Colesevelam (Oral)

Colesevelam, along with changes in the patient's diet, is an effective antidote to high cholesterol; this prescription drug is also used to successfully treat the high blood sugar that often occurs in patients that have type 2 diabetes.

Overview

Patients that suffer from high cholesterol or elevated blood sugar due to type 2 diabetes often find colesevelam to be an effective treatment. The medications are available via prescription and come in either tablet or oral suspension form. The oral suspension delivery option is recommended for children and adolescents that are prescribed the drug as part of their treatment for high cholesterol. While there are numerous prescription drugs that are contraindicated for use by patients that are taking colesevelam, it is not deemed to be an issue to take this medication with statins that are used to lower the patient's lipid level.

There are a number of medical conditions that may preclude the use of colesevelam for treatment of high cholesterol or elevated blood sugar caused by type 2 diabetes. If you suffer from any of the conditions or ailments that are listed below, be sure to inform your doctor, it may be determined that a drug other than colesevelam may be more appropriate.

Colesevelam has been known to cause certain side effects that warrant immediate medical attention, such as anxiety, blurred vision, and confusion. Review the list of these symptoms and consult your doctor immediately should you experience any of them. Additionally, your body may have mild and negative reactions as it adjusts to the level of colesevelam in your system. In such cases, the symptoms will dissipate on their own after a few days. If you do experience such side effects and they worsen or last for a longer period than a few days, be sure to notify your prescribing physician as this may be a sign of a more serious condition.

Condition(s) Treated

  • High Cholesterol
  • High Blood Sugar Associated with Type 2 Diabetes

Type of Medicine

  • Antihyperlipidemic

Side Effects

There are a number of side effects that require immediate medical attention, even if you feel that the symptoms are mild. If you experience any of the symptoms or side effects listed below, it is best practice to consult with the prescribing physician as soon as possible.

Unlikely:

  • Anxiety
  • Changes to your voice
  • Blurred vision
  • Difficulty swallowing
  • Cold sweats
  • Tender and swollen glands in the neck area
  • Confusion
  • Slurred speech
  • Cool and pale skin
  • Shivering
  • Depression
  • Seizures
  • Dizziness
  • Pounding in the ears
  • Fast heartbeat
  • Nervousness
  • The occurrence or feeling of general illness and/or discomfort
  • Muscle aches or pain
  • Hoarseness
  • Decrease in appetite
  • Joint pain
  • Nightmares
  • Increased hunger
  • Nausea
  • Headache
  • Fever
  • Runny nose
  • A dry or a sore throat
  • Shakiness
  • Diarrhea
  • Accelerated heartbeat or one that is slow
  • Cough
  • Sweating
  • Congestion
  • Any difficulty with sleeping
  • Coma
  • Unusual and unexplained weakness or general fatigue
  • Chills
  • Vomiting

Unknown Likelihood:

  • Bleeding after vacating the bowels
  • Trouble swallowing
  • Severe stomach pain
  • Unpleasant sensations in the chest
  • Unable to swallow saliva
  • Pressure in the stomach
  • Stomach pain
  • Distended stomach
  • Indigestion
  • Darkened urine
  • Yellow coloration of the skin or of the eyes

Patients that are taking colesevelam may experience certain symptoms as their bodies adjust to the medication. Side effects listed below will likely dissipate on their own in a few days and typically do not require medical attention except in cases where they worsen or last for longer than a few days. Patients that feel unsure if their symptoms warrant medical advice, must remember that it is always a good idea to consult with your doctor or pharmacist about your concerns.

Likely:

  • Excessive acid in the stomach
  • Stomach discomfort, upset, or pain
  • Heartburn
  • Constipation
  • Belching
  • Abdominal cramps or other stomach discomforts
  • Full or bloated feeling
  • Bloating

Unlikely:

  • Stuffy nose
  • Sneezing
  • Lack or loss of strength

While this list of possible side effects is comprehensive, it is still possible that you may experience symptoms that do not appear on the list above. If your side effects become worse or linger for longer than a few days, it is always best to consult with the prescribing physician.

Dosage

Colesevelam is available in both tablet and a powder that is mixed with liquid. Whichever type of medication that you take, it should be taken with food, and patients that take the tablet should do so with extra juice, milk, water or other beverage.

