Pravastatin and Colesevelam: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pravastatin
Colesevelam
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
Reduced exposure to pravastatin
Interaction Deep Dive
Concomitant use of colesevelam and pravastatin may markedly reduce the absorption of pravastatin. When pravastatin was administered with cholestyramine or colestipol, the bioavailability of pravastatin was decreased approximately 40% to 50%; however, there was no clinically significant decrease in pravastatin bioavailability when pravastatin was administered 1 hour before or 4 hours after cholestyramine, or 1 hour before colestipol1.
Why it happens (mechanism)
Unknown
Common questions
Can I take Pravastatin and Colesevelam together?
Reduced exposure to pravastatin Always confirm with your pharmacist or prescriber before making any change.
How serious is the Pravastatin and Colesevelam interaction?
It is rated major. Potentially serious — often needs a change or close 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.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Pravastatin or Colesevelam 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: Pravafenix oral capsules, pravastatin sodium fenofibrate oral capsules. Laboratoires SMB s.a. (per EMA), Brussels, Belgium, 2011.
Keep reading about Pravastatin
Keep reading about Colesevelam
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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