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

By Jemima Faith

As people try every day to keep shape, fitness, and good health, their number one enemy is cholesterol. High cholesterol or fat is often times not good for our health. It often times accumulate in the blood vessels of the heart and brain. If this occurs, it may lead to serious heart and brain problems, stroke and may also be fatal in some cases. The fact that cholesterol may not be adequately eliminated from the system brings to light the need for an agent to help in this process. Colesevelam hydrochloride (colesevelam HCl), the active component in the drug Welchol is an effective lipid-lowering (fat reducing) and glucose-lowering agent. Once taken, it goes to help the body to get rid of and lower the amount of "bad" cholesterol in the human blood. “Bad” cholesterol is also referred to as low-density lipoprotein (LDL). It is advisable to take Welchol, as part of a recovery program which involves maintaining a healthy eating habit (eat more fruits and less fatty diets) and exercise.

This medicine is recommended in adult subjects, (alone or in combination), following 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. It also comes as an oral suspension for those who may not be able or with difficulty in swallowing and children. Thus, 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 in a go. In order to prepare the suspension, empty all the contents of one packet into a glass or cup and add a 0.5 to 1 cup of 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). This medicine can also take be taken simultaneously with 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. 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. 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 next scheduled dose, skip the missed dose and go back to your normal or regular dosing schedule. You should never take the 2 doses at once.

To be able to determine whether Welchol is working for you, you will need to be examined before and during the Welchol therapy. Diagnosis and monitoring should include the cholesterol, triglyceride, and blood glucose levels. The fasting lipid profile should be examined before the onset of the treatment, 3 months after its initiation (or within 4 to 6 weeks for people with moderate baseline fasting triglycerides), and every 6 to 12 months. This medication should not be used in subjects with high whose baseline fasting triglycerides. 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.

Patients are advice not to take this medicine if they are a few days, weeks or months pregnant, planning to take in (to get pregnant), or are breastfeeding your child, are on any other prescription or over the counter medicine, a herbal medicines, vitamins or some dietary supplement (s), have some allergies to medications, particular foods, or some other substances, 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, and if they have a history of relatively high triglyceride levels, pancreatitis, or bowel or stomach problems.

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. Some medicines may also interact with Welchol. Inform your health care provider if at all you are taking any other medicines, especially any of the drugs such as 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 and Hydantoins (e.g. phenytoin), Cyclosporine, thyroid hormones (e.g. levothyroxine), or warfarin owing to the fact that their effectiveness may be decreased by Welchol.

It is very important for a patient to strictly follow the dosage of Welchol, as given by their health personnel in an effort to avoid negative Welchol side effects. For Welchol to be effective or to obtain the maximum benefit from its used, you should take it as prescribed by your healthcare provider. This should include taking it as part of a program that includes diet, exercise, and weight control. You should also, for no reason change the dose or schedule of other cholesterol or diabetes medicine without the concern of your pharmacist or healthcare provider.


Functioning and Effectiveness

Welchol is the brand name for the medicine, Colesevelam HCl, a cholesterol lowering drug the work mainly in the system to clear fat deposit in the arteries and veins (the circulatory system). Colesevelam HCl is an effective drug that reduces or prevents the accumulation of cholesterol. Welchol is regarded as a bile acid sequestrant. This is because it does a lot of jobs 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. It may however take several weeks for Welchol to begin working or for any significant improvement to be noticed. 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. You should inform your doctor or dentist that you take Welchol before you receive any medical or dental care, emergency care, or surgery. Also make sure you inform your healthcare provider if you have any difficulty swallowing, or if you have a history of a major stomach surgery and vitamin deficiency.

Once you are on Welchol therapy, you should always skip about 4 before or after you take Welcol and other drugs. 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. This is because Colesevelam may hinder the rate by which other drugs are absorbed into the system. Once you notice symptoms of severe stomach pain and constipation, you should immediately discontinue the use of this medicine and consult your healthcare provider.