Patients that are taking colesevelam as part of their treatment of type 2 diabetes need to be sure to follow the diet and activity guidelines provided by their prescribing physician in order to ensure that the medication is effective. Your doctor will also likely order both blood and urine tests in order to measure the efficacy of colesevelam in treating your high blood sugar.

When colesevelam is prescribed for the treatment of high cholesterol, your doctor may advise you to follow a diet that restricts the intake of sugar and foods that are high in fat. It is important that you follow these guidelines regarding changes to your diet, as well as any direction that your physician provides relating to exercise and increased activity levels.

The powder, or oral suspension, formulation comes in single-use packets and the entire contents of which should be added to a beverage of your choice. The juice or water should equal between 4 and 8 cups and the concoctions should be consumed right away after vigorous stirring, and all at once.

Patients that regularly take herbal remedies, or vitamin and mineral supplements should inform their doctor of the medications that they are taking, and also wait at least 4 hours between taking any supplements and taking their colesevelam.

Patients that take colesevelam as part of their treatment of high cholesterol and also take statins to lower their lipid level, can take the drugs at the same time. It is also alright to wait between doses if that is the patient's preference. If you would like further guidance on taking both statins and colesevelam, consult with your prescribing physician or pharmacist for advice.

There are different dosage levels for both children and adults that are taking colesevelam; there are also differences based on which ailment the drug is treating, either high cholesterol or the elevated blood sugar that comes with type 2 diabetes.

Children who are aged 10 or younger should follow the guidance provided by their doctor or pediatrician regarding the dosage and frequency that is appropriate for treating their condition, whether it be high cholesterol or type 2 diabetes.

Adult patients that are taking the oral suspension colesevelam should take one packet equaling 3.75 grams, or two 1.875 gram packets.

Children that are prescribed colesevelam, and are older than 10 years of age, will also take 3.75 grams, whether it is administered in one or two packets.

The tablet option of colesevelam is administered as follows:

Adults are typically prescribed 6 tablets per day whether they are taking colesevelam for the treatment of type 2 diabetes or high cholesterol. It is not recommended that children or adolescents take colesevelam in tablet form, as the oral suspension option is regarded to be more appropriate for this age group.

Patients who are prescribed the medication in the tablet form can choose to take all 6 tablets at one time or break up the dosage into two groups of three pills each. If you are unsure how to best take your medication, it is always best to confer with the prescribing doctor or with your pharmacist.

If you miss a dose, take it as soon as you remember, unless it is close to the time for your next dosage. Do not take double the prescribed amount for any reason. If you miss a scheduled dose and are unsure of what to do, it is always best practice to ask your doctor or pharmacist for advice.

Major Drug Interactions

There are certain medications that are typically not used concurrently with colesevelam due to the negative side effects that can occur. Your doctor will review your medications, the conditions that they treat, and possible alternatives. If you are prescribed colesevelam while taking one of these drugs, your doctor may alter the dosage or frequency with which you take one or both of the medications. In these cases, it becomes even more important to follow the instructions provided by your prescribing physician.

  • Mycophenolic Acid
  • Deferasirox
  • Pravastatin
  • Bezafibrate
  • Mycophenolate Mofetil

If you are being treated for a condition with one of the following medications, your doctor may choose to alter the amount of colesevelam that you are taking or may make changes to your instructions when taking the following:

  • Olmesartan Medoxomil
  • Desogestrel
  • Norgestimate
  • Drospirenone
  • Norelgestromin
  • Estradiol Valerate
  • Medroxyprogesterone Acetate
  • Ethynodiol Diacetate
  • Levonorgestrel
  • Glimepiride
  • Norgestrel
  • Glyburide
  • Glipizide
  • Levothyroxine
  • Etonogestrel
  • Ethinyl Estradiol
  • Norethindrone
  • Estradiol Cypionate
  • Mestranol
  • Dienogest
  • Phenytoin
  • Cyclosporine
  • Warfarin

In addition to the drugs listed above, it is also important that you inform your doctor and your pharmacist about all other medications that you are taking. This includes all prescription and non-prescription medications as well as any herbal remedies or vitamin or mineral supplements that you are currently using. Patients should wait for a period of 4 hours between taking their prescribed colesevelam dosage and any supplements that they use.

