All Known Side Effects & Uses of Welchol (Slimming Medicine)

By Jemima Faith

Welchol (colesevelam hydrochloride) is a lipid-lowering (fat reducing) and glucose-lowering agent used to lower "bad" cholesterol in the human blood. It is very important to do a medical checkup very often and in a case where an illness is diagnosed (in this case cholesterol related complications), it will be to your advantage to have it put under control. However in a case where you are tested infection free, you are advised to go home and continue living a healthy life because health is wealth. In this write-up we shall take a brief look at the following details about Welchol.

Uses of Welchol:

Some of the uses of Welchol are:

Reducing high cholesterol amounts

Welchol is used along with diet and exercise to control blood sugar in patients who are suffering from type 2 diabetes. It should never be used in the treatment of people suffering diabetic ketoacidosis or type 1 diabetes.

Welchol is a bile acid sequestrant. It does a lot of work in the bowel to help remove bile acids from the body. The body in turn uses cholesterol to make more bile acids, which causes the blood cholesterol levels to decrease (reduce). The exact explanation how Welchol works to treat type 2 diabetes is not yet known.

Welchol is also being used to improve glycemic control in people who are suffering with type 2 diabetes.

It may be used singly (just alone) or with other types of medicines especially with other cholesterol-lowering medications.

Welchol uses honest diet control and regular unexaggerated exercise.

There may be other uses of Welchol or other drugs that Welchol uses to optimize its effects. However, if you have any doubt on the uses of Welchol here feel free to consult your medical expert.

Before making use of Welchol

There are some medical conditions which may interact (disturb the smooth functioning) with Welchol. It is very important to inform your doctor or pharmacist if you have any medical conditions in order to avoid the negative side effects of Welchol, especially if any of the following points apply to you:

  • if you are few days, weeks or months pregnant, planning to take in (to get pregnant), or are breast-feeding your child
  • if you are taking any other prescription or nonprescription medicine, a herbal preparation, or some dietary supplement (s)
  • if you have some allergies to medications, particular foods, or some other substances
  • if you are having trouble in swallowing, esophagus problems (e.g. painful inflammation, narrowing), hemorrhoids, generally low levels of certain vitamins ( vitamins A, D, E, or K), or effective nutrient absorption problems
  • if you have a history of relatively high triglyceride levels, pancreatitis, or bowel or stomach problems

Some medicines may also interact with Welchol. Tell your health care provider if at all you are taking any other medicines, especially any of the drugs that follow:

  • Insulin or sulfonylureas (e.g. glipizide) because the actual risk of high triglyceride levels may be increased
  • Metformin because the risk of its own side effects may be increased by the uses of Welchol
  • Hydantoins (e.g. phenytoin), Cyclosporine, thyroid hormones (e.g. levothyroxine), or warfarin owing to the fact that their effectiveness may be decreased by Welchol

Ask your health care provider if at all Welchol may interact with other medicines that you take. Always check with your health care provider before you start, stop, or change the dose of any of your medicines.

How to use Welchol:

As Welchol uses have been discussed above, use it only as directed by your doctor. Always check the label on the medicine or leaflet for exact dosing instructions.

  • Take Welchol by oral route (by mouth) with plenty of fluids (water, juices and others) and a meal.
  • If you also take birth control pills, olmesartan,  glipizide, glyburide, hydantoins (e.g. phenytoin), cyclosporine, glimepiride, thyroid hormones (e.g. levothyroxine), or vitamins, you are advised to take them at least 4 hours before you take Welchol.
  • It is important to continue taking Welchol even if you feel very well. Do not miss any doses until your doctor tells you to stop.
  • If you miss a one-time dose of Welchol, don’t fail to take it with a liquid at your next meal. If it is almost time for your following dose, skip the missed dose and go back to your normal or regular dosing schedule. You should never take the 2 doses at once.
  • Welchol has been indicated as an adjunct to diet and exercise to reduce elevated low-density lipoprotein cholesterol (LDL-C) in adults with the primary hyperlipidemia (Fredrickson Type IIa) as monotherapy or in a combination with a hydroxymethyl-glutaryl-coenzyme A (HMG CoA) reductase inhibitor (statin).
  • Welchol is indicated as monotherapy or in the combination with a statin to reduce LDL-C levels in boys and postmenarchal girls, 10 to 17 years of age, with heterozygous familial hypercholesterolemia.

