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Lipid-lowering agent (bile-acid sequestrant)

Colesevelam: uses, side effects & precautions

Also known as Welchol, Cholestagel.

This information is for general guidance only and does not constitute medical advice. Always consult a qualified healthcare professional for personal medical concerns. In an emergency, call your local emergency number.

What it is used for

  • High cholesterol (raised LDL), often added to other cholesterol treatment
  • Sometimes used to help manage blood sugar in type 2 diabetes alongside other treatments

How it works

Colesevelam binds bile acids in the gut so they are passed out of the body. The liver then uses more cholesterol to make new bile acids, which lowers blood cholesterol. Because it stays in the gut, it has few effects on the rest of the body.

How it is taken

Usually supplied as oral tablets or as a powder for oral suspension mixed with liquid, generally taken with a meal and plenty of water. Take it exactly as your doctor or pharmacist directs and as written on the label, and space it apart from other medicines as advised.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Constipation
  • Bloating or wind
  • Indigestion
  • Nausea
  • Tummy pain

Serious effects — get help

  • Severe constipation or signs of a bowel blockage: severe tummy pain, swelling, no bowel movements or wind, vomiting - seek urgent care
  • Signs of very high triglycerides or pancreas problems: severe upper tummy pain spreading to the back
  • Difficulty swallowing or choking sensation with tablets (take with plenty of water)

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • Can reduce absorption of many other medicines - these often must be taken several hours apart
  • Some vitamins (especially fat-soluble vitamins A, D, E, K)
  • Certain thyroid, contraceptive, seizure and diabetes medicines
  • Blood thinners such as warfarin (may affect control)

Who should take care

  • Tell your clinician about any bowel problems, swallowing difficulty or very high triglycerides
  • Drink plenty of water and eat enough fibre to reduce constipation
  • Space other medicines apart from colesevelam as your pharmacist advises
  • Discuss pregnancy or breastfeeding with your clinician
  • Mix the powder form fully with liquid and drink promptly

Frequently asked questions

Why do I need to take other medicines at a different time?
Colesevelam can bind other medicines and vitamins in the gut, reducing how much you absorb. Your pharmacist will tell you how many hours to leave between doses.
It is making me constipated - what can I do?
Drinking more water and eating more fibre often helps. Tell your clinician if constipation is severe or does not settle, and seek urgent care for severe tummy pain or no bowel movements.
Can it help my blood sugar too?
It is sometimes used as an add-on in type 2 diabetes, but it is not a main diabetes treatment. Your clinician decides if this applies to you.
Do I still need a statin?
Colesevelam is often used alongside a statin rather than instead of it. Follow the combination your clinician prescribes.
Is Colesevelam safe to take?
For most people it is safe when taken exactly as a doctor or pharmacist advises and as printed on the label. Tell your clinician about your other medicines and health conditions, and seek urgent care for any serious reaction.

Related conditions

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