Colesevelam indications and usage

Colesevelam indications and usage

Clinical data
Trade names	Welchol, Cholestagel
MedlinePlus	a699050
Pregnancy category	B
Routes of administration	Oral
ATC code	C10AC04 (WHO)
Legal status
Legal status	In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability	N/A
Metabolism	Colesevelam is not absorbed and not metabolised.
Elimination half-life	N/A (non-systemic drug)
Excretion	By intestines only, colesevelam is non-systemic.
Identifiers
CAS Number	182815-44-7 Y
PubChem CID	160051
DrugBank	DB00930 Y
ChemSpider	NA N
UNII	P4SG24WI5Q
KEGG	D03582 Y
ChEMBL	ChEMBL1201677 Y
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
NY (what is this?)  (verify)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]

Indications and Usage

Primary Hyperlipidemia

WELCHOL is indicated as an adjunct to diet and exercise to reduce elevated low-density lipoprotein cholesterol (LDL-C) in adults with primary hyperlipidemia (Fredrickson Type IIa) as monotherapy or in combination with an hydroxymethyl-glutaryl-coenzyme A (HMG CoA) reductase inhibitor (statin).

WELCHOL is indicated as monotherapy or in combination with a statin to reduce LDL-C levels in boys and postmenarchal girls, 10 to 17 years of age, with heterozygous familial hypercholesterolemia if after an adequate trial of diet therapy the following findings are present: a. LDL-C remains ≥ 190 mg/dL or
b. LDL-C remains ≥ 160 mg/dL and

• there is a positive family history of premature cardiovascular disease or
• two or more other CVD risk factors are present in the pediatric patient.

Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol when response to diet and non-pharmacological interventions alone has been inadequate [See Clinical Studies (14.1)].

In patients with coronary heart disease (CHD) or CHD risk equivalents such as diabetes mellitus, LDL-C treatment goals are < 100 mg/dL. An LDL-C goal of < 70 mg/dL is a therapeutic option on the basis of recent trial evidence. If LDL-C is at goal but the serum triglyceride (TG) value is > 200 mg/dL, then non-HDL cholesterol (non-HDL-C) (total cholesterol [TC] minus high density lipoprotein cholesterol [HDL-C]) becomes a secondary target of therapy. The goal for non-HDL-C in persons with high serum TG is set at 30 mg/dL higher than that for LDL-C.

Type 2 Diabetes Mellitus

WELCHOL is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus [See Clinical Studies (14.2)].

Diabetes mellitus is considered a CHD risk equivalent. In addition to glycemic control, intensive lipid control is warranted [See Indications and Usage (1.1) and Warnings and Precautions (5.2)].

Important Limitations of Use

• WELCHOL should not be used for the treatment of type 1 diabetes or for the treatment of diabetic ketoacidosis.
• WELCHOL has not been studied in type 2 diabetes in combination with a dipeptidyl peptidase 4 inhibitor and has not been extensively studied in combination with thiazolidinediones.
• WELCHOL has not been studied in pediatric patients with type 2 diabetes.
• WELCHOL has not been studied in Fredrickson Type I, III, IV, and V dyslipidemias.
• WELCHOL has not been studied in children younger than 10 years of age or in pre-menarchal girls.