Ask your health care expert any questions you may have about how to use Welchol.

Dosage of Welchol

It is very important for a patient to strictly follow the dosage of Welchol as given by your health personnel in an effort to avoid negative Welchol side effects.

Primary Hyperlipidemia

Type 2 Diabetes Mellitus

Welchol is indicated to be used either alone or in combination with a statin.

For tablets, the recommended dosage of Welchol in adult subjects, (alone or in combination), is a daily regimen of 3 tablets taken two times a day or 6 tablets taken all at once. These tablets should be taken alongside a meal and liquid.

For Oral Suspensions, the recommended dosage of Welchol children age between 10 and 17 year is a daily regimen of 1.875 gram packet taken two times a day or a 3.75 gram packet taken all at once. To prepare the suspension, empty all the contents of one packet into a glass or cup and add a 0.5 to 1 cup (4 to 8 ounces) of clean drinkable water, fruit juice, or diet soft drinks. Stir the mixture well and drink. Always take the oral Suspension with meals. In order not to have distress in the esophagus, avoid taking oral suspensions in its dry form (without dissolving it).

It is also advisable that, due to the size of the tablets, subjects having difficulties with swallowing tablets should use this medicine as an Oral Suspension.

You can also take this drug at the same time as a statin or the two drugs can be dosed apart

After the initiation of this medicine, lipid levels should be analyzed between 4 to 6 weeks.

Important safety information:

  • Strictly follow the diet and exercise program given to you by your health care provider.
  • It may however take several weeks for Welchol to begin working. Do NOT take more than the dose that has been recommended or use it for longer than prescribed without checking either with your doctor or pharmacist.
  • Welchol can also cause constipation. To prevent this constipation, it is also important to maintain a diet adequate in fiber, drink plenty amounts of water, and exercise. If Welchol causes constipation, check either with your doctor or pharmacist for ways to control this effect.
  • Welchol may greatly decrease the absorption of certain other medicines into your body. Either check with your doctor or pharmacist to see how you should take your other medicines alongside Welchol.
  • Inform your doctor or dentist that you take Welchol before you receive any medical or dental care, emergency care, or surgery.

For Diabetes patients: Carry an ID card at all times that shows that you have diabetes. Always check your blood sugar levels as directed by your doctor. If they are most of the times higher or lower than they usually should be and you take Welchol exactly as prescribed, report to your doctor.

Diabetes patients: Welchol may actually lower your blood sugarlevels resulting, in some subject in hypoglycemia. Hypoglycemia has been associated with anxious, weak, dizzy, sweaty, drowsy, or faint. It may also result in increased heartbeat; blurred vision to change; headaches, chills, or tremors; or hungry. Lower glucose levels can be treated by taking glucose directly or any other source of glucose (such as tablets or gel) to treat the low blood sugar. If a glucose source is not available at the time of the attack, you should eat or drink a quick source of sugar such as candy, orange juice, table sugar, honey, or non-diet soda. This will be able to raise your blood sugar level very faster to a considerable level. Tell your doctor right away if this occurs. In order to prevent low blood sugar, eat your meals at the same time each day and do not skip meals.

Pregnancy and Breastfeeding: If you become pregnant while using this medicine, inform your health care provider immediately. Base on your clinical reports and the side effects of Welchol, your doctor will be able to weigh the benefits and risks associated with the use of Welchol during pregnancy. The presence of this medication in breast milk has not been documented. Thus, if you choose to breastfeed your child while using Welchol, talk about it with your health care provider. Have all your questions about any possible risks to your baby answered before embarking on the use.

Lab tests: Diagnosis and monitoring should include the cholesterol, triglyceride, and blood glucose levels. Such test may be carried out while you are still on Welchol therapy and also after such therapy. Such tests are great ways to be able to monitor your condition or check for Welchol side effects. Keep all appointments with your doctor and lab, don’t miss such appointments as the use of this medicine has some serious adverse reactions that needs to be monitored and preventive actions taken.

