Colesevelam and Pioglitazone and glimepiride interaction
Colesevelam and Pioglitazone and glimepiride: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Colesevelam (COLESEVELAM HYDROCHLORIDE) label · effective 2023-12-28
…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…
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) ].
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).
Sulfonylureas Clinical Impact: In vivo drug interactions studies showed a decrease in sulfonylureas when coadministered with colesevelam hydrochloride [see Clinical Pharmacology (12.3) ].
Intervention: Administer sulfonylureas 4 hours prior to colesevelam hydrochloride.
From the Pioglitazone and glimepiride label · effective 2025-12-12
Colesevelam: Coadministration may reduce glimepiride absorption.
Concomitant Administration of Colesevelam Glimepiride Colesevelam can reduce the maximum plasma concentrations and total exposure of glimepiride when the two are coadministered.
However, absorption is not reduced when glimepiride is administered four hours prior to colesevelam.
Pioglitazone and glimepiride tablets should be administered at least 4 hours prior to colesevelam.
Therefore, pioglitazone and glimepiride tablets should be administered at least four hours prior to colesevelam [see Clinical Pharmacology (12.3) ] .
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.