The Medical Letter on Drugs and Therapeutics
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1285
In Brief: A New Indication for Colesevelam (Welchol)
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Med Lett Drugs Ther. 2008 May 5;50(1285):33
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 Select a term to see related articles  2008   A New Indication for Colesevelam (Welchol)   Cholesterol   Colesevelam   diabetes   Glucophage   In brief   insulin   Issue 1285   May 5   Metformin   page 33   Page 37   Sulfonylurea   type 2 diabetes   volume 50   Welchol 

Colesevelam (Welchol - Daiichi Sankyo - Med Lett Drugs Ther 2000; 42:102), a bile-acid sequestrant used to lower LDL cholesterol, has been approved by the FDA as an adjunct to diet and exercise in the treatment of type 2 diabetes. In unpublished studies summarized in the package insert, patients with type 2 diabetes taking metformin (Glucophage, and others), a sulfonylurea or insulin (each as either monotherapy or in combination with other anti-diabetic agents) were given colesevelam 3800 mg per day or placebo; colesevelam significantly reduced glycosylated hemoglobin (A1c) by about 0.5% more than placebo in all three trials. The mechanism is unclear.

Colesevelam can cause constipation, nausea and dyspepsia, increase serum triglyceride concentrations, and interfere with absorption of other oral drugs. One month's treatment with Welchol obtained from drugstore.com would cost about $200. Medical Letter consultants are not enthusiastic about prescribing it for this indication.

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