This medicine can be taken alone or in combination with other drugs like simvastatin (Zocor), atorvastatin (Lipitor), rosuvastatin (Crestor), and fluvastatin (Lescol). However, you should not take Welchol if you have an obstruction in the intestine (bowel obstruction), if you are suffering from pancreatic caused by high levels of triglycerides or if you are allergic to colesevelam. Welchol when used in combination with other anti-diabetes drug such as metformin, sulfonylureas, or insulin, can be effective in controlling the level of blood glucose in diabetes type 2 individuals. People with type 1 diabetes and those in a state of diabetic ketoacidosis are not recommended to be treated with Welchol.

You should not take this medicine if you are in any doubt or when it has not been prescribed for your case. If when taking this medicine there is no observed changes in the symptoms, or if the symptoms get worse, you should report it to your healthcare provided who may decide to put you on another cholesterol medicine or adjust your dose.

There is no information about the half-life of this drug since it is not absorbed into the bloodstream.

Healthcare providers should advise patients on the specific use of this drug and side effects as it relates to the treatment.


Uses of Welchol

Welchol is primarily prescribed for the control of unwanted fat or bad cholesterol. This medication prevents fat formation in the veins and arteries thus, reducing the risk of stroke and heart failure. It has also been associated with the treatment of diarrhea. Welchol can also be used by those who are overweight to reduce their weight as it has been associated with the reduction of adipose tissue. The uses of Welchol may also purposes not discussed in this medication guide. Thus, if you have any doubt on the uses of Welchol here, feel free to consult your medical expert.

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. Some Welchol side effects may be associated with some other phenomena such as the individual clinical history. What is more important is that some of these unwanted reactions are less common and severe while others are more common and mild.

Major Side Effects of Welchol

These are some of the serious Welchol side effects. You should get an emergency medical help immediately you suspect or notice any of these symptoms by calling either your healthcare provider or emergency help services near you.

  • cold sweats
  • coma
  • confusion
  • diarrhea
  • dizziness
  • general feeling of discomfort or illness
  • blurred vision
  • chills
  • congestion
  • cool, pale skin
  • cough
  • depression
  • joint pain
  • pounding in the ears
  • runny nose
  • seizures
  • shakiness
  • unable to swallow saliva
  • nightmares
  • pressure in the stomach
  • severe stomach pain
  •  headache
  • hoarseness
  • increased hunger
  • shivering
  • slow or fast heartbeat
  • slurred speech
  • sweating
  • darkened urine
  • difficulty with swallowing uncomfortable swelling around the anus
  • yellow eyes or skin
  • trouble with sleeping
  • trouble with swallowing
  • unusual tiredness or weakness
  • voice changesswelling of the
  • fever
  • loss of appetite
  • muscle aches or pain
  • nausea
  • nervousness
  •  tender, swollen glands in the neck
  • indigestion
  • pain or discomfort in the chest
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • vomiting
  • Bleeding after defecation
  • abdominal or stomach area
  • dry or sore throat
  • fast heartbeat
  • anxiety


Minor Side Effects Welchol

  • acid or sour stomach
  • belching
  • bloating
  • constipation
  • full or bloated feeling
  • heartburn
  • pain or cramping in the abdomen or stomach
  • stomach discomfort, upset, or pain
  • Lack or loss of strength
  • sneezing
  • stuffy nose


While this may not be a complete or comprehensive list of all the possible Welchol side effects, you should consult your healthcare provider or pharmacist for the possible side effects that may result due to your specific clinical record. If you, however notice some side effects while taking this drug that is not listed here, you should immediately report it to your healthcare provider.  

Overdose with Welchol

Contact the Association of Poison Control Centers or emergency help services near you immediately. Symptoms may also include severe constipation.

There is no systemic absorption of colesevelam (it’s not absorbed into the bloodstream) thus, there is no expected life-threatening symptom of overdose with Welchol. The only, possible side effects may be severe constipation. 

Welchol Warnings and Precautions

Gastrointestinal Disease or Disorders

Due to the high potential risk of this drug to cause constipation, subjects with gastroparesis, gastrointestinal movement disorder, history of GI tract surgery, or those at risk of bowel obstruction are not recommended to use this medicine. Healthcare professionals should prescribe this drug with caution in subjects with a history of dysphagia of swallowing difficulties. In order to avoid esophageal obstruction, the oral suspension form of coleselam should instead be used in place of the large sized tablets.


