Colesevelam is a prescription medication. It belongs to a class of drugs known as bile acid sequestrants. This medication works in the digestive system by binding to bile acids, which are substances produced by the liver. Colesevelam is not absorbed into the bloodstream itself; instead, it acts locally within the intestines.
Treating High Cholesterol
Colesevelam plays a role in managing high cholesterol, specifically targeting low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol. It works by binding to bile acids in the intestine, preventing their reabsorption into the body. These bound bile acids are then excreted in the feces.
The liver needs bile acids for digestion, and when they are removed, the liver responds by converting more cholesterol into new bile acids to replace those lost. This process increases the production and activity of certain enzymes, like cholesterol 7-alpha-hydroxylase, and leads to an increase in the number of LDL receptors on liver cells. These receptors pull more LDL cholesterol from the bloodstream into the liver, thereby lowering circulating LDL levels.
Colesevelam is used as an addition to diet and exercise modifications. It can be used alone or in combination with other cholesterol-lowering medications, such as statins, which work by a different mechanism to reduce cholesterol production in the liver.
Managing Type 2 Diabetes
Colesevelam is also used to help improve blood sugar control in adults with type 2 diabetes. While its primary role is in cholesterol management, it has been observed to lower blood glucose levels. The exact way colesevelam achieves this effect on blood sugar is not fully understood, but it is thought to involve potential impacts on glucose absorption or signaling pathways related to bile acids.
This medication is used in conjunction with dietary changes, regular exercise, and often alongside other medications prescribed for type 2 diabetes. Its use provides an additional option for managing blood sugar levels in individuals who may also have elevated cholesterol, a common co-occurrence with type 2 diabetes.
Important Considerations for Taking Colesevelam
Colesevelam is recommended to be taken with a meal. Dosing frequency can vary, prescribed once or twice daily. Healthcare providers may offer different forms, including oral tablets or a prepared suspension.
Common side effects associated with colesevelam involve the gastrointestinal system, such as constipation, indigestion, and bloating. Adequate fluid intake is advised to mitigate these effects. Colesevelam can interfere with the absorption of certain fat-soluble vitamins (A, D, E, K) and folic acid, as well as some other medications. Therefore, it is important to space out the administration of colesevelam from other medications by at least four hours, to ensure proper absorption of all drugs.