Welchol Oral Suspension
Welchol Oral Suspension
Colesevelam Hydrochloride
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Lodalis
Colesevelam Hydrochloride
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Welchol Oral Suspension (Colesevelam Hydrochloride)

What is Welchol Oral Suspension?

Welchol Oral Suspension is a powdered form of colesevelam that requires patients to prepare the powder into an oral suspension form for daily consumption. This medication is a bile acid sequestrant that is used for the treatment of high cholesterol levels (hyperlipidemia). The primary goal of this medication is to reduce patients’ low-density lipoprotein cholesterol (LDL-C), and it is used in children older than ten years of age as well as adults. In adults, Welchol Oral Suspension may also be used in the management of type 2 diabetes.

How is Welchol Oral Suspension Used?

Welchol Oral Suspension should be consumed once per day. One packet of Welchol Oral Suspension powder is to be mixed with 8 ounces of fluid (juice, diet soda, or water), stirred until well-combined, and then immediately consumed along with a meal. Welchol Oral Suspension is not a medication that will fully dissolve and disappear when mixed into other liquids, but this is normal and should simply leave your preferred beverage used for preparing the suspension with a more cloudy appearance. Patients using Welchol Oral Suspension should consume the entire dose of the prepared suspension all at once when taking this medication.

Storage

Welchol Oral Suspension should be stored in an environment that remains at room temperature without allowing the medication to exceed a low of 59°F (15°C) or a high of 86°F (30°F) for any extended period of time.

Keep this medication out of the reach of pets and children at all times.

Once Welchol Oral Suspension has been prepared with the patient’s liquid of choice, it should be consumed immediately. The prepared suspension should not be retained or stored for later consumption.

Patients should not consume Welchol Oral Suspension without first mixing it with liquids. The powder should not be taken by itself.

Uses

Welchol Oral Suspension is prescribed for the treatment of hyperlipidemia in adults as well as children between the ages of 10 to 17 who have hereditary hypercholesterolemia. Female pediatric patients using this medication should only do so if they have begun menstruating, as this medication has not been studied in patients who fall into the range of 10 to 17 years of age that have not begun to have menstrual periods.

This medication may also be used for adult patients with type 2 diabetes to assist in lowering their blood glucose levels. These individuals should also include a healthy diet and exercise regiment alongside treatment with Welchol Oral Suspension to ensure effective management of their blood sugar levels.

How Does Welchol Oral Suspension Work?

Welchol Oral Suspension is a bile acid sequestrant, and its method of reducing a patient’s cholesterol levels involves attaching to the bile acids present within the body. This action takes place within the intestines of the patient, and the excess cholesterol attaches to the medication as it passes through. Once the cholesterol has become bound to the Welchol, the medication and the trapped cholesterol pass through the remainder of the patient’s digestive tract and are removed from the body during defecation.

The amount of cholesterol in the patient’s bloodstream is reduced after this medication has removed a significant amount of cholesterol-like substances from the digestive tract. The liver of the individual taking Welchol Oral Suspension will require additional bile acids as the medication traps and removes what is presently available, and it will pull cholesterol from the blood, reducing its overwhelming presence in the bloodstream and alleviating the associated symptoms of hyperlipidemia.

When Welchol Oral Suspension is included as part of a patient’s plan to manage their type 2 diabetes, the function of the medication remains the same. However, as the binding properties of Welchol prevent absorption from occurring within the digestive tract of those using the medication, this instead helps to prevent spikes in blood glucose levels in those with type 2 diabetes, as any food or beverages they consume will be less likely to be properly absorbed. This impaired absorption is what will alleviate some of the fluctuations in regard to their blood sugar levels.

Dosage

Welchol Oral Suspension is available as a packet containing 3.75 g of powder to be mixed with 8 ounces of fluid to create the oral suspension.

Patients using this oral suspension, regardless of the health condition for which it has been prescribed, should only consume one packet of this medication each day as instructed by their prescribing physician. Patients should not exceed this maximum daily dosage amount.

Overdose

Although Welchol Oral Suspension is not absorbed into the bloodstream or body in the same way as many other medications, anyone suspected to have ingested additional doses or excessive amounts of this medication should seek emergency medical assistance or contact their local Poison Control Center. Welchol Oral Suspension has a very low risk of any actual toxicity occurring, but an individual that has consumed too much of this medication is likely to present with adverse digestive symptoms.

