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Bile acid sequestrant

Colesevelam hydrochloride

Brand names: Cholestagel

Adult dose

Dose: 1.875g BD or 3.75g OD with meals; max 4.375g/day
Route: PO
Frequency: OD-BD

Clinical pearls

  • Hypercholesterolaemia adjunct, bile-acid diarrhoea; better tolerated than colestyramine

Contraindications

  • Bowel obstruction
  • Triglycerides >5.6 mmol/L

Side effects

  • Constipation
  • Flatulence
  • Headache
  • Hypertriglyceridaemia

Interactions

  • Reduces absorption of many drugs — give other drugs at least 4h before colesevelam
  • Levothyroxine, warfarin, statins, ciclosporin

Monitoring

  • Lipids
  • FBG

Reference: BNF; https://bnf.nice.org.uk/drugs/colesevelam-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.