Why is this medication prescribed?

Colesevelam is prescribed primarily for the treatment of high cholesterol levels in the blood. It is specifically used to lower LDL cholesterol (often referred to as “bad” cholesterol) in adults, especially when changes in diet and exercise alone have not been sufficient. Here are some key reasons why Colesevelam may be prescribed:

• Lowering LDL Cholesterol: Colesevelam works by binding bile acids in the intestine, which reduces the amount of bile acids that can be reabsorbed into the bloodstream. To compensate for this loss, the liver increases the uptake of LDL cholesterol from the blood, thereby lowering LDL cholesterol levels.
• Adjunct Therapy: It is often prescribed as an adjunct therapy along with diet and exercise changes, especially for individuals who have not achieved their target cholesterol levels through lifestyle modifications alone.
• Treatment of Type 2 Diabetes: In addition to lowering cholesterol, Colesevelam is sometimes prescribed to improve glycemic control in adults with type 2 diabetes, as it can help lower blood sugar levels.

How should this medicine be used?

Colesevelam should be used exactly as prescribed by your healthcare provider. Here are general guidelines on how it should be used:

• Dosage: Follow the dosage instructions provided by your doctor. Typically, Colesevelam is taken orally with a meal and a sufficient amount of liquid (usually a full glass of water). The dosage can vary depending on the condition being treated (such as high cholesterol or type 2 diabetes).
• Administration: Colesevelam usually comes in tablet form. Swallow the tablets whole; do not crush, break, or chew them unless instructed otherwise by your doctor or pharmacist.
• Timing: It’s important to take Colesevelam with meals and plenty of liquid. This helps prevent gastrointestinal side effects and ensures proper absorption.
• Consistency: Try to take Colesevelam at the same time(s) each day to maintain a consistent level of the medication in your body. This can help improve its effectiveness.
• Other Medications: If you are taking other medications, especially oral medications, take them at least 4 hours before or 4 hours after taking Colesevelam. This is because Colesevelam can interfere with the absorption of other drugs.
• Follow-Up: Attend regular follow-up appointments with your healthcare provider to monitor your response to Colesevelam and to check for any side effects.
• Lifestyle Changes: Colesevelam is often prescribed alongside diet and exercise changes. It’s important to continue following these lifestyle modifications as recommended by your healthcare provider.

Always read the medication guide provided with Colesevelam and ask your doctor or pharmacist if you have any questions about its use or potential side effects.

Other uses for this medicine

• Control of bile acid malabsorption: Colesevelam can help in conditions where there is excessive loss of bile acids from the body, such as in certain types of diarrhea or malabsorption syndromes.
• Potential use in managing other lipid disorders: While primarily used for lowering LDL cholesterol, Colesevelam may also have a role in managing other lipid abnormalities, though this would depend on individual patient factors and specific lipid profiles.

What special precautions should I follow?

Special Precautions for Colesevelam:

• Pregnancy and breastfeeding: Colesevelam should only be used during pregnancy if clearly needed and under the supervision of a healthcare provider. It is not recommended during breastfeeding due to potential adverse effects on the infant.
• Gastrointestinal effects: Common side effects of Colesevelam include constipation, nausea, and abdominal pain. Patients should ensure adequate fluid intake and dietary fiber to help alleviate these symptoms.
• Interactions with other medications: Colesevelam can interfere with the absorption of other medications such as certain antibiotics, thyroid hormones, and some vitamins. It’s important to take Colesevelam at least 1 hour before or 4 hours after taking other medications to minimize this interaction.
• Monitoring: Regular monitoring of liver function tests may be necessary, especially in patients with pre-existing liver disease or in those taking other medications known to affect liver enzymes.
• Cholesterol monitoring: Periodic monitoring of lipid levels is essential to assess the effectiveness of Colesevelam in lowering LDL cholesterol and to adjust the dosage if necessary.
• Allergic reactions: Patients should be monitored for signs of allergic reactions such as rash, itching, swelling, severe dizziness, or trouble breathing, although these are rare.
• Gastrointestinal disorders: Caution should be exercised in patients with a history of severe gastrointestinal disorders, as Colesevelam may exacerbate symptoms such as constipation.

Always consult with your healthcare provider or pharmacist for specific precautions based on your medical history and current medications before starting Colesevelam or any new medication.

What special dietary instructions should I follow?

