Welchol Oral Suspension (colesevelam)
What is Welchol Oral Suspension (colesevelam)?
Welchol oral suspension is used to decrease low-density lipoprotein (LDL) cholesterol.
Welchol oral suspension is prescribed to adults and pediatric patients, 10-years or older, with heterozygous familial hypercholesterolemia (HeFH). Female pediatric patients must have had a menstrual period.
Welchol belongs to the drug class bile acid sequestrants; sequestrants or resins work by binding to bile acids preventing reabsorption in the intestines. Welchol is not absorbed through the gastrointestinal system, such as the intestine.
Welchol oral suspension is also used to treat type 2 diabetes mellitus in adults with high blood sugar.
Welchol oral suspension is not recommended:
- For treatment of type 1 diabetes or diabetic ketoacidosis
- For the prevention of cardiovascular diseases
- For patients with high triglyceride levels greater than 500 mg/dL
- For patients who have or have had pancreatitis related to high triglyceride levels
- For patients who have or have had an intestinal blockage
- For pediatric patients younger than 10-years old
- For female pediatric patients younger than 17 who have not had a menstrual period
How is Welchol oral suspension used?
Welchol for oral suspension comes in a 3.75-gram powder packet. The packet will need to be mixed with a liquid solution. Welchol oral suspension is citrus-flavored and sugar-free. Welchol oral suspension is prescribed as part of a treatment plan that includes diet and exercise.
Store Welchol oral suspension away from moisture and heat at room temperature, approximately 25 C.
Mix the Welchol for oral suspension packet; pour the packet into an empty cup and thoroughly stir with 1 cup (8 oz) of water, fruit juice, or diet soda. The oral suspension may not dissolve fully and may leave a residue on the inside of the cup.
Drink the entire cup as directed by your doctor with food. Ask your doctor or pharmacist for further direction if you do not understand the instruction.
Before taking Welchol oral suspension, your doctor will evaluate your lipid levels. Welchol oral suspension should be taken once daily with food.
Treatment of LDL Cholesterol
The recommended dosage for adults and pediatric patients, 10 to 17 years old, with primary hyperlipidemia is to take 3.75 gm of Welchol oral suspension by mouth once daily.
Welchol oral suspension may be taken at the same time with cholesterol-lowering medications such as statins.
Treatment of Type 2 Diabetes
The recommended dosage for adults is to take 3.75 gm of Welchol oral suspension by mouth once daily.
Continue taking Welchol oral suspension as prescribed until directed by your doctor to discontinue. You can expect to see results as soon as two weeks. Maximum results will be seen within 12-18 weeks.
It’s important to understand that although Welchol Oral Suspension is FDA approved, it comes with side effects that may or may not affect you.
Before starting Welchol Oral Suspension, you should discuss possible side effects with your doctor or pharmacist.
Common Side Effects
Not all side effects require medical attention. As your body adjusts to Welchol Oral Suspension, side effects may go away.
Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own:
- Abdominal pain
- Upset stomach
- Back pain
- Lack of strength
- Unusual tiredness or weakness
- Sore throat
Serious Side Effects
Severe adverse reactions while taking Welchol oral suspension are not common but can occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:
- Allergic reaction: difficulty breathing, hives, swelling in your throat or face
- Pancreatitis: redness and swelling of the pancreas
- Severe constipation
- Severe stomach pain
- Severe nausea and vomiting
The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.
Warnings & Precaution
Before taking Welchol oral suspension, tell your doctor or pharmacist:
- If you are allergic to any medications
- If you are breastfeeding, pregnant, or plan to become pregnant
- If you have high triglycerides
- If you have or have had pancreatitis related to high triglyceride levels
- If you have or have ever had a vitamin K deficiency
- If you have or have had an intestinal blockage
- If you have diabetic ketoacidosis
The risk of a toxic overdose is low since Welchol oral suspension is not absorbed in the gastrointestinal system. If an overdose is suspected, contact your doctor or seek medical attention. An overdose will be treated based on symptoms.
High Triglyceride Levels
Taking Welchol oral suspension may increase your triglyceride levels. High triglycerides may cause inflammation of the pancreas, pancreatitis.
Welchol oral suspension should not be taken if you have or have had intestinal blockage or stomach problems such as gastroparesis, where your stomach takes too long to empty. Welchol oral suspension can cause constipation.
The study of safety and effectiveness was studied in children, 10-years of age and older, with heterozygous familial hypercholesterolemia (HeFH). Welchol has not been studied for pediatric patients younger than 10-years old or in female pediatric patients who have not had a menstrual period.
Taking one Welchol oral suspension 3.75 gm packet contains 27mg of phenylalanine which can be harmful if you have phenylketonuria (PKU).
Interactions & Contraindications
Before taking Welchol oral suspension, tell your doctor or pharmacist if you take any medications, herbal supplements, or vitamins.
Drugs with a narrow therapeutic index
Taking Welchol oral suspension may result in a decreased efficiency of these types of drugs. Your doctor may recommend taking these medications at a minimum of 4 hours before taking Welchol oral suspension.
Metformin Extended-Release (ER)
Taking Welchol oral suspension may result in increased efficiency of Metformin ER. Your doctor will monitor your blood sugar level and adjust as needed.
Welchol oral suspension may decrease the effect of olmesartan medoxomil. Your doctor may recommend taking oral contraceptives at a minimum of 4 hours before taking Welchol oral suspension.
Oral contraceptives Containing Ethinyl Estradiol and Norethindrone.
Welchol oral suspension may decrease the effect of Ethinyl estradiol and norethindrone. Your doctor may recommend taking oral contraceptives at a minimum of 4 hours before taking Welchol oral suspension.
Taking Welchol oral suspension may result in an increased risk of seizures or inhibit the effectiveness by decreasing phenytoin levels. Your doctor may recommend taking Phenytoin at a minimum of 4 hours before taking Welchol oral suspension.
Welchol oral suspension may decrease the effect of sulfonylureas such as glipizide, glimepiride, and glyburide. Your doctor may recommend taking oral contraceptives at a minimum of 4 hours before taking Welchol oral suspension.
Taking Welchol oral suspension while taking a thyroid medication such as Synthroid may increase thyroid-stimulating hormones (TSH). Thyroid medications must be taken at least 4 hours before taking Welcol oral suspension.
Fat-Soluble Vitamin Deficiencies
Taking Welchol oral suspension may increase the risk of patients susceptible to vitamin A, D, E, and K or other fat-soluble vitamins by decreasing their absorption of these vitamins. Fat-soluble vitamins such as vitamin K must be taken at least 4 hours before taking Welcol oral suspension.
Welchol oral suspension may interact with Warfarin. Your doctor will monitor your INR frequently at the beginning of your treatment with Welchol oral suspension.
No Known Interactions
Welchol oral suspension may decrease the absorption of other medications and vitamins not listed or that have not been tested to determine interaction. Your doctor may recommend taking these medications at a minimum of 4 hours before taking Welchol oral suspension to decrease the risk of possible drug interactions or decreased absorption.
Frequently Asked Questions