FDA-filed SPL labeling · retrieved through openFDA

Colesevelam

Colesevelam is a bile acid sequestrant used to lower LDL cholesterol in adults and certain children, and to improve blood sugar control in adults with type 2 diabetes.

Brand name Welchol
Drug class Bile Acid Sequestrant
Rx Forms 2 Route Oral
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 31 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveSep 27, 2025
Clinical labels in scope 31
AvailabilityRx
Earliest approval/marketing year 2000
FDA-listed product records 82
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 16, 2026 🚨Recall on record
Colesevelam at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Colesevelam is a non-absorbed gut-acting medication that lowers LDL cholesterol in adults and qualifying children with high cholesterol, and also helps manage blood sugar in adults with type 2 diabetes. It works best as part of a plan that includes diet and exercise. Take it with meals, space other medications at least 4 hours apart, and have your triglycerides monitored regularly.

📖 Colesevelam: Patient Information Guide

A plain-language walkthrough of Colesevelam — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Colesevelam is approved for several related uses across its available products — always used alongside diet and exercise, never as a standalone fix.

  • Lowers LDL cholesterol ("bad" cholesterol) in adults with primary hyperlipidemia (high cholesterol not caused by another disease)
  • Lowers LDL cholesterol in boys and postmenarchal girls aged 10–17 with heterozygous familial hypercholesterolemia (HeFH) — an inherited cholesterol disorder — when diet and lifestyle changes haven't brought levels to goal
  • Improves blood sugar control in adults with type 2 diabetes — available in both the tablet and oral suspension forms (including Welchol)
  • Not approved for type 1 diabetes, diabetic ketoacidosis, or children under 10 or premenarchal girls
  • Has not been studied in certain rare lipid disorders (Fredrickson Type I, III, IV, and V dyslipidemias)
⚙️How it works

Colesevelam is a bile acid sequestrant — a polymer that works entirely inside the gut and is never absorbed into the bloodstream. It binds to bile acids in the intestine, preventing them from being recycled back into the body. The liver normally relies on reabsorbed bile acids; when that supply is cut off, the liver converts more cholesterol into new bile acids and draws more LDL cholesterol out of the blood to do so. The result is a measurable drop in LDL levels. Triglyceride levels may increase or stay the same.

For type 2 diabetes, colesevelam also improves blood sugar control, though the exact mechanism behind this effect is not yet known.

💊How it's taken

Colesevelam is taken by mouth with a meal — either as tablets or as a powder mixed into a drink (oral suspension). Tablets are taken once or twice daily with food and a full glass of liquid. The oral suspension is prepared by emptying a packet into a cup of water, fruit juice, or diet soft drink, stirring well, and drinking it with a meal.

  • Always take with food to reduce stomach upset and improve tolerability
  • Take other medications — especially those with known interactions — at least 4 hours before colesevelam
  • If you miss a dose, take it with your next meal; don't double up

Follow your prescriber's specific instructions — do not adjust your dose on your own.

🤒Side effects — in detail

The most common side effects are digestive in nature and tend to be manageable:

  • Constipation (most common)
  • Upset stomach or indigestion (dyspepsia)
  • Nausea
  • Vomiting (seen more in children)
  • Headache (more common in children)
  • Fatigue or weakness
  • Back pain

More serious reactions — including bowel obstruction, pancreatitis (severe abdominal pain), and difficulty swallowing with the tablet form — require prompt medical attention. Stop taking colesevelam and contact your doctor or go to the ER if you experience severe abdominal pain or an inability to have a bowel movement.

⚠️Warnings & precautions
  • High triglycerides and pancreatitis: Colesevelam can raise triglyceride (blood fat) levels. If triglycerides get very high, pancreatitis — a serious inflammation of the pancreas causing severe abdominal pain — can occur. Your doctor will check your triglycerides before and during treatment. Stop taking it and seek emergency care for sudden, severe abdominal pain.
  • Bowel obstruction: Cases of bowel blockage have occurred, especially in people with a history of bowel problems or prior gut surgery. Colesevelam is not recommended if you have gastroparesis or other digestive motility disorders. Report severe constipation to your doctor right away.
  • Vitamin absorption: Colesevelam can reduce absorption of fat-soluble vitamins A, D, E, and K. Take vitamin supplements at least 4 hours before colesevelam. People on warfarin or with malabsorption conditions are at higher risk.
  • Drug absorption: Colesevelam can reduce blood levels of several other medications. Drugs with known interactions should be taken at least 4 hours before colesevelam — especially narrow therapeutic index drugs (those where small changes in blood levels matter a lot).
🔀What it interacts with

