How Does Colesevelam Work?
Colesevelam is part of a class of drugs known as bile acid sequestrants. It works by binding to bile acids in the intestines, preventing them from being reabsorbed into the body. Bile acids are made in the liver from broken-down
cholesterol. Therefore, removing these substances from your body helps lower your blood cholesterol. Colesevelam can lower total and
LDL cholesterol, while slightly
raising HDL cholesterol ("good" cholesterol).
It is not yet known how colesevelam works to help control blood sugar in people with
type 2 diabetes. However, it is clear that the drug works within the digestive tract, since it is not absorbed into the rest of the body.
Colesevelam has been evaluated in several different studies for cholesterol and
diabetes.
Effects of Colesevelam on Cholesterol
Since colesevelam can lower total and LDL
cholesterol levels (along with raising
HDL), a person can decrease his or her risk of developing certain health problems by taking it.
In clinical research studies, people taking colesevelam 3800 to 4500 mg daily were able to:
- Reduce LDL cholesterol by 15 to 18 percent
- Reduce total cholesterol by 7 to 10 percent
- Raise HDL cholesterol by 3 percent.
The combination of colesevelam with an HMG-CoA reductase inhibitor (known more commonly as a statin) can further
lower cholesterol levels.
Effects of Colesevelam on Diabetes
Studies have shown that colesevelam can help lower blood sugar in people with type 2 diabetes. These studies used colesevelam in combination with other
diabetes medications, such as
metformin, sulfonylureas, and
insulin. These studies showed that adding colesevelam to this regimen can help lower fasting blood sugar and hemoglobin A1c (HbA1c), a measure of long-term blood sugar control.
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