COLESEVELAM HYDROCHLORIDE

COLESEVELAM HYDROCHLORIDE
(co-less'e-ve-lam)
Welchol
Classifications: antilipemic; bile acid sequestrant;
Therapeutic: cholesterol-lowering agent
; bile acid sequestrant
Prototype: Cholestyramine resin
Pregnancy Category: B

Availability

625 mg tablets

Action

Anion exchange resin used for its cholesterol-lowering effect. Binds with bile salts in the intestinal tract to form an insoluble complex that is excreted in the feces, thus reducing circulating cholesterol and increasing serum LDL removal rate. Serum triglyceride levels may increase slightly.

Therapeutic Effect

Decreases serum LDL and total cholesterol level. Removes bile salts from the intestine.

Uses

Adjunctive therapy to diet and exercise for reduction of elevated LDL cholesterol alone or in combination with an HMG-CoA reductase inhibitor (statin).

Contraindications

Hypersensitivity to colesevelam; complete biliary obstruction; bowel obstruction; children <2 y of age.

Cautious Use

Preexisting GI disorders or bowel disease, primary biliary cirrhosis, partial biliary obstruction, biliary atresia; hypertriglyceridemia; older adults, pregnancy (category B); malabsorption states; bleeding disorders.

Route & Dosage

Hypercholesterolemia, Monotherapy
Adult: PO 3 tablets b.i.d. with meals or 6 tablets q.d. with a meal, may be increased to 7 tablets/d

Hypercholesterolemia, Combination Therapy
Adult: PO 4–6 tablets/d with meals or 6 tablets q.d. with a meal

Administration

Oral
  • Give with meals (mandatory) and adequate liquid (e.g., 8 oz).
  • Store at 15°–30° C (59°–86° F) with occasional fluctuations to 40° C (90° F); protect from moisture.

Adverse Effects (≥1%)

Body as a Whole: Infection, pain, flu-like syndrome, asthenia, myalgia. CNS: Headache. GI: Abdominal pain, flatulence, constipation, diarrhea, nausea, dyspepsia. Respiratory: Sinusitis, rhinitis, cough, pharyngitis.

Interactions

Drug: May decrease absorption of verapamil. Can bind and affect absorption of any drug.

Pharmacokinetics

Absorption: Not absorbed. Metabolism: Not metabolized. Elimination: In feces.

Nursing Implications

Assessment & Drug Effects

  • Lab tests: Monitor total cholesterol, LDL-C, HDL-C, and triglycerides periodically.
  • Withhold drug and notify physician for triglycerides >300 mg/dL.

Patient & Family Education

  • Report S&S of GI distress (see Appendix F), especially constipation.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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