acarbose vs colesevelam
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of acarbose and colesevelam. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Precose
Welchol
Acarbose is a medicine that helps lower blood sugar levels in people with type 2 diabetes. It works best when used with diet and exercise.
Colesevelam is a medicine that helps lower bad cholesterol (LDL-C) and control blood sugar in adults. It can also lower LDL-C in children ages 10-17 with certain cholesterol problems.
Acarbose is used to help control blood sugar in adults with type 2 diabetes. You should use it along with a healthy diet and regular exercise. This medicine helps to keep your blood sugar from getting too high after you eat.
This medicine can help lower high LDL cholesterol in adults and children (10-17 years old) who have primary hyperlipidemia or heterozygous familial hypercholesterolemia. These conditions mean you have high levels of bad cholesterol in your blood. Colesevelam can also help improve blood sugar control in adults with type 2 diabetes.
Acarbose slows down the digestion of carbohydrates (sugars and starches) in your body. It does this by blocking certain enzymes in your small intestine that break down carbs. This helps to prevent a sharp rise in blood sugar after meals.
Colesevelam is a bile acid sequestrant. It works by binding to bile acids in your gut. This helps your body get rid of cholesterol and can also lower blood sugar levels.
- • Gas
- • Diarrhea
- • Abdominal pain
- • Constipation
- • Upset stomach
- • Nausea
- • Accidental injury
- • Weakness
- Hypoglycaemia 269
- Nausea 203
- Blood Glucose Increased 200
- Dizziness 160
- Diarrhoea 147
- Diarrhoea 121
- Dyspnoea 72
- Cough 64
- Muscle Spasms 61
- Fatigue 59
You should not take acarbose if you have diabetic ketoacidosis or cirrhosis. Also, do not take it if you have inflammatory bowel disease, colon ulcers, or any bowel obstruction. This medicine can cause liver problems in some people. Tell your doctor right away if you develop symptoms like yellowing of the skin or eyes.
Colesevelam can raise your triglyceride levels, which could cause pancreatitis. Tell your doctor right away if you have severe stomach pain. This medicine may also cause bowel obstruction, especially if you have stomach problems or have had major surgery on your stomach or intestines. Colesevelam can also lower the amount of fat-soluble vitamins your body absorbs.
Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if acarbose will harm your unborn baby. Talk to your doctor if you are breastfeeding or plan to breastfeed. It is not known if acarbose passes into breast milk.
This medicine is not absorbed into your body, so it is not expected to harm your baby during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. This medicine is also not expected to pass into breast milk.
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How to Read This acarbose vs colesevelam Comparison
acarbose is classified in the Alpha-Glucosidase Inhibitor drug class, while colesevelam sits within the Bile Acid Sequestrant (Diabetes) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, acarbose has 979 submissions while colesevelam has 377. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for acarbose or colesevelam.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.