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Welchol (colesevelam) is used to lower high blood sugar in patients with type 2 diabetes and to lower cholesterol in patients with hyperlipidemia (high blood cholesterol). It can be used to treat either these conditions alone or to treat both simultaneously if present in the same patient. Likewise it may be used as a stand-alone treatment or in combination with other medications for more powerful results.

In both cases patients are strongly advised to incorporate lifestyle changes into treatment as well, such as dietary changes, losing weight, quitting smoking and so forth. Lifestyle changes can, in many cases, eventually lead to discontinuation of medications, though this will take some time. In the interim medications like Welchol help slow the progression of the conditions and minimize complications, which can be severe---even fatal---if diabetes or hyperlipidemia are not controlled.

Welchol provides a number of benefits:

• Reduces LDL cholesterol by 15 to 18 percent.
• Reduces total cholesterol by 7 to 10 percent.
• Raises HDL cholesterol by 3 percent.
• Can be used with statins for greater overall LDL control.
• Can be used with other glycemic therapies for greater glycemic control.
• Administered via tablet; no needles or injections.

The medication can be used in children. A doctor will need to calculate dosage according to weight and other factors. For children the medication is typically administered by oral suspension, which can be prepared by a pharmacist.

Getting Started with Welchol

In the majority of cases Welchol is administered by tablet. Tablets only come in one strength; 625 mg. Tablets should always be taken with food and a full glass of fluid.

Dosage may vary to some extent according to individual variables, but in most cases---particularly in otherwise healthy adults---treatment is strikingly similar no matter what it's being used for:

• Take 6 tablets a day, either all in one dose or 3 tablets twice a day.
• Take with a meal and a full glass of fluid.
• If a dose is missed for more than a few hours, it should be skipped completely. Do not take a double dose to compensate.

Whether using Welchol for LDL cholesterol management, blood glucose management, or to treat other, off-label conditions, it will take 4 to 6 weeks for full effects to be appreciated; as long as no serious side effects occur, treatment should continue for at least that long before judging its usefulness or lack thereof. Regular doctor checkups are advisable for the duration of treatment to enure the medication is continuing to work as intended, as well as to monitor for any developing adverse effects.

Patients will usually be advised to make dietary changes, and sometimes other lifestyle changes as well. Dietary changes in particular are important to follow if at all possible; this can have a far more significant effect on treating the condition than even the most potent medication.

Precautions & Side Effects

Side effects from Welchol are not unusual, but are typically mild and not cause for concern unless severe enough to be disruptive to daily life. Often they will stop occurring as the body adjusts to treatment and cholesterol and/or glucose levels stabilize. The most commonly reported side effects include:

• Flatulence
• Constipation
• Hard stools
• Diarrhea
• Muscle pain
• Indigestion
• Nausea
• Vomiting
• Headache
• Abdominal pain

In some studies incidence of flatulence and diarrhea were actually higher in those taking placebo than in those taking Welchol. Severe abdominal pain and severe constipation should be brought to the attention of a doctor.

Patients with a history of bowel obstructions should not take Welchol.

Welchol is associated with a very slight increase of cardiovascular events. Patients with a history of such will want to use this medication with caution, alert for symptoms or warning signs.

Welchol is known to interact with some other medications:

• Phenytoin should only be given four hours prior to Welchol.
• Warfarin patients may experience reduced International Normalized Ratio (INR) when taking Welchol.
• Elevated thyroid-stimulating hormone should only be given four hours prior to Welchol.

Other interactions are possible. Always check with a doctor or pharmacist before mixing medications or modifying doses.