Side Effects

Welchol Oral Suspension comes with quite a few common side effects, primarily related to digestive disturbances, but is generally considered a well-tolerated medication in most circumstances.

The most common side effects of taking Welchol Oral Suspension are as follows:

  • abdominal discomfort
  • bowel changes
  • constipation
  • diarrhea
  • fatigue
  • flatulence
  • flu symptoms
  • headaches
  • indigestion
  • muscle pain
  • nausea
  • runny nose
  • sore throat
  • weakness

Some of the following serious side effects may occur and should be discussed with your doctor if they remain persistent or increase in severity while taking Welchol Oral Suspension:

  • severe abdominal pain
  • severe constipation
  • severe nausea
  • upper stomach pain that is severe and spreads to the back
  • vomiting

Children taking Welchol Oral Suspension may experience many of the side effects that adults taking the medication will have, but they are also more likely to have the following occur when taking Welchol:

  • common cold
  • headache
  • increased phosphokinase levels
  • vomiting

Please seek emergency medical care if you or your child are taking Welchol Oral Suspension and experience any of the following rare but serious side effects that may occur:

  • an allergic reaction
    • hives
    • swelling of the face
    • swelling of the throat
    • trouble breathing
  • bowel obstruction
    • constipation
    • cramping
    • distension of the abdomen
    • pain in the stomach
    • vomiting
    • vomiting fecal matter
  • difficulty swallowing
  • fecal impaction
    • appetite loss
    • bloating
    • constipation (chronic)
    • pain in the stomach
  • pancreatitis
    • nausea
    • upper abdominal pain that is severe and radiates toward the back
    • vomiting

Warnings & Precautions

Welchol Oral Suspension is associated with a number of potential risks that will need to be monitored and managed during the treatment period in which a patient is using the medication. Please inform your physician of any current health conditions or concerns as well as any family history of certain medical conditions before beginning this medication.

Pancreatitis and High Triglycerides

The use of Welchol Oral Suspension has resulted in the development of hypertriglyceridemia, or high levels of triglycerides, in patients using the medication. This risk is significantly increased in patients who are simultaneously using insulin or sulfonylureas in the treatment of their type 2 diabetes. Before beginning treatment with Welchol Oral Suspension, a patient’s prescribing physician will check their current triglyceride levels, and this physician should also regularly monitor these levels throughout the entire treatment period as well.

Increased levels of triglycerides can contribute to patients having an increased risk of stroke, heart attack, and acute pancreatitis. Patients that develop symptoms such as fever, vomiting, severe nausea, and severe abdominal pain should inform their doctor immediately as these symptoms may indicate the development of pancreatitis while using Welchol Oral Suspension. Despite being rare in occurrence, this condition can very quickly become a serious concern and may even become life-threatening in some cases.

Phenylketonuria

Welchol Oral Suspension contains 27 mg of phenylalanine in each packet of 3.75 g of the powder for oral suspension. Patients with phenylketonuria are advised against taking Welchol Oral Suspension due to the risks of complications stemming from the amount of phenylalanine that would be consumed each day if taking this medication. If you have been diagnosed with phenylketonuria, please discuss this condition with your doctor, and you may be prescribed an alternative medication with less risk.

Obstruction of the Bowels

Welchol Oral Suspension should typically not be prescribed for any patients who have a history of gastrointestinal motility disorders, gastroparesis, or previous gastrointestinal surgeries. Patients who are prescribed this medication in spite of such a medical history should exercise extreme caution when using it for treatment. Welchol Oral Suspension’s method of function may result in significant constipating effects that can contribute to patients developing bowel obstructions. The development of an obstruction can become a serious health condition, and patients that feel they may be at risk of such when taking Welchol Oral Suspension should discuss all concerns with their doctor before using this medication for treatment. Taking a stool softener regularly may help alleviate some of the bowel obstruction and constipation risks of taking this medication.

Impaired Absorption of Other Medications

Patients using Welchol Oral Suspension may also have difficulties with impaired absorption of any other medications, vitamins, or supplements they are taking at the same time as this medication. The way in which Welchol Oral Suspension functions inhibits the absorption in the digestive tract, where most medications and supplements are broken down and absorbed for use by the body. Patients that are currently using other medications, supplements, or vitamins should take these other products at least four hours in advance of taking their daily dose of Welchol Oral Suspension. Allowing a four-hour window for other medications and supplements to absorb properly before taking Welchol Oral Suspension ensures the patient will be receiving the maximum benefit of their other medications without the absorption being impaired by the functioning of Welchol.