Welchol use in subjects with high levels of serum triglyceride and also in subjects using thiazolidinediones, sulfonylureas, or insulin may result in overdose, thus, it should be administered with caution. You should discontinue Welchol therapy when triglyceride concentrations are found to be very high or when symptoms of hypertriglyceridemia-induced pancreatitis are noticed.

Vitamin K or Fat-Soluble Vitamin Deficiencies Precautions

Welchol should be administered with caution in subjects who have or have a history to easily develop symptoms associated to fat-soluble vitamin deficiencies. In other subjects, the absorption of soluble vitamins A, D, E, and K may be inhibited. Such patients are advised to take vitamins at least 4 hours before Welchol.

Use in Specific Populations


At the time of writing this article, there has been no well-controlled studies Welchol use in pregnant women for any meaningful conclusion to be drawn. However, due to the high need for vitamins and nutrients during pregnancy, and due to the effect of Welchol on the absorption rate of fat-soluble vitamins, Welchol should only be used during pregnancy only when the potential benefits clearly justify its use. 

Nursing/ Breastfeeding Women

The active component in Welchol, colesevelam hydrochloride may not possibly pass in human milk. This is simply because colesevelam hydrochloride and its metabolites are not absorbed from the gastrointestinal tract into the circulatory system.

Pediatric Use                                                

The result of the study of the safety and effectiveness of Welchol used either alone or in combination with statin involving children in the 10 - 17 age range shows no significant effects on sexual maturation, growth, fat-soluble vitamin levels or clotting factors. However, due to the large size of the tablet, Welchol for Oral suspension should be used instead in the pediatric population. The safety and effectiveness of Welchol have not been documented in children younger than 10 years of age and in non-puberty girls.

Geriatric Use

There were no significant overall changes in the safety and effectiveness of the use of Welchol involving geriatric (people older than 65 years of age) and younger subjects during hyperlipidemia clinical studies.  However, due to greater sensitivity of people in this age group, Welchol should be used with caution and only in subjects where the benefits justifies its use.

Also, there was no difference in the safety and effectiveness of geriatric subjects who were diagnosed with type 2 diabetes and using this drug with normal and younger subjects.  

Hepatic Impairment

Studies show no significant differences in the safety and effectiveness between hepatic impaired and normal subjects treated with Welchol. Thus, there is no special consideration advisable or recommendable for the use of Welchol in hepatic (liver) impaired subjects.

Renal Impairment

Clinical studies with diabetes type 2 individuals, using Welchol in combination with other metformin, sulfonylureas, and insulin diabetes studies, and involving patients with mild and moderate renal impairment did not indicate any significant differences in the safety and effectiveness between subjects from these groups and between subjects from these groups and normal subjects. In other studies using Welchol alone, and in combination with pioglitazone, there were very few (3 and 5 patients, respectively) who show symptoms of moderate renal impairment.

Diabetes patients

Welchol may actually lower your blood sugar levels, 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.

Proper storage and handling of Welchol

Stored Welchol at room temperature 77oF (25oC). Store away from high temperatures, open flames, moisture, and from direct sunlight. Do not take this medicine if found to have expired. Properly dispose of all expired and unused drugs following best environmental practices. Keep Welchol out of the reach of all children and pets.

Customers’ Reviews

Customer reviews of Welchol can be positive and negative feedbacks based on the individual’s experience. Usually when a user’s experience is positive, the user attests the effectiveness of the drug while with a poor user experience, the patient will only express dissatisfaction.

Positive Feedbacks

One user, a 57 year old without gallbladder (gallbladder was removed) was suffering from IBS and high cholesterol for over 14 years. Once she was administered with Welchol by her healthcare provider, she received a miraculous relief from these symptoms. Another user reports to have been drastically relief from years of horrible pains, and diarrhea with Welchol.

Negative Feedbacks

One user who is suffering from genetic high cholesterol, report of serious side effects, including migraine headache, nausea, and hives-like symptoms (itching) just after the initiation of this medicine. No improvement of symptoms of cholesterol after months of Welchol therapy.

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 the services of a medical doctor or pharmacist.

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