From the Guidelines
The recommended dose of Colesevelam HCl for adults with primary hyperlipidemia is 3.75 grams daily, taken as either six 625 mg tablets once daily or three 625 mg tablets twice daily with meals. Alternatively, it can be administered as one 3.75-gram packet of powder once daily or one 1.875-gram packet twice daily, mixed with 4-8 ounces of water, fruit juice, or diet soft drinks. Colesevelam works by binding bile acids in the intestine, preventing their reabsorption and increasing fecal excretion, as described in the 2022 ACC expert consensus decision pathway on the role of nonstatin therapies for LDL-cholesterol lowering 1. This forces the liver to convert more cholesterol into bile acids, thereby reducing cholesterol levels in the bloodstream. The medication should be taken with meals to enhance its effectiveness. Patients should maintain adequate fluid intake while using Colesevelam and be aware that it may cause constipation as a side effect. It's also important to note that Colesevelam may interact with other medications by reducing their absorption, so other drugs should be taken at least 4 hours before or after Colesevelam, as indicated in the study 1. Key considerations for prescribing Colesevelam include:
- Pill burden and inconvenience in preparation of oral suspension preparations
- GI side effects, such as constipation, dyspepsia, and nausea
- Exacerbation of hypertriglyceridemia
- Potential for decreased absorption of other medications
- Importance of maintaining adequate fluid intake to minimize the risk of intestinal blockage. Overall, the recommended dose and administration of Colesevelam HCl should be individualized based on patient-specific factors and medical history, with careful consideration of potential interactions and side effects, as outlined in the 2022 ACC expert consensus decision pathway 1.
From the FDA Drug Label
2.2 Recommended Dosage in Primary Hyperlipidemia The recommended dosage of colesevelam hydrochloride for adults and for boys and postmenarchal girls aged 10 to 17 years with primary hyperlipidemia is 3.75 grams daily.
The dose of Colesevelam HCl for adults with primary hyperlipidemia is 3.75 grams daily 2.
From the Research
Dose of Colesevelam HCl
The dose of Colesevelam HCl for adults with primary hyperlipidemia is as follows:
- The maintenance dosage is three 625-mg tablets twice daily or six tablets once daily, taken with meals 3
- Colesevelam can be uptitrated to a maximum dosage of 3.75 g/day as necessary to achieve a 15-30% reduction from baseline in LDL-C level 4
- In some studies, subjects received 3.75 g/day colesevelam 5, 6, 7
Key Points
- Colesevelam HCl is a bile acid sequestrant that lowers low-density lipoprotein cholesterol (LDL-C) in hyperlipidemia and improves glycemic control in adults with type 2 diabetes 5, 6
- The maximum dosage of colesevelam (3.75 g/day) was taken by 50% of subjects at week 50 in one study 4
- Colesevelam has been shown to be safe and effective for the management of LDL-C levels in adults with primary hypercholesterolemia 4