Because colesevelam can bind other drugs in the gut, timing your other medications correctly is important — most should be taken at least 4 hours before colesevelam:

  • Cyclosporine (organ transplant medication): reduced blood levels; take 4 hours before
  • Phenytoin (seizure medication): lower levels and increased seizure risk reported; take 4 hours before
  • Levothyroxine and thyroid hormone replacement: reduced absorption; elevated TSH reported; take 4 hours before
  • Warfarin (blood thinner): reduced effectiveness (lower INR); monitor INR closely when starting or stopping colesevelam
  • Oral contraceptives containing ethinyl estradiol and norethindrone: reduced effectiveness; take 4 hours before
  • Olmesartan (blood pressure medication): reduced absorption; take 4 hours before
  • Sulfonylureas (diabetes drugs — glimepiride, glipizide, glyburide): reduced blood levels; take 4 hours before
  • Metformin extended-release: colesevelam may actually increase metformin ER levels — monitor blood sugar closely
  • Fat-soluble vitamins (A, D, E, K): reduced absorption; take supplements 4 hours before colesevelam

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Do not take colesevelam if your triglyceride level is above 500 mg/dL — it is contraindicated
  • Do not take if you have a history of pancreatitis caused by high triglycerides
  • Do not take if you have a history of bowel obstruction
  • Use with caution (or avoid) if you have gastroparesis, other digestive motility disorders, or have had major gastrointestinal surgery
  • Pregnancy: colesevelam is not absorbed, so fetal exposure is not expected — but it may reduce fat-soluble vitamin absorption, which matters during pregnancy; discuss with your doctor if you become pregnant
  • Breastfeeding: colesevelam is not absorbed by the mother and is not expected to reach breast milk
  • If you could become pregnant, note that colesevelam may reduce the effectiveness of oral contraceptives — take them at least 4 hours before colesevelam
  • Children under 10 and premenarchal girls: safety and effectiveness have not been established
  • Older adults: generally as safe and effective as in younger patients, though individual sensitivity may vary
🚑If you take too much

Colesevelam is not absorbed into the bloodstream, so the risk of serious systemic harm from too much is very low. Taking too much may cause more intense gastrointestinal effects, particularly constipation. If you think you've taken too much, contact Poison Control or your doctor for guidance.

📡Pharmacodynamics — effects in the body

For high cholesterol, colesevelam reaches its maximum LDL-lowering effect within about 2 weeks of starting treatment, and that effect is maintained with continued use. For type 2 diabetes, a noticeable improvement in HbA1c (a measure of average blood sugar control over time) typically appears within 4 to 6 weeks, with the full or near-full effect reached after 12 to 18 weeks of treatment.

🔬Pharmacokinetics — how your body processes it

Colesevelam is unique among medications: it is not absorbed by the body at all. It stays entirely within the gastrointestinal tract, is not broken down by digestive enzymes or liver enzymes, and is not metabolized. Less than 0.05% of a dose is recovered in urine. Because it never enters the bloodstream, it does not interact with liver drug-processing enzymes (such as cytochrome P450) — its interactions with other drugs happen purely within the gut, by physically binding to them and reducing their absorption.

📦How to store it

Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F) . Protect from moisture.

📄 Written from Colesevelam’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

17

Supplements & herbs that interact with Colesevelam

17 supplements and herbal products have documented interactions with Colesevelam in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 1
  • Moderate · 7
  • Minor · 9
Every supplement checked against Colesevelam — ranked by severity The full interaction hub: 1 major · 7 moderate · 9 minor · every one linked to its full report. Check Colesevelam against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Colesevelam — the kind of thing our pharmacy team would talk through with you at the counter.

