Colesevelam (Welchol)
Colesevelam (Welchol) is a bile-acid sequestrant available as tablets or powder for suspension. At about 3.8 g daily, it lowered LDL cholesterol by 15% from baseline in a 24-week trial. Study results
How much does colesevelam lower LDL cholesterol?
Colesevelam lowered LDL cholesterol by an average of 15% at approximately 3.8 g daily in a 24-week monotherapy trial. Read the evidence.
| Dose and treatment context | LDL result |
|---|---|
| Approximately 3.8 g daily | 15% from baseline |
The current usual adult regimen is 3.75 g daily. Colesevelam can raise triglycerides, so LDL lowering is only one part of deciding whether it fits a lipid profile.
Individual responses vary. LDL and ApoB measure different things; these LDL percentages should not be used as ApoB estimates. Compare ApoB-lowering treatments.
How is colesevelam taken?
The usual daily dose is six 625 mg tablets or one 3.75 g powder packet, taken with a meal and liquid. Tablets may be divided into three twice daily. Mix the powder before taking it; do not swallow it dry. Prescribing information.
How does colesevelam compare with other medications?
Colesevelam avoids systemic absorption but requires several tablets or a powder dose. Compared with Ezetimibe, medication spacing and constipation can be more burdensome. It also has an indication for glycemic control in type 2 diabetes.
Which medications can be combined with colesevelam?
Colesevelam can be added to a statin. It can reduce absorption of other medicines and fat-soluble vitamins; susceptible drugs and vitamins generally need to be taken at least four hours before colesevelam. Review thyroid hormone, warfarin, and oral contraceptives carefully.
How much does colesevelam cost?
Cost Plus Drugs lists colesevelam 3.75gm, 30 packets, at $52.92 before shipping ($58.17 with standard shipping). Prices were checked October 6, 2026; the quantity is not necessarily a month’s supply.
Cost Plus Drugs
Colesevelam 3.75gm, 30 packets: $52.92 including the dispensing fee, or $58.17 with standard shipping.
GoodRx
Compare local coupon prices for the same 3.75gm strength and 30 packets. The pharmacy, ZIP code, and coupon can change the price; this is a live comparison, not a second fixed quote.
Compare the cash price with your plan’s out-of-pocket quote for the same strength and quantity. Coupon purchases may not count toward your insurance deductible.
Does insurance cover colesevelam?
Coverage for colesevelam varies by plan and formulation. These named formularies and medical policies were checked October 6, 2026; your plan’s rules and cost sharing may differ.
| Insurer | Coverage policy |
|---|---|
| UnitedHealthcare | Tablets are Tier 2, with no prior authorization, step therapy, or quantity limit listed. Commercial PDL, September 2026. |
| Aetna | Aetna lists colesevelam as a preferred generic across the listed tablet and powder products. Advanced Control, October 2026. |
| Cigna | Cigna lists generic colesevelam at Tier 1, with possible home delivery and no prior authorization, step therapy, or quantity limit listed. California Standard 4-Tier (DMHC), July 2026. |
| Anthem | Anthem lists colesevelam at Tier 2; tablets are limited to six daily and 3.75 g packets to one daily. California Individual Select, October 2026. |
| Blue Shield of California | Tablets and powder are Tier 2, without a listed prior-authorization, step-therapy, or quantity-limit marker. Standard Formulary. |
| BCBS of Texas | BCBS of Texas lists colesevelam as a nonpreferred generic, with no prior-authorization, step-therapy, or quantity-limit marker listed. Performance Annual, 2026. |
What are the side effects of colesevelam?
Constipation, indigestion, and nausea are common concerns. Colesevelam is contraindicated with triglycerides above 500 mg/dL, a history of hypertriglyceridemia-induced pancreatitis, or prior bowel obstruction. Large tablets can be difficult to swallow. Full safety information.
Does colesevelam reduce heart attacks or strokes?
The cited trial establishes LDL lowering. Colesevelam’s effect on cardiovascular morbidity and mortality has not been determined; outcome results for older bile-acid sequestrants should not be assigned to colesevelam. Read the supporting evidence.
Is colesevelam right for you?
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