While administering Welchol in children younger than 10 years of age and young girls (girls who have not started ovulation or have not had their first menstrual period), cautions should be taken with strict monitoring. The safety and effectiveness of this medicine in this age group have not been confirmed.


Natural cholesterol is the major building material of bile acid. Colesevelam, the active component of Welchol binds with bile acids in the intestine. This resulted in an insoluble complex substance that is sent out of the body in feces. This reaction leads to an increased excretion of the bile acids, which in turn causes an increased in the oxidation of cholesterol to form bile acid (an action to balance the bile acid in the body) and thus, serum cholesterol is lowered.

Side effects of Welchol

Generally, side effects may come even if one has strictly followed the actual dosage of Welchol in a case where it has been prescribed. However, some Welchol side effects may occur due to some other natural phenomena.

Some Common side effects of Welchol include: constipation. 

Other side effects of wechol include: dyspepsia. See below for a comprehensive list of the adverse effects.

As well as the needed effects, Welchol may cause some unwanted effects that require medical attention. Some of these Welchol side effects may be serious, requiring an emergency medical help. Still, other may not be serious and as such need no medical help. Such side effects will disappear as the body adapts to the drug of following discontinuation of the medicine.

Major Side Effects of Welchol

If any of the following side effects occur while you are taking colesevelam, check your doctor immediately:

Less common:

  • Anxiety
  • blurred vision
  • chills
  • cold sweats
  • coma
  • confusion
  • congestion
  • cool, pale skin
  • cough
  • depression
  • diarrhea
  • dizziness
  • dry or sore throat
  • fast heartbeat
  • fever
  •  illness general feeling of discomfort
  • Headache
  • muscle aches or pain
  • hoarseness
  • increased hunger
  • joint pain
  • loss of appetite
  • nausea
  • nervousness
  • nightmares
  • pounding in ears
  • runny nose
  • seizures
  • shakiness
  • shivering
  • slow or relatively fast heartbeat
  • slurred speech
  • sweating
  • tender, some swollen glands in the neck
  • trouble in sleeping
  • trouble in swallowing
  • unusual tiredness or weakness
  • voice changes
  • vomiting

Incidence not known:

  • severe or minute bleeding after defecation
  • darkened urine
  • difficulty in swallowing
  • indigestion
  • painful feeling or discomfort in the chest
  • pains in one’s stomach, or abdomen, side, possibly radiating to the back
  • pressure in one’s stomach
  • severe stomach pain
  • swelling of the abdominal area
  • unable to swallow your own saliva
  • uncomfortable painful swelling around the anus
  • yellowing of eyes or skin

Minor Side Effects of Welchol

Some colesevelam side effects may not actually need any medical attention. As your body gradually gets used to the medicine these side effects may just disappear. Your health care professional may also be able to help you prevent or reduce these side effects, but do check with them if any of this following side effects continue, or if you are concerned about their occurrence:

More common:

  • Acidic or sour stomach
  • belching
  • bloating
  • constipation
  • full or bloated feelings
  • heartburns
  • cramping or pain in the abdomen or stomach
  • stomach discomfort, upset, or pains

Less common:

  • Lack or excess loss of strength
  • sneezing
  • a stuffy nose

For Healthcare Professionals


The most frequently reported side effects so far have been constipation, dyspepsia, and nausea.


It is very common: Constipation, flatulence
Common: Dyspepsia, diarrhea, abdominal pain, nausea, vomiting, abnormal stools, and abdominal distension

  • ·         Uncommon: Dysphagia
  • ·         Very rare: Pancreatitis
  • ·         Frequency not actually reported: Intestinal obstruction

Post marketing reports: Bowel obstruction, fecal impaction, esophageal obstruction, exacerbation of hemorrhoids.


