colesevelam, Welchol

GENERIC NAME: colesevelam

BRAND NAME: Welchol

DRUG CLASS AND MECHANISM: Colesevelam is an oral drug that lowers cholesterol levels in the blood. It also improves control of blood sugar in type 2 diabetes.

Cholesterol made by the liver or from the food we eat can be converted into bile acids by the liver. The bile acids are secreted by the liver into the bile and enter the intestine with the bile. In the intestine the bile acids assist with the digestion of fat. Some of the bile acids are excreted from the body with the stool, but the majority of bile acids are absorbed from the intestine into the blood, are removed by the liver from the blood, and are re-secreted into the bile. Colesevelam binds bile acids in the intestine and causes more of the bile acids to be excreted in the stool. This reduces the amount of bile acids that returns to the liver and forces the liver to make more bile acids to replace the bile acids lost in the stool. In order to make more bile acids, the liver converts more cholesterol into bile acids, and this lowers the level of cholesterol in the blood. Colesevelam is not absorbed into the body.

The mechanism whereby colesevelam improves blood sugar levels in people with diabetes is unknown.




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