Colesevelam and Cholic Acid: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Colesevelam
Cholic Acid
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased efficacy of cholic acid
Interaction Deep Dive
Bile acid sequestrants (ie, cholestyramine, colestipol, colesevelam) bind to cholic acid, a primary bile acid, and lead to its elimination. Concomitant use of cholic acid with bile acid sequestrants may reduce the efficacy of cholic acid. If coadministration is required, administer cholic acid at least 1 hour before or at least 4 hours (or as great an interval as possible) after administration of a bile acid sequestrant1.
Why it happens (mechanism)
Binding and elimination of bile acids
Common questions
Can I take Colesevelam and Cholic Acid together?
Decreased efficacy of cholic acid Always confirm with your pharmacist or prescriber before making any change.
How serious is the Colesevelam and Cholic Acid interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Colesevelam or Cholic Acid need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: CHOLBAM(R) oral capsules, cholic acid oral capsules. Asklepion Pharmaceuticals (per FDA), Baltimore, MD, 2015. DailyMed
Keep reading about Colesevelam
Keep reading about Cholic Acid
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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