Interaction Checker

Colesevelam interactions

Colesevelam (Welchol), a bile acid sequestrant has 48 documented interactions across the FDA labels and fact sheets we index: 2 major, 43 moderate, 3 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (2)

  • Deferasiroxiron supplementMajor

    Bile Acid Sequestrants Avoid the concomitant use of bile acid sequestrants (e.g., cholestyramine, colesevelam, colestipol) with Exjade due to a possible decrease in deferasirox concentration. (Deferasirox label, Drug interactions)

  • Raloxifeneselective estrogen receptor modulatorMajor

    EVISTA should not be co-administered with other anion exchange resins [see Clinical Pharmacology ( 12.3 )] . (Raloxifene label, Drug interactions)

Moderate interactions (43)

  • Cholestyraminebile acid sequestrantModerate

    Hypertriglyceridemia and Pancreatitis Colesevelam hydrochloride, like other bile acid sequestrants, can increase serum TG concentrations. (Colesevelam label, Warnings and precautions)

  • Conjugated estrogensestrogenModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • CyclosporineimmunosuppressantModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Drospirenone and ethinyl estradioloral contraceptiveModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Empagliflozin and metforminSGLT2 inhibitorModerate

    Concomitant use with colesevelam hydrochloride may increase the exposure of the following drugs: Metformin extended release. (Colesevelam label, Drug interactions)

  • EstradiolestrogenModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • EzetimibeModerate

    Bile Acid Sequestrants Clinical Impact: Concomitant cholestyramine administration decreased the mean exposure of total ezetimibe. (Ezetimibe label, Drug interactions)

  • Ezetimibe and simvastatinstatinModerate

    Table 3: Drug Interactions that Decrease the Efficacy of VYTORIN Bile Acid Sequestrants Clinical Impact: Concomitant cholestyramine administration decreased the mean exposure of total ezetimibe approximately 55%. (Ezetimibe and simvastatin label, Drug interactions)

  • GemfibrozilfibrateModerate

    (F) Bile Acid-Binding Resins Gemfibrozil AUC was reduced by 30% when gemfibrozil was given (600 mg) simultaneously with resin-granule drugs such as colestipol (5 g). (Gemfibrozil label, Drug interactions)

  • GlimepiridesulfonylureaModerate

    Examples: Glimepiride, glipizide, and glyburide Oral Vitamin Supplements Clinical Impact: Colesevelam hydrochloride may decrease the absorption of fat-soluble vitamins A, D, E, and K [see Warnings and Precautions (5.3) ]. (Colesevelam label, Drug interactions)

  • GlipizidesulfonylureaModerate

    Examples: Glimepiride, glipizide, and glyburide Oral Vitamin Supplements Clinical Impact: Colesevelam hydrochloride may decrease the absorption of fat-soluble vitamins A, D, E, and K [see Warnings and Precautions (5.3) ]. (Colesevelam label, Drug interactions)

  • GlyburidesulfonylureaModerate

    Examples: Glimepiride, glipizide, and glyburide Oral Vitamin Supplements Clinical Impact: Colesevelam hydrochloride may decrease the absorption of fat-soluble vitamins A, D, E, and K [see Warnings and Precautions (5.3) ]. (Colesevelam label, Drug interactions)

  • Glyburide and metforminsulfonylureaModerate

    Concomitant use with colesevelam hydrochloride may increase the exposure of the following drugs: Metformin extended release. (Colesevelam label, Drug interactions)

  • Insulin aspartinsulinModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • Insulin degludecinsulinModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • Insulin detemirinsulinModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • Insulin glargineinsulinModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • Insulin lisproinsulinModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • Insulin regular (human)insulinModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • LevonorgestrelprogestinModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Levonorgestrel and ethinyl estradioloral contraceptiveModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Levothyroxinethyroid hormoneModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Liothyroninethyroid hormoneModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • MedroxyprogesteroneprogestinModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • MegestrolprogestinModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • MetforminbiguanideModerate

    Concomitant use with colesevelam hydrochloride may increase the exposure of the following drugs: Metformin extended release. (Colesevelam label, Drug interactions)

  • Methimazoleantithyroid drugModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • MycophenolateimmunosuppressantModerate

    Examples Cyclosporine A, trimethoprim/sulfamethoxazole, bile acid sequestrants (cholestyramine), rifampin as well as aminoglycoside, cephalosporin, fluoroquinolone and penicillin classes of antimicrobials Drugs Modulating Glucuronidation Clinical Impact Concomitant use with drugs inducing glucuronidation decreases MPA systemic exposure, potentially reducing MYHIBBIN… (Mycophenolate label, Drug interactions)

  • NorethindroneprogestinModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Norethindrone and ethinyl estradioloral contraceptiveModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Norgestimate and ethinyl estradioloral contraceptiveModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Olmesartanangiotensin II receptor blocker (ARB)Moderate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • PhenytoinanticonvulsantModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Phytonadione (vitamin K1)vitamin KModerate

    Vitamin K or Fat-Soluble Vitamin Deficiencies: Colesevelam hydrochloride may decrease absorption of fat-soluble vitamins. (Colesevelam label, Warnings and precautions)

  • PioglitazonethiazolidinedioneModerate

    …TG levels occurred when colesevelam hydrochloride was used as monotherapy (median increase 9.7% compared to placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and… (Colesevelam label, Warnings and precautions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    …TG levels occurred when colesevelam hydrochloride was used as monotherapy (median increase 9.7% compared to placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and… (Colesevelam label, Warnings and precautions)

  • PravastatinstatinModerate

    • Bile Acid Sequestrants: in patients taking a bile acid sequestrant, administer pravastatin sodium at least 1 hour before or at least 4 hours after the bile acid sequestrant () 7.1 Drug Interactions that Increase the Risk of Myopathy and Rhabdomyolysis with Pravastatin Sodium Pravastatin sodium is a substrate of the transport protein OATP1B1. (Pravastatin label, Drug interactions)

  • ProgesteroneprogestinModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Propylthiouracilantithyroid drugModerate

    Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide). (Colesevelam label, Drug interactions)

  • Sitagliptin and metforminDPP-4 inhibitorModerate

    Concomitant use with colesevelam hydrochloride may increase the exposure of the following drugs: Metformin extended release. (Colesevelam label, Drug interactions)

  • TirzepatideGLP-1 receptor agonistModerate

    …placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (Colesevelam label, Warnings and precautions)

  • Vitamin KVitamin and mineralModerate

    Vitamin K or Fat-Soluble Vitamin Deficiencies: Colesevelam hydrochloride may decrease absorption of fat-soluble vitamins. (Colesevelam label, Warnings and precautions)

  • WarfarinanticoagulantModerate

    Patients with a susceptibility to deficiencies of vitamin K (e.g., patients on warfarin, patients with malabsorption syndromes) or other fat-soluble vitamins may be at increased risk. (Colesevelam label, Warnings and precautions)

Minor mentions (3)

  • FenofibratefibrateMinor

    Bile-Acid Binding Resins Clinical Impact: Bile-acid binding resins may bind other drugs given concurrently. (Fenofibrate label, Drug interactions)

  • NiacinMinor

    Bile Acid Sequestrants: Bile acid sequestrants have a high niacin-binding capacity and should be taken at least 4 to 6 hours before niacin extended-release tablets administration. (Niacin label, Drug interactions)

  • Vitamin DVitamin and mineralMinor

    These reduce absorption of vitamin D (a fat-soluble vitamin); take vitamin D several hours apart. (NIH Office of Dietary Supplements, Vitamin D)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.