colesevelam hydrochloride (redirected from Welchol)

colesevelam hydrochloride

Welchol

Pharmacologic class: Bile acid sequestrant

Therapeutic class: Antihyperlipidemic

Pregnancy risk category B

Action

Binds bile acids in GI tract and forms insoluble complex, impeding bile acid reabsorption and promoting its excretion. As a result, cholesterol and low-density lipoprotein (LDL) levels decrease.

Availability

Tablets: 625 mg

⊘Indications and dosages

➣ Adjunct to diet and exercise to reduce LDL cholesterol in patients with primary hypercholesterolemia

Adults: Three tablets (1,875 mg) P.O. b.i.d., or six tablets (3,750 mg) once daily. Maximum daily dosage is 4,375 mg.

Contraindications

• Hypersensitivity to drug
• Bowel obstruction
• Vitamin K deficiency

Precautions

Use cautiously in:
• serum triglyceride level above 300 mg/dl
• children (safety and efficacy not established).

Administration

• Give with meals and fluids.
• Ensure that patient swallows tablets whole without crushing or chewing.
• Know that drug may be used alone or with HMG-CoA reductase inhibitor.
• Store tablets at room temperature.

Route	Onset	Peak	Duration
P.O.	Unknown	2 wk	Unknown

Adverse reactions

CNS: headache, anxiety, vertigo, dizziness, insomnia, fatigue, syncope

EENT: tinnitus

GI: nausea, vomiting, diarrhea, constipation, abdominal discomfort, flatulence, fecal impaction, loose stools, fatty stools, rectal or hemorrhoidal bleeding, other GI bleeding

GU: increased libido

Hematologic: anemia, bleeding tendency

Metabolic: malabsorption of vitamins A, D, E, and K

Musculoskeletal: back, muscle, or joint pain

Skin: bruising

Interactions

Drug-drug. Fat-soluble vitamins (A, D, E, and K): decreased vitamin absorption

Patient monitoring

• Monitor lipid levels before starting therapy and periodically thereafter.

Patient teaching

• Instruct patient to take drug with meals as directed.
• Tell patient to report persistent GI upset, back or muscle pain or weakness, and respiratory problems.
• If drug causes constipation, instruct patient to increase exercise, drink plenty of fluids, consume more fruits and fiber, or take a stool softener.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.