What exactly is colesevelam supposed to do for me?
That depends on why your doctor prescribed it. If you have high LDL cholesterol, colesevelam helps pull that 'bad' cholesterol down by working inside your gut — it's never absorbed into your body. If you have type 2 diabetes, it can also help improve your blood sugar control, though it's always used alongside diet and exercise, not instead of them. It won't fix everything on its own, but as part of your overall plan it can make a real difference.
How do I take it, and does it matter when I take my other medications?
Yes, timing really matters here. Colesevelam — whether you're taking the tablets or mixing the powder into a drink — should always be taken with a meal. The tricky part is that it can grab onto other medications in your gut and reduce how much of them your body absorbs. To avoid that, take your other medications — especially thyroid hormones, seizure medications, blood thinners like warfarin, oral contraceptives, or blood pressure pills like olmesartan — at least 4 hours before you take colesevelam. Your pharmacist can help you map out a schedule that works.
What side effects should I expect, and when should I be worried?
The most common issue is constipation — it affects a meaningful number of people taking this medication. You might also notice some nausea or an upset stomach, especially at first. Those tend to be manageable. What you do want to call your doctor about right away is severe abdominal pain — that can be a sign of pancreatitis, which is a serious condition. Also call if you develop severe constipation or can't have a bowel movement, or if you're taking the tablets and have trouble swallowing them.
Can I take colesevelam if I'm pregnant or breastfeeding?
Colesevelam is never absorbed into your bloodstream, so it isn't expected to reach your baby during pregnancy or through breast milk. That said, it can reduce your absorption of fat-soluble vitamins like A, D, E, and K — and those vitamins matter a lot during pregnancy. If you become pregnant while taking colesevelam, talk to your doctor about whether to continue. And if you take a prenatal vitamin or other vitamin supplement, take it at least 4 hours before colesevelam to make sure your body gets what it needs.
I have high triglycerides — is colesevelam safe for me?
This is important: if your triglyceride level is above 500 mg/dL, you should not take colesevelam — it's contraindicated because it can raise triglycerides further, and very high triglycerides can trigger pancreatitis. Even if your levels are between 300 and 500 mg/dL, your doctor will want to monitor you more closely. Make sure your doctor checks your triglycerides before you start and periodically while you're on it. If you've ever had pancreatitis caused by high triglycerides, that's also a reason not to use this medication.
My child has been prescribed colesevelam — is it safe for kids?
Colesevelam is approved for boys and postmenarchal girls (girls who have already started their periods) aged 10 to 17 who have a genetic form of high cholesterol called heterozygous familial hypercholesterolemia, when diet changes alone haven't been enough. It has not been studied in children under 10 or in premenarchal girls. Because the tablets are large and harder for kids to swallow, the oral suspension (powder mixed into a drink) is generally recommended for the pediatric age group. Side effects seen a bit more in kids than adults include headache, vomiting, and a lab finding called creatine phosphokinase elevation — worth knowing about, but your child's doctor will monitor for these.
Is Colesevelam available over the counter?
Colesevelam is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Colesevelam first available?
Colesevelam has been available in the United States since at least 2000, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Colesevelam?
Colesevelam is supplied by 29 manufacturers listed in the FDA NDC Directory, including Bryant Ranch Prepack, A-S Medication Solutions, Cosette Pharmaceuticals, Inc..

💬 Answers drafted from Colesevelam’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Colesevelam comes

Colesevelam is available in 2 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Tablet

By mouth
Brands Welchol
How this form is used
What it may be used for
  • Used to lower LDL cholesterol in adults with primary hyperlipidemia
  • Used to lower LDL cholesterol in boys and postmenarchal girls aged 10–17 with heterozygous familial hypercholesterolemia (HeFH) when diet and lifestyle changes are not enough
  • Welchol tablets are used to improve blood sugar control in adults with type 2 diabetes
Important instructions
  • Take tablets once daily or split into two doses taken twice daily, each time with a meal and a full glass of liquid
  • Swallow tablets whole with plenty of liquid — do not crush or chew
  • If you have difficulty swallowing the tablets, ask your doctor about the oral suspension form instead
  • Take any interacting medications (such as thyroid hormones, sulfonylureas, or oral contraceptives) at least 4 hours before taking colesevelam tablets
Available strengths 1 strength
60 FDA-listed product records

Oral suspension

By mouth
Brands Welchol
How this form is used
What it may be used for
  • Used to lower LDL cholesterol in adults with primary hyperlipidemia
  • Used to lower LDL cholesterol in boys and postmenarchal girls aged 10–17 with heterozygous familial hypercholesterolemia (HeFH) when diet and lifestyle changes are not enough
  • Welchol oral suspension is used to improve blood sugar control in adults with type 2 diabetes
  • Welchol oral suspension is recommended for pediatric patients due to the large size of the tablets
Important instructions
  • Empty the entire contents of one packet into a glass or cup
  • Add about 1 cup of water, fruit juice, or diet soft drink; stir well and drink
  • Take with a meal — once daily or as directed by your prescriber
  • Take any interacting medications (such as thyroid hormones or oral contraceptives) at least 4 hours before taking colesevelam oral suspension
Available strengths 1 strength
16 FDA-listed product records

