Colesevelam Disease Interactions

Colesevelam should not be used for glycemic control in type 1 diabetes or for treating diabetic ketoacidosis.

The manufacturer considers colesevelam contraindicated in patients with a history of bowel obstruction. Because of its constipating effects, colesevelam is not recommended in patients with gastroparesis, other gastrointestinal motility disorders, and in those who have had major gastrointestinal tract surgery and who may be at risk for bowel obstruction. Because of the tablet size, colesevelam tablets can cause dysphagia or esophageal obstruction and should be used with caution in patients with dysphagia or swallowing disorders.

Questran Light and LoCholest Light (brands of cholestyramine) contain 16.8 mg and 22.4 mg of phenylalanine, respectively, per each dose. Flavored Colestid (brand of colestipol) contains 18.2 mg of phenylalanine per each 7.5-gram dose. WELCHOL (brand name of colesevelam) for Oral Suspension contains 13.5 mg phenylalanine per 1.875 gram dose and 27 mg phenylalanine per 3.75 gram dose. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics). Regular Colestid, Questran and LoCholest do not contain phenylalanine.

Bile acid sequestrants, including colesevelam may decrease the absorption of fat-soluble vitamins A, D, E, and K. Caution should be exercised when treating patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins. The manufacturer recommends to instruct patients taking colesevelam and oral vitamin supplementation to take their vitamins at least 4 hours prior to colesevelam.