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.
🧬 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 →
📖 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 →
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.
- Major · 1
- Moderate · 7
- Minor · 9
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? ▾
How do I take it, and does it matter when I take my other medications? ▾
What side effects should I expect, and when should I be worried? ▾
Can I take colesevelam if I'm pregnant or breastfeeding? ▾
I have high triglycerides — is colesevelam safe for me? ▾
My child has been prescribed colesevelam — is it safe for kids? ▾
Is Colesevelam available over the counter? ▾
When was Colesevelam first available? ▾
Who makes Colesevelam? ▾
💬 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
How this form is used
- 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
- 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
Oral suspension
How this form is used
- 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
- 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
📊 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.
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.
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.
How commonly is Colesevelam prescribed? Of the 1,594 medications we measure, Colesevelam ranks #827 by Medicaid prescriptions — more than 48% of them.
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.
colesevelam hydrochloride 625 MG Oral Tablet Most dispensed
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
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.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Oral suspension | ||||
| 3.75 g | Oral | Amneal Pharmaceuticals of New York LLC | ANDA | View NDC → |
| 3.75 g | Oral | Ascend Laboratories, LLC × 2 listings | ANDA | View NDC → |
| 3.75 g | Oral | Bryant Ranch Prepack × 4 listings | ANDA | View NDC → |
| 3.75 g | Oral | Cosette Pharmaceuticals, Inc. × 4 listings | NDA | View NDC → |
| 3.75 g | Oral | Daiichi Sankyo Inc. | NDA | View NDC → |
| 3.75 g | Oral | Glenmark Pharmaceuticals Inc.,USA × 3 listings | ANDA | View NDC → |
| 3.75 g | Oral | Ohm Laboratories, Inc. | NDA | View NDC → |
| 💊Tablet | ||||
| 625 mg | Oral | A-S Medication Solutions × 8 listings | ANDA | View NDC → |
| 625 mg | Oral | A-S Medication Solutions × 2 listings | NDA | View NDC → |
| 625 mg | Oral | American Health Packaging × 3 listings | ANDA | View NDC → |
| 625 mg | Oral | Amneal Pharmaceuticals of New York LLC × 3 listings | ANDA | View NDC → |
| 625 mg | Oral | Ascend Laboratories, LLC × 4 listings | ANDA | View NDC → |
| 625 mg | Oral | AvKARE × 2 listings | ANDA | View NDC → |
| 625 mg | Oral | Bionpharma Inc. × 4 listings | ANDA | View NDC → |
| 625 mg | Oral | Bryant Ranch Prepack × 8 listings | ANDA | View NDC → |
| 625 mg | Oral | Cosette Pharmaceuticals, Inc. × 4 listings | NDA | View NDC → |
| 625 mg | Oral | Cranbury Pharmaceuticals, LLC | ANDA | View NDC → |
| 625 mg | Oral | Daiichi Sankyo Inc. | NDA | View NDC → |
| 625 mg | Oral | Dr.Reddys Laboratories Inc × 2 listings | ANDA | View NDC → |
| 625 mg | Oral | Glenmark Pharmaceuticals Inc., USA × 3 listings | ANDA | View NDC → |
| 625 mg | Oral | Golden State Medical Supply | ANDA | View NDC → |
| 625 mg | Oral | Golden State Medical Supply, Inc. × 2 listings | ANDA | View NDC → |
| 625 mg | Oral | Macleods Pharmaceuticals Limited | ANDA | View NDC → |
| 625 mg | Oral | Nivagen Pharmaceuticals, Inc. × 2 listings | ANDA | View NDC → |
| 625 mg | Oral | Ohm Laboratories, Inc. | NDA | View NDC → |
| 625 mg | — | Patheon Inc. | DRUG FOR FURTHER PROCESSING | View NDC → |
| 625 mg | Oral | PD-Rx Pharmaceuticals, Inc. | ANDA | View NDC → |
| 625 mg | Oral | Tris Pharma Inc | ANDA | View NDC → |
| 625 mg | Oral | Zydus Lifesciences Limited × 2 listings | ANDA | View NDC → |
| 625 mg | Oral | Zydus Pharmaceuticals (USA) Inc. | ANDA | View NDC → |
| 625 mg | Oral | Zydus Pharmaceuticals USA Inc. × 2 listings | ANDA | View NDC → |
| 💊Bulk drug substance | ||||
| 4.999 kg/4.999 kg | — | Apothecon Pharmaceuticals Pvt Ltd | BULK INGREDIENT | View NDC → |
| 24.999 kg/24.999 kg | — | Apothecon Pharmaceuticals Pvt Ltd | BULK INGREDIENT | View NDC → |
| 50 kg/50 kg | — | Aurobindo Pharma Limited | BULK INGREDIENT | View NDC → |
| 5 kg/5 kg | — | Emcure Pharmaceuticals Limited | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Formosa Laboratories, Inc. | BULK INGREDIENT | View NDC → |
| 1 kg/kg | — | Patheon Austria GmbH & CoKG | BULK INGREDIENT | View NDC → |
Showing 82 of 82 products — FDA National Drug Code Directory. See every product, package size and price: browse all 82 Colesevelam NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Colesevelam — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Colesevelam in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Colesevelam went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
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.
RxCUI 141626 2 dose forms · 3 strengths
-
Dose form (SCDF) Oral Tablet RxCUI 374632In current FDA listingsClinical drug / strength (SCD) hydrochloride 625 MGRxCUI 866910 -
Dose form (SCDF) Powder for Oral Suspension RxCUI 1870338In current FDA listingsClinical drug / strength (SCD) hydrochloride 1875 MGRxCUI 866900hydrochloride 3750 MGRxCUI 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.
📦 Supply & shortage status
Whether Colesevelam is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
…and 5 more on the FDA NDC directory.
RxNorm drug class
Colesevelam belongs to the Bile Acid Sequestrant class.
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.
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.