• Fiber intake: Ensure an adequate intake of dietary fiber to help prevent constipation, which can be a common side effect of Colesevelam.
• Fluid intake: Drink plenty of fluids throughout the day to help with digestion and to prevent constipation.
• Fat-soluble vitamins: If recommended by your healthcare provider, consider taking a multivitamin supplement that includes fat-soluble vitamins (A, D, E, K) to offset any potential deficiency caused by reduced absorption.

What should I do if I forget a dose?

• Take it as soon as you remember on the same day, with a meal and a liquid.
• If it is almost time for your next scheduled dose, skip the missed dose and take your next dose at the regular time. Do not double up on doses to make up for a missed one.
• Contact your healthcare provider or pharmacist if you are unsure about what to do or if you have missed several doses in a row.

What side effects can this medication cause?

Colesevelam, like any medication, can cause side effects. Here are some common and less common side effects associated with Colesevelam:

• Gastrointestinal effects: The most common side effects include constipation, indigestion, nausea, abdominal pain, flatulence (gas), and diarrhea. These symptoms usually improve over time as your body adjusts to the medication.
• Nutrient absorption: Colesevelam can interfere with the absorption of certain nutrients and vitamins, particularly fat-soluble vitamins (A, D, E, K). This may lead to deficiencies if not monitored and managed appropriately.
• Allergic reactions: Although rare, some people may experience allergic reactions such as rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing. Seek immediate medical attention if you experience any of these symptoms.
• Liver function: There have been reports of abnormal liver function tests in some patients taking Colesevelam. Regular monitoring of liver enzymes may be recommended, especially in patients with pre-existing liver disease or when using Colesevelam with medications known to affect liver function.
• Other side effects: Less common side effects may include headache, muscle aches, joint pain, and back pain.
• Interaction with other medications: Colesevelam can interact with certain medications by reducing their absorption. It’s important to take other medications at least 1 hour before or 4 hours after taking Colesevelam to minimize this interaction.
• Kidney function: While uncommon, there have been reports of worsening kidney function in patients taking Colesevelam. Use caution and consult with your healthcare provider if you have kidney disease.

It’s essential to discuss any concerns or potential side effects with your healthcare provider. They can provide guidance on managing side effects and monitor your overall health while you are taking Colesevelam. If you experience severe or persistent side effects, contact your healthcare provider promptly.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Keep Colesevelam tablets in their original container at room temperature, away from moisture and heat. Avoid storing them in the bathroom. Keep the container tightly closed.
• Disposal: Dispose of Colesevelam tablets according to local regulations or guidelines. Do not flush them down the toilet unless specifically instructed to do so. Ask your pharmacist or healthcare provider about the best way to dispose of unused medications.

In case of emergency/overdose

• Symptoms of overdose: If you suspect an overdose of Colesevelam, seek immediate medical attention or contact a poison control center (1-800-222-1222 in the US). Symptoms of overdose may include severe constipation, abdominal pain, vomiting, and difficulty swallowing.
• Treatment of overdose: Treatment will typically involve supportive measures to manage symptoms. There is no specific antidote for Colesevelam overdose. Activated charcoal may be administered if the overdose was recent and significant.

What other information should I know?

• Effectiveness: Colesevelam is most effective when taken consistently as prescribed. It helps to lower LDL cholesterol levels by binding bile acids in the intestines.
• Monitoring: Regular monitoring of cholesterol levels and liver function may be necessary while taking Colesevelam. Your healthcare provider will determine the frequency of these tests based on your individual health status and response to the medication.
• Interaction with other medications: Colesevelam can interact with other medications by reducing their absorption. Take Colesevelam at least 1 hour before or 4 hours after other medications to minimize this interaction. Discuss all medications, including over-the-counter drugs and supplements, with your healthcare provider to avoid potential interactions.
• Diet and lifestyle: Colesevelam is often part of a treatment plan that includes dietary changes, exercise, and other lifestyle modifications to manage cholesterol levels effectively.
• Regular follow-up: Keep all scheduled appointments with your healthcare provider for check-ups and monitoring. This helps ensure that Colesevelam is working effectively and safely for you.
• Patient information: Always carry information about Colesevelam with you, especially if you are traveling or seeing a new healthcare provider. This includes details about your dosage, any potential side effects you’ve experienced, and emergency contact information.

By understanding these aspects of Colesevelam use, storage, handling emergencies, and other pertinent information, you can effectively manage your treatment and ensure its safety and efficacy.