Pregnancy and Breastfeeding

The use of Welchol Oral Suspension for treatment is not recommended for any patients that are pregnant or at risk of becoming pregnant. Some physicians may still recommend this medication if the benefits of its use outweigh the risks in a pregnant patient. Any questions or concerns about using Welchol Oral Suspension during pregnancy should be directed to your prescribing physician.

It is not known whether Welchol Oral Suspension is capable of being passed into breastmilk. Patients that are using Welchol Oral Suspension and who wish to breastfeed should consult their physician regarding the safety of this practice and alternatives to the medication if a significant risk is determined.

Additional Medical Conditions

If you have any of the following medical conditions, exercise caution when taking Welchol Oral Suspension and discuss your medical history with your doctor before beginning this medication:

  • A history of bowel motility conditions
  • A history of bowel surgeries
  • A history of bowel obstructions
  • Diabetic ketoacidosis
  • Dysphagia (swallowing difficulties)
  • Fat-soluble vitamin deficiencies (A, D, E, K)
  • High triglyceride levels
  • Malabsorption conditions
  • Pancreatitis (due to hypertriglyceridemia)
  • Phenylketonuria (PKU)
  • Type 1 diabetes

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with Welchol Oral Suspension. Please discuss any concerns you may have with your doctor or a trusted pharmacist.

The following medications may interact with Welchol Oral Suspension and similar medications, and this may increase your chances of experiencing adverse side effects during treatment. Some of the following medications may still be prescribed for use during a patient’s treatment with Welchol Oral Suspension if the patient’s physician deems the risks to be minimal by comparison to the benefits of using the medication:

  • Amiodarone
  • Anti-coagulant medications
  • Anti-seizure medications
  • Bezafibrate
  • Birth control pills
  • Calcitriol
  • Carbamazepine
  • Cholecalciferol
  • Corticosteroids
  • Cyclosporine
  • Deferasirox
  • Desogestrel
  • Dexamethasone
  • Diabetes medications
  • Diclofenac
  • Dienogest
  • Diuretics
  • Doxycycline
  • Drospirenone
  • Estradiol
  • Ethinyl estradiol
  • Ethynodiol
  • Ezetimibe
  • Furosemide
  • Gestodone
  • Glimepiride
  • Glipizide
  • Glyburide
  • Hydrochlorothiazide
  • Hydrocortisone
  • Ibuprofen
  • Indapamide
  • Leflunomide
  • Levothyroxine
  • Levonorgestrel
  • Lomitapide
  • Mestranol
  • Metformin
  • Methotrexate
  • Minocycline
  • Multivitamins
  • Mycophenolate
  • Mycophenolate mofetil
  • Mycophenolic acid
  • Naproxen
  • Niacin
  • Nomegestrol
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • NSAIDs
  • Obeticholic acid
  • Olmesartan
  • Phenytoin
  • Pravastatin
  • Prednisone
  • Propranolol
  • Raloxifene
  • Repaglinide
  • Teriflunomide
  • Tetracycline
  • Thyroid replacement medications
  • Thyroxine
  • Ursodiol
  • Vancomycin (oral)
  • Valproic acid
  • Verapamil
  • Vitamin D analogs
  • Warfarin

Alternative Medications

For patients who are unable to take Welchol Oral Suspension or who are experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed.

Some of the alternative medication options for the treatment of high cholesterol include the following:

  • Crestor (rosuvastatin)
  • Colestid (colestipol)
  • Lipitor (atorvastatin)
  • Praluent (alirocumab)
  • Prevalite (cholestyramine)
  • Repatha (evolocumab)
  • Zetia (ezetimibe)

Some of the alternative medication options for the treatment of type 2 diabetes include the following:

  • Actos (pioglitazone)
  • Farxiga (dapagliflozin)
  • Fortamet (metformin)
  • Glucotrol (glipizide)
  • Humalog (insulin lispro)
  • Lantus (insulin glargine)
  • Tradjenta (linagliptin)
  • Trulicity (dulaglutide)

Frequently Asked Questions