Colesevelam and Alcohol/Food Interactions

ADJUST DOSING INTERVAL: Bile acid sequestrants can decrease the absorption of fat-soluble vitamins A, D, E, and K. By binding bile acids, these agents may interfere with normal fat digestion and absorption, thereby preventing the absorption of fat-soluble vitamins. Colesevelam did not induce any clinically significant reduction in the absorption of vitamins A, D, E or K during clinical studies of up to one year. However, chronic use of other bile acid sequestrants has been rarely associated with an increased bleeding tendency due to hypoprothrombinemia resulting from vitamin K deficiency. Isolated cases of Vitamin A (including one case of night blindness) and D deficiencies have also been reported with chronic cholestyramine therapy.

MANAGEMENT: Oral vitamin supplements should be administered at least 4 hours before colesevelam to minimize the potential impact on their absorption.