Is Welchol Safe To Take With Pomegranate Extract?
In our latest question and answer, our pharmacist discusses the safety of combining Welchol and pomegranate extract.
I take 625 mg of Welchol once a day. Would it be possible for me to take pomegranate extract four hours later, or could the extract reduce the effectiveness of Welchol? Thank you, John.
Mar 17, 2023- Welchol and pomegranate extract are unlikely to have a clinically significant interaction with each other. Welchol should be taken at least 1 hour before or 4 hours after pomegranate to avoid delaying its absorption. While pomegranate may affect certain liver enzymes, human studies show this is unlikely to significantly impact how medications work.
Answer
Thanks for reaching out!
Although there is little evidence available to draw on regarding a specific interaction between pomegranate and Welchol, based on what is known about both, a clinically significant interaction appears to be very unlikely.
However, they should not be taken at the same time as Welchol can decrease the absorption of other drugs.
Pomegranate Does Have Potential Drug Interactions
Pomegranate certainly does have the potential to interact with a number of medications as preliminary studies show that it may affect, at least to a minor degree, several metabolizing enzymes located in the liver (e.g., CYP3A4, CYP2D6, etc.). We have these all documented in our herbal interaction checker.
The evidence is quite conflicting, however.
For example, some studies have shown that pomegranate juice can inhibit the CYP3A4 enzyme in the laboratory, similar to how grapefruit juice does. However, most studies of humans have shown no significant effect on drugs that are broken down by this enzyme.
Overall, it appears that pomegranate is unlikely to significantly affect how this enzyme works in humans but is important to be aware of.
Welchol Isn't Metabolized Or Absorbed
Welchol (colesevelam) is an interesting drug because, for the most part, it is not absorbed systemically (i.e., into the bloodstream) and doesn't undergo any significant metabolism. It essentially just goes right through you.
Due to this, it isn't known to affect how most drugs/supplements work.
However, and this is an important point, if Welchol is administered at the same time as other drugs, it can significantly delay their absorption.
For this reason, it is generally recommended to take medications either at least 1 hour before Welchol or 4 hours after, to avoid changes to absorption.
Final Words
So, as mentioned, there is no known clinically significant interaction between pomegranate and Welchol but Welchol administration should be separated from it to avoid absorption issues.
Thanks again for contacting us and please do so again anytime!
References & sources
- Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice — PubMed
- Effects of pomegranate juice on human cytochrome p450 3A (CYP3A) and carbamazepine pharmacokinetics in rats — PubMed
- Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer — PubMed
- Welchol Prescribing Information — AccessFDA
Glossary — Terms in This Answer
- Clinically significant interaction
- An interaction between drugs or supplements that causes a meaningful change in how well a medication works or increases the risk of side effects.
- Absorption
- The process by which a drug or substance passes from the digestive system into the bloodstream.
- Metabolizing enzymes
- Proteins in the body, mainly in the liver, that break down drugs and other substances so they can be eliminated.
- CYP3A4
- A specific liver enzyme that breaks down many common medications.
- CYP2D6
- A specific liver enzyme responsible for breaking down certain medications.
- Inhibit
- To slow down or block a process, such as when a substance prevents an enzyme from doing its job.
- Colesevelam
- The active chemical ingredient in the medication Welchol, used to help lower cholesterol.
- Systemically absorbed
- When a substance enters the bloodstream and circulates throughout the body.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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