Bile acid malabsorption: colesevelam

About colesevelam

Colesevelam is licensed for treating primary hypercholesterolaemia in adults. Primary hypercholesterolaemia is a condition in which levels of cholesterol in the blood are higher than normal.

Colesevelam works by binding to bile acids in the intestine and stopping them from being reabsorbed. Bile acids are made from cholesterol. When colesevelam binds to bile acids, the body uses cholesterol to make more bile acid, so reducing cholesterol levels in the blood.

Colesevelam is sometimes used for bile acid malabsorption because when it binds to bile acids it reduces their effects on the colon, including diarrhoea. Colesevelam does not have a UK licence for treating bile acid malabsorption.

There are 2 other drugs that work in a similar way and are licensed for treating hypercholesterolaemia. These are called colestyramine and colestipol. They are also sometimes used to treat bile acid malabsorption. Colestipol is not licensed for this; colestyramine is licensed for treating diarrhoea in some conditions that may cause bile acid malabsorption. These drugs are powders which have to be mixed with water or another liquid before they are taken, and some people find that they have an unpleasant taste. Colestyramine and colestipol have some side effects including constipation (when stools are not passed regularly), nausea (feeling sick), stomach rumbling, flatulence (wind), bloating and abdominal pain.