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Related to colesevelam: bromocriptine, colesevelam hydrochloride


a polymer that binds bile acids in the intestine and prevents them from being reabsorbed, resulting in decreased serum levels of total cholesterol, LDL cholesterol (LDL-C), and apolipoprotein B and increased levels of HDL cholesterol (HDL-C); administered orally as the hydrochloride salt as adjunctive therapy to reduce elevated LDL-C levels in patients with primary hypercholesterolemia.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


(koe-le-sev-e-lam) ,


(trade name),


(trade name)


Therapeutic: lipid lowering agents
Pharmacologic: bile acid sequestrants
Pregnancy Category: B


Adjunctive therapy to diet and exercise for the reduction of LDL cholesterol in patients with primary hypercholesterolemia; may be used alone or in combination with statins.Adjunctive therapy to diet and exercise for the reduction of LDL cholesterol in children 10–17 yr with heterozygous familial hypercholesterolemia if diet therapy fails (LDL cholesterol remains ≥190 mg/dL or remains ≥160 mg/dL [with family history of premature cardiovascular disease or ≥2 risk factors for cardiovascular disease]); may be used alone or in combination with statin.Adjunctive therapy to diet and exercise to improve glycemic control in patients with type 2 diabetes.


Binds bile acids in the GI tract.
Result in increased clearance of cholesterol.
Mechanism for lowering blood glucose unknown.

Therapeutic effects

Decreased cholesterol and blood glucose.


Absorption: Not absorbed; action is primarily local in the GI tract.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile (cholesterol-lowering effect)

PO24–48 hr2 wkunknown


Contraindicated in: Hypersensitivity;Bowel obstruction;Triglycerides >500 mg/dL;History of pancreatitis due to hypertriglyceridemia.
Use Cautiously in: Triglycerides >300 mg/dL;Dysphagia, swallowing disorders, severe GI motility disorders, or major GI tract surgery; Obstetric / Lactation / Pediatric: Pregnancy, lactation, or children <10 yr (safety not established).

Adverse Reactions/Side Effects


  • constipation
  • dyspepsia


Drug-Drug interaction

May ↓ absorption of glyburide, glimepiride, glipizide, levothyroxine, olmesartan, phenytoin, cyclosporine, warfarin, and estrogen-containing oral contraceptives (give ≥4 hr before colesevelam).May ↑ levels of metformin extended-release



Oral (Adults) 3 tablets twice daily or 6 tablets once daily.
Oral (Adults and Children 10–17 yr) Suspension—one 3.75-g packet once daily or one 1.875-g packet twice daily.

Type 2 Diabetes

Oral (Adults) 3 tablets twice daily or 6 tablets once daily; Suspension—one 3.75-g packet once daily or one 1.875-g packet twice daily.


Tablets: 625 mg
Granules for oral suspension: 1.875 g/packet (contains 13.5 mg phenylalanine), 3.75 g/packet (contains 27 mg phenylalanine)

Nursing implications

Nursing assessment

  • Hypercholesterolemia: Obtain a diet history, especially in regard to fat consumption.
  • Type 2 Diabetes: Observe patient for signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety).
  • Lab Test Considerations: Monitor serum total cholesterol, LDL, and triglyceride levels before initiating, 4–6 wk after starting, and periodically during therapy.
    • Monitor serum glucose and glycosylated hemoglobin periodically during therapy in patients with diabetes.

Potential Nursing Diagnoses

Constipation (Side Effects)
Noncompliance (Patient/Family Teaching)


  • Patients stabilized on a diabetic regimen who are exposed to stress, fever, trauma, infection, or surgery may require administration of insulin.
  • Oral: Administer once or twice daily with meals. Colesevelam should be taken with a liquid. For oral suspension, empty the entire contents of one packet into a glass or cup. Add 1/2 to 1 cup (4 to 8 ounces) of water, fruit juice, or a diet soft drink; do not take in dry form to avoid espophgeal distress.

Patient/Family Teaching

  • Instruct patient to take medication as directed; do not skip doses or double up on missed doses.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking other Rx, OTC, or herbal products. Advise patients taking oral vitamin supplementation or oral contraceptives to take their vitamins at least 4 hr prior to colesevelam.
  • Instruct patient to consume a diet that promotes bowel regularity. Patients should be instructed to promptly discontinue colesevelam and notify health care professional if severe abdominal pain or severe constipation or symptoms of acute pancreatitis (severe abdominal pain with or without nausea and vomiting) occur.
  • Hypercholesterolemia: Advise patient that this medication should be used in conjunction with diet restrictions (fat, cholesterol, carbohydrates, alcohol), exercise, and cessation of smoking.
  • Diabetes: Explain to patient that this medication controls hyperglycemia but does not cure diabetes. Therapy is long term.
    • Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise patient to drink a glass of orange juice or ingest 2–3 tsp of sugar, honey, or corn syrup dissolved in water or an appropriate number of glucose tablets and notify health care professional.
    • Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent hypoglycemic or hyperglycemic episodes.
    • Instruct patient in proper testing of serum glucose and ketones. These tests should be closely monitored during periods of stress or illness and health care professional notified if significant changes occur.
    • Insulin is the recommended method of controlling blood sugar during pregnancy. Counsel female patients to use a form of contraception other than oral contraceptives and to notify health care professional promptly if pregnancy is planned or suspected.
    • Advise patient to carry a form of sugar (sugar packets, candy) and identification describing disease process and medication regimen at all times.

Evaluation/Desired Outcomes

  • Decrease in serum total choesterol, LDL cholesterol, apolipoprotein, and blood glucose levels.
  • Control of blood glucose levels without the appearance of hypoglycemic or hyperglycemic episodes.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
Effective immediately, the company has launched the commercialisation activities for this first-to-market generic Welchol (colesevelam HCI) tablets, 625 mg.
These structures are yellow on acid-fast bacillus and are suggestive of BAS (colesevelam [Welchol], colestipol [Colestid], cholestyramine [LoCholest, Prevalite, Questran]).
(iv) Bile acid sequestrants (which prevent fat absorption) such as cholestyramine, colestipol, or colesevelam
Colesevelam is the only hypoglycemic agent approved for such use in this category because it incidentally lowers HbA1c by 0.5% [8].
Bile acid sequestrants include cholestyramine (Prevalite, Questran), colesevelam (Welchol), and colestipol (Colestid).
Colesevelam hydrochloride: evidence for its use in the treatment of hypercholesterolemia and type 2 diabetes mellitus with insights into mechanism of action.
Other, less commonly used drugs for T2DM include pramlintide (Symlin[R], not licensed in Europe for T2DM), colesevelam (Welchol[R]), and bromocriptine (Parlodel[R]).
Gordon et al., "Colesevelam hydrochloride (Cholestagel): a new, potent bile acid sequestrant associated with a low incidence of gastrointestinal side effects," Archives of Internal Medicine, vol.
In particular, colesevelam has already received an indication from the US FDA for lowering glucose in patients with type 2 diabetes.
Jones, "Colesevelam hydrochloride therapy in patients with type 2 diabetes mellitus treated with metformin: glucose and lipid effects," Archives of Internal Medicine, vol.
The three main bile acid resins prescribed in the United States are cholestyramine (Questran), colestipol (Colestid) and colesevelam (WelChol).
Similar reductions of both apo B and LDL-P were observed as a result of treatment of individuals with type 2 diabetes with colesevelam. Overall, 14 of 16 outcomes were in agreement between apo B and LDL-P (87.5%).