Welchol vs Cholestyramine – Uses, Dosage, Side Effects, Differences


It is the brand name of a drug called colesevelam that lowers LDL cholesterol in the blood. It belongs to a class of medications called bile acid-binding resins. Bile acid is a hydroxylated steroid synthesized in the liver from cholesterol.

This medication is produced by Daiichi Sankyo, the 2nd largest pharmaceutical company in Japan. It was first approved by the Food and Drug Administration in 2000.


It is typically used to lower blood sugar in individuals with high blood sugar levels. In the United States, there are more than 31 million people with diabetes and over 450 million worldwide. People with diabetes have a higher risk of life-threatening complications, like – heart disease, vision loss, kidney failure, amputation of toes or legs, stroke, premature death.

This medication is also used to lower LDL cholesterol. Having a high LDL (bad) cholesterol is strongly associated with an increased risk of heart disease. This is because LDL cholesterol tends to clog and harden arteries. Moreover, high levels of LDL cholesterol increase the risk of stroke, by facilitating the formation of cholesterol plaque along the inside of artery walls.

Occasionally, this medication is used together with other cholesterol-lowering drugs, like – fluvastatin (Lescol), atorvastatin (Lipitor), pravastatin (Pravachol), lovastatin (Mevacor), simvastatin (Zocor), or rosuvastatin (Crestor).

Note – while taking this medication, it is recommended to avoid eating foods that are high in cholesterol or fat since it will not be as effective in lowering your LDL cholesterol levels.


The usual recommended dose is 6 tablets once per day or 3 tablets two times per day.

Side Effects And Precautions Of Colesevelam

Common side effects may include:

  • nausea;
  • constipation;
  • indigestion;
  • upset stomach;
  • headaches;
  • vomiting;
  • a sore throat;
  • gas;
  • flu symptoms;
  • a runny nose;
  • muscle pain;
  • feeling weak.

Tell your healthcare professional about all the medicines you take, including over-the-counter and prescription medicines, herbal supplements, and vitamins. Particularly tell your healthcare professional if you take:

  • glimepiride (Duetact, Amaryl, Avandaryl);
  • cyclosporine (Gengraf, Sandimmune, Neoral);
  • phenytoin (Dilantin);
  • glipizide (Glucotrol XL, Glucotrol);
  • warfarin (Jantoven, Coumadin);
  • metformin (Glucophage XR, Glucophage, Glumetza, Fortamet);
  • oral contraceptives containing ethinyl estradiol and norethindrone (Femcon FE, Gildess, Norethrin);
  • olmesartan (Tribenzor, Azor, Benicar);
  • levothyroxine (Tirosent, Synthroid, Levo-T, Levoxyl, Unithroid, Levothroid);
  • glyburide (Glynase, Diabeta, Glucovance).

Some people may experience an allergic reaction, with symptoms including:

  • swelling of the face, mouth, tongue, lips, or throat;
  • unusual hoarseness;
  • trouble talking;
  • problems breathing;
  • tightness in the chest or throat;
  • wheezing;
  • red, swollen, blistered, or peeling skin without or with fever;
  • hives.

There are no clinical studies regarding the safe use of this medication by pregnant and nursing women, therefore, if you are pregnant or breastfeeding a baby avoid this medication and lower your LDL cholesterol with lifestyle changes. In addition, the consumption of caffeine and alcohol may increase the risk of side effects.


It is a drug that is part of the family of drugs called – bile acid-binding resins. This drug works by removing bile acid from the human body. It can be found under the brand name of Questran.

It is produced by Par Pharmaceutical Companies, Inc, a pharmaceutical company with headquarters in Chestnut Ridge, NY. This medication was first approved by the Food and Drug Administration in 1973.


It is used to treat itching caused by a blockage of the bile ducts of the gallbladder (a 4-inch, pear-shaped organ that is positioned under the liver). Moreover, it is used to lower high levels of LDL (bad) cholesterol in the blood.

Additionally, this medication is occasionally prescribed for the rapid elimination of leflunomide (a drug approved to treat adult rheumatoid arthritis).


The initial recommended dose is 1 packet one time per day. The maintenance dosage is 2 to 4 packets divided into 2 doses per day. The maximum recommended dose is 6 packets per day.

Side Effects And Precautions Of Questran

Common side effects may include:

  • bloating;
  • diarrhea;
  • skin rash;
  • mild constipation;
  • irritation of the tongue;
  • ringing in the ears;
  • dizziness;
  • stomach pain;
  • muscle or joint pain;
  • irritation around the rectal area;
  • a sour taste in the mouth;
  • weight changes;
  • loss of appetite;
  • nausea.

Rare side effects may include:

  • severe stomach pain;
  • blood in the urine;
  • easy bruising;
  • tarry stools;
  • feeling short of breath;
  • ongoing constipation.

Long-term use of this medication may cause a deficiency of vitamin A, vitamin D, vitamin E, and vitamin K. Also, before taking this drug, tell your healthcare provider if you have or have ever had:

  • bleeding problems;
  • heart disease;
  • high blood chloride levels;
  • chest pain;
  • kidney problems;
  • gallbladder disease;
  • allergies to any type of medicine;
  • phenylketonuria, a rare inherited disorder that causes phenylalanine to build up in the body;
  • liver problems;
  • a complete blockage of the biliary tract;
  • type 2 diabetes mellitus;
  • an addiction to alcohol or any other drug;
  • problems with staying hydrated;
  • low blood volume;
  • underactive thyroid;
  • hemorrhoids;
  • severe constipation;
  • a bowel blockage.

Tell your healthcare professional if you are breastfeeding and avoid taking it since there are no studies regarding the safe use of this medication by nursing women. Also, if you are pregnant or plan on getting pregnant, avoid this medication because it may harm the unborn baby.

Welchol vs Cholestyramine – Differences

Welchol (active ingredient – colesevelam) is a lipid-lowering and glucose-lowering drug used to lower LDL cholesterol in the blood. It belongs to a group of drugs called bile acid sequestrants. This drug is occasionally used together with other cholesterol-lowering drugs (statins). However, it should not be used by patients who have type 1 diabetes or diabetic ketoacidosis.

Cholestyramine is a drug that reduces LDL cholesterol levels in the blood. It belongs to a class of medications called bile acid sequestrants.

In conclusion, both these drugs are part of the same family of drugs (bile acid sequestrants) but have different active ingredients. Both have similar effects in the body as well as plenty of side effects. Plus, neither treats the real cause of high LDL cholesterol – an unhealthy lifestyle.

4 Ways To Lower LDL Cholesterol

#1 Omega 3

These essential fatty acids can help raise HDL cholesterol and lower LDL cholesterol. Healthy foods high in omega 3 fatty acids include – chia seeds, flax seeds, red kidney beans, walnuts, almonds, broccoli, navy beans, and pinto beans.

#2 Physical Exercise

Regular physical exercise can provide other cardiovascular benefits, like – reduced blood pressure and weight loss. Also, at least 30 minutes of moderate physical exercise per day has been shown to decrease LDL cholesterol levels.

#3 Reduce Your Stress

According to studies, there is a link between excess emotional stress and high LDL and total cholesterol levels. The best method to reduce your stress is mindfulness meditation. Aim for about half an hour a day.

#4 Fiber-Rich Foods

Dietary fiber binds to cholesterol and eliminates it from the body. You can increase your dietary fiber intake by getting more whole fruits, grains, legumes, seeds, vegetables, and nuts.

Image credit – Shutterstock & Getty

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