Common: Occurrence of severe hypertriglyceridemia and hypoglycemia


Common: Hypertension, aortic stenosis, a myocardial tissue death, or bradycardia


Common: Pharyngitis, nasopharyngitis, rhinitis, upper respiratory tract infection


Common: Accidental injury, flu syndrome, influenza, fatigue, asthenia, creatine phosphokinase increased
Uncommon: Serum transaminases in increased levels


Common: Myalgia, back pains

Nervous system

Common: severe Headache


In clinical trials of the type 2 diabetes, patients who received this drug as an add-on to a sulfonylurea where required to discontinue the trial because of body rashes and mouth blistering. This hypersensitivity reaction was recorded on the first day of the treatment with Welchol. The frequencyof such hypersensitivity reaction has not been reported:

This is not a complete list of Welchol side effects as there may be more that have not been included here. Talk with your health care provider or pharmacist about the various adverse reactions that may be associated with Welchol therapy. If you however make a mistake or have some side effects, not listed here, while taking this medicine or in the uses of Welchol, do not hesitate to seek medical attention.

If Overdose with Welchol is suspected:

Contact 1-800-222-1222 (the Association of Poison Control Centers), your local area poison control center, or an emergency room immediately. Symptoms may also include severe constipation.

Proper storage of Welchol:

When we respect the proper storage of this drug, we will be minimizing incidences of drug spoilage which will also reduce wastage of resources. Store Welchol at a standard of 77 degrees F (25 degrees C). Brief storage at temperatures between the temperatures of 59 and 86 degrees F (15 and 30 degrees C) is also permitted. Store far away from heat, moisture, and light. Do not store Welchol in the bathroom. Keep Welchol out of the reach of all children and away from pets as well.

General information:   

Here are some of the general information tips about this drug that you should also take note of:

  • Whenever you have any questions about Welchol, please talk with your doctor, pharmacist, or other health care personnel.
  • Welchol is to be used only by the patient for whom it has been prescribed. Do not share it with other persons.
  • If your symptoms do not improve or if they eventually become worse, check with your doctor.
  • Always check with your pharmacist about how to dispose of all unused drugs.

After looking at possible Welchol uses, we can coclude that Welchol uses our personal efforts to give us a good health.


Pregnancy Considerations

Adverse effects have not yet been observed in animal reproduction studies. Colesevelam is not just absorbed systemically, but may interfere with some vitamin absorption; therefore, regular supplementation may not really be adequate.

Monitoring Parameters

In order to effectively follow up with the progress made while taking Welchol, the fasting the lipid profile should be examine before the onset of the treatment, 3 months after its initiation (or within 4 to 6 weeks if baseline fasting triglycerides of 250-299 mg/dL), and every 6 to 12 months. This medication should not be used in subjects whose baseline fasting triglycerides greater than 300 mg/dL

Patient Education

• Always discuss specific use of drug and side effects with patient as it relates to the treatment. During this period of hospital stay, were you given any type of medicine that you had never taken before? Before giving you any new medication, how often did any of the hospital staff tell you what the medicine was meant for? How often did the hospital staff describe possible side effects in a way that you could understand?)

• A patient may experience a headache, heartburn, back pain, or rhinitis. Have the patients report immediately to prescriber in case of signs of pancreatitis (severe back pain, serious abdominal pain, severe nausea, or vomiting), signs of reduced or low blood sugar (dizziness, fatigue, feeling weak, headache, shaking, tachycardia, increased hunger, confusion, or sweating), severe constipation, severe abdominal pain, or difficulty in swallowing.

• It is very important to educate patient about signs of a significant reaction (such as chest tightness; bad cough; blue skin color; fever; itching; wheezing; seizures; or swelling of lips, tongue, face, or throat). Note: This is not a complete list of all the possible side effects.

Having seen a lot about this drug such as its uses, side effects, dosage and a host of others, it is very important for us to take precaution when dealing drugs in general no matter how simple they appear to us and let us avoid drug abuse because drug abuse is very dangerous and if one does not discontinue such habits it can push someone to an early grave.

A Disclaimer: this piece of information or write-up as others may call it is nothing but a guide that aims at leading some patients through their moments of doubt especially when their health experts are not by their sides. However, in no occasion or whatsoever should this document be used to replace the savvy or services of a medical doctor or pharmacist.

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