These could be signs of pancreatitis.
Blockage of your digestive tract
- Risk factors: Severe constipation | Gastroparesis or other gut movement problems | Major stomach or gut surgery and at risk of bowel blockage | Swallowing problems
Colesevelam (Welchol) can cause constipation and, in rare cases, a serious bowel blockage. Because of this, it's not recommended for people with gut problems that slow how food moves through, like gastroparesis. It's also not recommended for people who've had major stomach or gut surgery and are at risk of a blockage. Tell your prescriber about any stomach or gut problems before taking colesevelam (Welchol). They can make sure it's safe for you to take.
Colesevelam (Welchol) tablets are large and can get stuck in your throat. If you have trouble swallowing pills, ask your prescriber about using the powder instead.
Stop taking colesevelam (Welchol) and get medical help right away if you have severe stomach pain or severe constipation. These could be signs of a bowel blockage.
Low vitamin A, D, E, and K levels
- Risk factors: Taking warfarin | Malabsorption conditions
Colesevelam (Welchol) can make it harder for you body to absorb vitamins A, D, E, and K. Your prescriber might recommend vitamin supplements to help keep your levels healthy. If you take these supplements, make sure to take them at least 4 hours before colesevelam (Welchol). This helps your body absorb the vitamins properly.
Must separate from certain medications
Colesevelam (Welchol) can make it harder for your body to absorb certain medications. This might make them work less well. Examples include birth control pills and thyroid medications. You might need to take medications at least 4 hours before colesevelam (Welchol) to avoid interactions. Ask your prescriber or pharmacist how to space out your medications, if needed.
Caution use in people with phenylketonuria (PKU) - powder for oral suspension only
Some Colesevelam (Welchol) powder packets can contain phenylalanine. This is a substance found in the artificial sweetener aspartame. If you have a genetic condition called phenylketonuria (PKU), phenylalanine can be harmful to you.
If you have PKU, ask your pharmacist if your colesevelam (Welchol) powder packets contain phenylalanine. They can help you find a safer option if needed.
Colesevelam (Welchol) dosage
The average cost for 180 tablets of 625mg of Colesevelam (Welchol) is $51.01 with a free GoodRx coupon. This is 89.08% off the average retail price of $467.21.
How much does Colesevelam (Welchol) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Colesevelam (Welchol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Colesevelam (Welchol) will not be safe for you to take.
- Triglyceride levels greater than 500 mg/dL
- History of pancreatitis due to high triglyceride levels
- History of stomach or intestinal blockage
What are alternatives to Colesevelam (Welchol)?
There are a number of medications that your doctor can prescribe in place of Colesevelam (Welchol). Compare a few possible alternatives below.
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