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This medication carries several important safety warnings that you should be aware of. It is crucial to understand these risks and discuss any concerns with your healthcare provider.

• Risk of Pancreatitis: Colesevelam (Welchol) may increase blood triglyceride levels, potentially leading to pancreatitis, which is inflammation of the pancreas. Symptoms can include nausea, vomiting, and abdominal pain that may radiate to your back. If you experience these symptoms, discontinue use immediately and seek medical attention. Individuals with high triglyceride levels (300 mg/dL to 500 mg/dL), a history of pancreatitis, or diabetes are at greater risk.

• Digestive Tract Blockage: This medication may cause blockage in the digestive tract, particularly in those with pre-existing constipation or digestive issues. If you have difficulty swallowing, consider using the powder form to reduce choking risk. Notify your provider immediately if you experience severe abdominal pain, new or worsening constipation, bloody stools, or vomit resembling coffee grounds.

• Vitamin Absorption Concerns: Colesevelam (Welchol) can interfere with the absorption of vitamins A, D, E, and K. To maintain healthy vitamin levels, your provider may recommend supplements. Ensure these are taken at least four hours prior to taking colesevelam to prevent interaction.

• Drug Interactions: This medication may reduce the effectiveness of other oral medications, including birth control and thyroid treatments. To minimize interaction, take other medications at least four hours before colesevelam.

• Phenylketonuria (PKU) Warning: Certain powder formulations of colesevelam may contain phenylalanine, which is harmful to individuals with PKU. Verify with your pharmacist if your specific product is safe.

Contraindications:

• Do not use colesevelam if you have blood triglyceride levels over 500 mg/dL, a history of pancreatitis linked to high triglycerides, or a history of stomach or intestinal blockages. Consult your healthcare provider if any of these conditions apply to you.

Common side effects:

• Constipation
• Indigestion
• Nausea
• Weakness

Less common but important to monitor:

• Sore throat
• Flu-like symptoms
• Runny nose
• Muscle aches
• Accidental injury
• Low blood sugar (when used alongside other diabetes treatments or if meals are skipped/exercise is unusually intense)
• High blood sugar

Serious side effects:

• Signs of pancreatitis (nausea, vomiting, severe stomach pain radiating to the back)
• Severe constipation
• Stomach pain
• Blood in the stool
• Serious allergic reaction (rash, itching/swelling especially of the face/tongue/throat, severe dizziness, trouble breathing)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Raloxifene
• Warfarin

Interactions with low risk that usually do not require a change in therapy:

• metoprolol
• Propranolol
• Timolol