Therapeutic: Npid-lowering agents
Pharmacologic: bile acid sequestrants
Adjunctive therapy to diet and exercise for the reduction of LDL cholesterol in patients with primary hypercholesterolemia; may be used alone or in combination with hepatic hydroxymethylglutaryl coenzyme A (HMG CoA) reductase inhibitor. Adjunctive therapy to diet and exercise to improve glycemic control in patients with type 2 diabetes.
Binds bile acids in the GI tract. Result in increased clearance of cholesterol. Mechanism for lowering blood glucose unknown. Therapeutic Effects: Decreased cholesterol and blood glucose.
Adverse Reactions/Side Effects
GI: constipation, dyspepsia.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Remind patients to take medication as directed to control hyperlipidemia even though they are asymptomatic.
Counsel patients about additional interventions to help control lipid disorders and improve cardiovascular health, including dietary modification, regular exercise, moderation of alcohol consumption, and smoking cessation.
Absorption: Not absorbed; action is primarily local in the GI tract.
Metabolism and Excretion: Unknown.
TIME/ACTION PROFILE (cholesterol-lowering effect)
|ROUTE ||ONSET ||PEAK ||DURATION |
|PO ||24–48 hr ||2 wk ||unknown |
Contraindicated in: Hypersensitivity; Bowel obstruction; Triglycerides >500 mg/dL; History of pancreatitis due to hypertriglyceridemia.
Use Cautiously in: Triglycerides >300 mg/dL; Dysphagia, swallowing disorders, severe GI motility disorders, or major GI tract surgery; Pregnancy, lactation, or children (safety not established).
Drug-Drug: May ↓ absorption of glyburide, levothyroxine, phenytoin, estrogen-containing oral contraceptives (give ≥4 hr before colesevelam).
PO (Adults): 3 tablets twice daily or 6 tablets once daily.