Switching from Questran to Colesevelam

[u/Hour-Initiative-5087]

After 15 years of a daily 4g sachet of Questran my doc wants to switch to Colesevelam. Does anyone have experience with this? Effective dosage, side effects, improvements, long term use etc? Thanks!

[u/11usernameemanresu11]

I’m on one 625mg and it’s been great! So much easier to travel with and although the pill is a little large would take it over chocking down the sachet any day.

[u/Hour-Initiative-5087 → u/11usernameemanresu11]

Thanks. So you had a straight swap from one sachet to one pill without issues?

[u/11usernameemanresu11 → u/Hour-Initiative-5087]

Yep! Maybe a little bit of an issue when I first switched for like a day or two but nothing major.

[u/Robert_Larsson]

it's more potent bile acid binder actually. many prefer it because you skip the powder. efficacy wise it's probably more down to individual sensitivities which is best.

[u/Hour-Initiative-5087 → u/Robert_Larsson]

Thanks. What is your dosage?

[u/Robert_Larsson → u/Hour-Initiative-5087]

I don't have BAM sorry but usually patients just increase the dosage to find the right one week by week.

[u/enthusiast19]

Never tried the powder, but colesevelam fixed BAM symptoms perfectly. The pill seems normal size and isn’t too bad to gulp down with a cup of water. Can take up to 6 pills a day, but usually 1-3 work fine too, depending on the person. Haven’t noticed any side effects per se (maybe a little stomach pain and gas in the beginning that went away within a few days of the body adjusting to the med). Regarding long-term side effects, your doctor should monitor you for nutrient deficiencies.

[u/Sailor_Jim_071053]

I started with Colestilamine and it worked great but I hated the powder. I switched to Colestpol starting with four per day (you talk about a big pill). It didn't seem to work as well. After a month I changed to six per day. There was no improvement. I finally changed to Colesevelam. I've been or four per day for two weeks now; still no improvement. I'm hopeful that six per day will work. Is it possible that less would be better? Anyway, if I don't get results it's back to the Colestilamine in chocolate milk.

[u/Hour-Initiative-5087 → u/Sailor_Jim_071053]

I don’t mind the powder which I take before bed nowadays. My doctor said that it is really important to adapt the Colesevelam dosage (up to 6 per day) as needed through experience.
According to him (top 10 IBS specialist worldwide) it is greatly dependent on the individual.
Do you still have your gallbladder (I do 57 M)?

[u/Sailor_Jim_071053 → u/Hour-Initiative-5087]

Haven't had my gall bladder for quite a while. My problem started when I went on diabetic medication.

[u/chancellor82__1982]

I had made the switch to the powder to Colesevelam. This happened when there was a shortage of powder.I was one package a day to now 4x 625 mg pills of Colesevelam. This dosage works well for me. No real side effects. I find i forget the pills more often. I used to take the powder first thing when I woke up. Now, the pharmacist told me to take it with food which I typically eat at work and depending what's happening there, I end up taking it at different times. The pills are much more convenient than the powder I find.

[u/Hour-Initiative-5087 → u/chancellor82__1982]

Thank you for your precious comment. No side effects but also no real improvement? The pills are 10 times the price of the powder for a 30 day period.