Trade Names:WelChol- Tablets 625 mg
Increases removal of bile acids from the body by binding bile acids in the intestine, impeding their reabsorption. As the bile acid pool becomes depleted, the conversion of cholesterol to bile acids is increased, which decreases serum cholesterol.
Maximum reduction in serum cholesterol is achieved within 2 wk.
Adjunctive therapy to diet and exercise given alone or with an HMG-CoA reductase inhibitor for the reduction of elevated LDL cholesterol in patients with primary hypercholesterolemia (Fredrickson type IIa). Adjunctive therapy to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
History of bowel obstruction; history of hypertriglyceridemia-induced pancreatitis; serum triglyceride concentration greater than 500 mg/dL.
PO 1,875 mg (3 tablets) twice daily with meals or 3,750 mg (6 tablets) once daily.
Store at controlled room temperature (59° to 86°F). Protect from moisture.
Administer at least 4 h prior to colesevelam.Warfarin
Reduced INR has been reported. Monitor INR when before starting colesevelam and frequently during concurrent treatment.
None well documented.
CV reactions (including arterial stenosis, bradycardia, MI), hypertension (3%).
Asthenia (4%); increased seizure activity (postmarketing).
Nasopharyngitis (4%); pharyngitis, rhinitis (3%).
Constipation (11%); dyspepsia (8%); nausea (4%); abdominal distension, bowel obstruction, dysphagia, esophageal obstruction, exacerbation of hemorrhoids, fecal impaction, pancreatitis (postmarketing).
Increased transaminases (postmarketing).
Triglyceride concentrations of 500 mg/dL or more (4%); hypoglycemia (3%).
Accidental injury (4%); flu syndrome (3%).
After initiation of treatment, assess lipid levels within 4 to 6 wk.
Category B .
Safety and efficacy not established.
No special considerations.
No differences in safety and efficacy between patients with CrCl less than 50 mL/min and those with CrCl of 50 mL/min or more.
No special considerations or dosage adjustments are recommended.
Use with caution in patients with dysphagia, major GI tract surgery, severe GI motility disorders, or swallowing disorders.
Use caution when treating patients with triglyceride levels higher than 300 mg/dL.
Ensure that secondary causes of hyperlipidemia (eg, alcoholism, dysproteinemias, hypothyroidism, nephritic syndrome, obstructive liver disease, other drug therapy, poorly controlled diabetes) have been excluded before starting therapy.
Because colesevelam is not absorbed, the risk of toxicity is low.
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