📊 Colesevelam across the U.S. market

How Colesevelam appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

2
Dose forms
29
Manufacturers
4
Brand names
82
FDA-listed product records
2000
First marketed

FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

Also listed with the FDA, not a patient dose form: Powder (6) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Bryant Ranch Prepack15%
A-S Medication Solutions12%
Cosette Pharmaceuticals, Inc.10%
Ascend Laboratories, LLC7%
Amneal Pharmaceuticals of New York LLC5%
Bionpharma Inc.5%
Other makers46%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Colesevelam is used

A general measure of how commonly Colesevelam is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Colesevelam is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

17,250
Medicaid prescriptions filled (Q1–Q4 2025)
$1.3M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Colesevelam prescribed? Of the 1,594 medications we measure, Colesevelam ranks #827 by Medicaid prescriptions — more than 48% of them.

Where Colesevelam ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Colesevelam product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 625 mg oral tablet is the most-dispensed Colesevelam product — about 95% of these Medicaid prescriptions.

colesevelam hydrochloride 625 MG Oral Tablet Most dispensed

16,315 Medicaid prescriptions (Q1–Q4 2025) 95% of Colesevelam prescriptions shown $1.2M gross reimbursement (before rebates) ≈ $73 per prescription (gross)

Summed across the 8 of 45 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 866910

colesevelam hydrochloride 3750 MG Powder for Oral Suspension

935 Medicaid prescriptions (Q1–Q4 2025) 5% of Colesevelam prescriptions shown $132,134 gross reimbursement (before rebates) ≈ $141 per prescription (gross)

Summed across the 2 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 866905

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Colesevelam, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 10 of 54 listed Colesevelam NDCs with Medicaid activity.

🔍 Compare Colesevelam products

A representative set of FDA-listed product records for Colesevelam — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 82 of 82 products — FDA National Drug Code Directory. See every product, package size and price: browse all 82 Colesevelam NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Colesevelam RxCUI 141626 2 dose forms · 3 strengths
  1. Dose form (SCDF) Oral Tablet RxCUI 374632 In current FDA listings
    Clinical drug / strength (SCD) hydrochloride 625 MG RxCUI 866910
  2. Dose form (SCDF) Powder for Oral Suspension RxCUI 1870338 In current FDA listings
    Clinical drug / strength (SCD) hydrochloride 1875 MG RxCUI 866900 hydrochloride 3750 MG RxCUI 866905

Look up RxCUI 141626 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Welchol

🏭 Manufacturers & labelers

Bryant Ranch Prepack 12 A-S Medication Solutions 10 Cosette Pharmaceuticals, Inc. 8 Ascend Laboratories, LLC 6 Amneal Pharmaceuticals of New York LLC 4 Bionpharma Inc. 4 American Health Packaging 3 Glenmark Pharmaceuticals Inc.,USA 3 Glenmark Pharmaceuticals Inc., USA 3 Zydus Pharmaceuticals USA Inc. 2 Zydus Lifesciences Limited 2 Ohm Laboratories, Inc. 2 Nivagen Pharmaceuticals, Inc. 2 Golden State Medical Supply, Inc. 2 Dr.Reddys Laboratories Inc 2 Daiichi Sankyo Inc. 2 AvKARE 2 Apothecon Pharmaceuticals Pvt Ltd 2 Formosa Laboratories, Inc. 1 Emcure Pharmaceuticals Limited 1 Golden State Medical Supply 1 Macleods Pharmaceuticals Limited 1 Cranbury Pharmaceuticals, LLC 1 Patheon Austria GmbH & CoKG 1

…and 5 more on the FDA NDC directory.

RxNorm drug class

Colesevelam belongs to the Bile Acid Sequestrant class.

Pharmacologic class Bile Acid Sequestrant
Drug family (ATC) Bile acid sequestrants
How it works Bile-acid Binding Activity

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Sep 27, 2025
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Colesevelam.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Colesevelam after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
31
NDC products indexed
82
Distinct labelers/manufacturers represented
29
Linked representative label
Zydus Pharmaceuticals USA Inc.
Linked label effective
Sep 27, 2025
Composite sections available
23
Linked SPL Set ID
6a26e745-7e38-4af0-9bcc-566b2812df75
Linked SPL Document ID
bf6a10ac-0317-4804-a504-cd00e522dc65
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 31 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Zydus Pharmaceuticals USA Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.