Dosing and uses of Colestid (colestipol)
Adult dosage forms and strengths
granules, bottle
- 5g
granules, packets
- 5g
tablet
- 1g
Hyperlipidemia
Tablets: 2 g PO qDay or q12hr; increases of 2 g should occur at 1- or 2-month intervals; titrate not to exceed 16 g/day
Granules: 5 g PO qDay; increases of 5 g should occur at 1- or 2-month intervals; titrate not to exceed 30 g/day
Overdose Management
Generally considered safe in acute overdose although not formally studied
Adverse drug reactions in overdose may include peripheral neuropathy, diarrhea, increase K+, myopathy , rhabdomyolysis, acute renal failure, elevated liver function tests, eye lens opacities)
Check renal function tests, urine myoglobin, CPK, LFT's
Administration
Mix dry form in water/fluids to avoid inhalation or esophageal distress
Mix granules in fluids or food; take before meals
Do not crush, chew, or cut tablets
Take 1 tablet at a time; swallow with water or other fluids
Other Information
Monitor: Serum cholesterol, triglycerides
Other Indications & Uses
Used in relief of pruritus associated with elevated levels of bile
Used to decrease plasma half-life of digoxin in toxicity
Hypercholesterolemia (adjunct to diet for Type IIa & IIb hyperlipidemia)
Pediatric dosage forms and strengths
Safety & efficacy not established
Geriatric dosage forms and strengths
Tablets: 2 g PO qDay or q12hr; increases of 2 g should occur at 1- or 2-month intervals; titrate not to exceed 16 g/day
Granules: 5 g PO qDay; increases of 5 g should occur at 1- or 2-month intervals; titrate not to exceed 30 g/day
Colestid (colestipol) adverse (side) effects
>10%
Gastrointestinal (mostly)
Constipation
1-10%
Stomach pain
Belching
Nausea/vomiting
Flatulance
Diarrhea
Dizziness
Anxiety
Vertigo
Fatigue
Drowsiness
Frequency not defined
Heartburn
Steatorrhea
Malabsorption of fat-soluble vitamins
Gallstones
Dysphagia
GI bleeding
Cholecystitis
Peptic ulceration
Transient esophageal obstruction
Warnings
Contraindications
Hypersensitivity to colestipoL
Bowel obstruction
Cautions
Increased risk of bleeding due to hypoprothrombinemia from vitamin K deficiency
May interfere with fat absorption, and decrease absorption of fat-soluble vitamins (A, D, E, K)
May worsen pre-existing constipation
Take other medications 1 hr before or 4 hr after colestipoL
If significant increase in triglycerides, consider dose reduction, discontinuation or alternatives
Pregnancy and lactation
Pregnancy category: C
Lactation: use caution; may interfere with vitamin absorption in infants
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Colestid (colestipol)
Mechanism of action
Forms a soluble complex after binding to bile acid, increasing fecal loss of bile acid-bound low-density lipoprotein cholesteroL
Pharmacokinetics
Onset: initial effect: 24-48 hr; max effect: 1 wk
Bioavailability: Not absorbed
Metabolism: Not metabolized
Excretion: feces 100%
