Two medicines, side by side
Colesevelam vs cholestyramine
Colesevelam and cholestyramine are both labeled for high cholesterol. Drugs@FDA records approvals of colesevelam since 2000 and of cholestyramine since 1973. Pharmacies paid $0.262 per colesevelam 625 mg tablet and $0.834 per packet (Cholestyramine packet) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Colesevelam, “Primary Hyperlipidemia: Colesevelam hydrochloride, the active pharmaceutical ingredient, is a non-absorbed, lipid-lowering polymer that binds bile acids in the intestine, impeding their reabsorption.”; Cholestyramine, “and an effect on serum lipids similar to that of cholestyramine for oral suspension) plus either nicotinic acid or lovastatin.”
Check it at the source: the colesevelam FDA label on DailyMed (effective December 28, 2023); the cholestyramine FDA label on DailyMed (effective August 20, 2026).
Highlights of the colesevelam record
Colesevelam (Welchol) · label of December 28, 2023
Used for
From the label: indicationsColesevelam hydrochloride is a bile acid sequestrant indicated as an adjunct to diet and exercise to: reduce elevated low-density lipoprotein cholesterol (LDL-C) in adults with primary hyperlipidemia ( 1.1 ). reduce LDL-C levels in boys and postmenarchal girls, 10 to 17 years of age, with heterozygous familial hypercholesterolemia (HeFH), unable to reach LDL-C target levels despite an adequate trial of diet and lifestyle modification ( 1.1 ). improve glycemic control in adults with type 2 diabetes mellitus ( 1.2 ). […]
On the market
- Earliest approval on file
- May 26, 2000
- Generic labelers
- 15 labelers
- Pharmacy cost
- $0.262 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the cholestyramine record
Cholestyramine (Questran) · label of August 20, 2026
Used for
From the label: indicationsCholestyramine for oral suspension, USP powder is indicated as adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia (elevated low-density lipoprotein [LDL] cholesterol) who do not respond adequately to diet. […]
On the market
- Earliest approval on file
- August 3, 1973
- Generic labelers
- 15 labelers
- Pharmacy cost
- $0.834 per packet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Colesevelam label of December 28, 2023, Cholestyramine label of August 20, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do colesevelam and cholestyramine differ on the record?
How each works, in its label's words: Colesevelam, “Primary Hyperlipidemia: Colesevelam hydrochloride, the active pharmaceutical ingredient, is a non-absorbed, lipid-lowering polymer that binds bile acids in the intestine, impeding their reabsorption.”; Cholestyramine, “and an effect on serum lipids similar to that of cholestyramine for oral suspension) plus either nicotinic acid or lovastatin.”
Both are in FDA's class bile acid sequestrants.
Generics: colesevelam since 2018; cholestyramine since 1996 (Drugs@FDA).
| Colesevelam | Cholestyramine | |
|---|---|---|
| Labeled for | High cholesterol, Type 2 diabetes | High cholesterol |
| Pharmacologic class | Bile Acid Sequestrant | Bile Acid Sequestrant |
| How it works (label) | Primary Hyperlipidemia: Colesevelam hydrochloride, the active pharmaceutical ingredient, is a non-absorbed, lipid-lowering polymer that binds bile acids in the intestine, impeding their reabsorption. | and an effect on serum lipids similar to that of cholestyramine for oral suspension) plus either nicotinic acid or lovastatin. |
| Half-life (label) | n/a | n/a |
| Earliest approval on file (Drugs@FDA) | May 26, 2000 | August 3, 1973 |
| First generic approved | May 16, 2018 | February 22, 1996 |
| Generic labelers (NDC) | 15 labelers | 15 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.262 per tablet (Colesevelam 625 mg tablet) | $0.834 per packet (Cholestyramine packet) |
| 12-month price change | -2% | -5% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 2,013 | 12,024 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to colesevelam
- every medicine labeled for the same conditions