If you are taking colesevelam and suffer from any of the ailments listed below, be sure to consult with your doctor about the possible side effects or negative outcomes that can occur from taking this medication. Inform your prescribing physician of any side effects or symptoms that you may experience while taking colesevelam if you suffer from:

  • Phenylketonuria (PKU)
  • Severe Hypertriglyceridemia
  • Gastrointestinal motility disorder/chronic constipation
  • Dysphagia and difficulty with swallowing
  • Blockage of the Bowels
  • Vitamin deficiency (of vitamins A, D, E, or K)
  • Esophageal blockage that causes problems when swallowing
  • Gastrointestinal surgery
  • Diabetic ketoacidosis
  • Gastroparesis
  • Malabsorption syndrome where food is not properly absorbed in the stomach

Warnings

Patients with Food Allergies or Who are Allergic to Other Medications:

Be sure to inform your doctor if you suffer from allergies of any type, whether of foods or medications. Colesevelam has not been found to cause an allergic reaction in users, but it is always best practice to inform your prescribing physician of any and all allergies that you may have.

Women Who are Pregnant, are Planning to Become Pregnant, or are Nursing:

There are currently no studies or reports that indicate that colesevelam is dangerous when taken by pregnant or nursing women. However, it is always advisable to inform your prescribing physician and pharmacist if you are planning to become pregnant, are pregnant, or are currently nursing.

Use of Colesevelam in Older and Geriatric Patients:

There are not currently any studies or reported instances of patients that are older or geriatric suffering from taking colesevelam. If you are of advanced age and are taking colesevelam, it is always best practice to inform your doctor or pharmacist of any side effects that you experience.

The use of colesevelam in children under the age of 10 has not been studied, nor is its effectiveness known. If your child suffers from high cholesterol, it is best to discuss the most appropriate treatment options with their doctor or pediatrician.

-If you suffer from Pancreatitis caused by hypertriglyceridemia it is likely that your doctor will not prescribe colesevelam as part of your treatment.

-Patients who suffer from type 1 diabetes should not be treated with colesevelam, and your doctor should prescribe insulin as the treatment for your type 1 diabetes.

Storage

It is always best to keep all medications in the original packaging. Do not expose colesevelam to direct light, extreme heat, and cold, and do not let it freeze. Store in a cool, dry place with low moisture; this makes the bathroom a less than ideal location for storage.

Keep this and all medication out of the reach of children.

If, at the end of your course of treatment, you have unused medication left over, or you have expired medications, contact your pharmacist for advice on how to safely dispose of the pills. If you are discarding the oral suspension formula, it is not advised that you flush it down the toilet.

Summary

Patients that suffer from high cholesterol or elevated blood sugar due to type 2 diabetes often find colesevelam to be an effective treatment. The medications are available via prescription and come in either tablet or oral suspension form. The oral suspension delivery option is recommended for children and adolescents that are prescribed the drug as part of their treatment for high cholesterol. While there are numerous prescription drugs that are contraindicated for use by patients that are taking colesevelam, it is not deemed to be an issue to take this medication with statins that are used to lower the patient's lipid level.

There are a number of medical conditions that may preclude the use of colesevelam for treatment of high cholesterol or elevated blood sugar caused by type 2 diabetes. If you suffer from any of the conditions or ailments that are listed below, be sure to inform your doctor, it may be determined that a drug other than colesevelam may be more appropriate.

Patients who are taking colesevelam will often be advised of necessary changes to their diets and activity levels whether they are taking the medication for high cholesterol or elevated blood sugar caused by type 2 diabetes. If your doctor advises changes to your diet, such as cutting out sugar, fat, and foods that are high in cholesterol, it is important that you follow this advice, as it will increase the efficacy of the colesevelam.

Colesevelam has been known to cause certain side effects that warrant immediate medical attention, such as anxiety, blurred vision, and confusion. Review the list of these symptoms and consult your doctor immediately should you experience any of them. Additionally, your body may have mild and negative reactions as it adjusts to the level of colesevelam in your system.

This medication has not been shown to cause any ill effects in pregnant or nursing women, but such patients should advise their doctor of their condition and follow any advice or direction that they are given.

Children age 10 or younger should follow the dosage guidance that is provided by their doctor or pediatrician as it may differ from the dosage recommendations for adults and older children.