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