Colestipol Hydrochloride

Colestid

Colestid, featuring colestipol hydrochloride, is a bile acid sequestrant used to lower cholesterol levels, particularly in patients unable to take statins. This FDA-approved medication works by binding to bile acids in the intestines, prompting the liver to use cholesterol from the blood to produce more bile acids, thus reducing blood cholesterol. Available in both granules and tablets, it is typically administered starting with a dose of one packet or scoop of granules or one to two tablets twice daily. Common side effects include nausea and constipation, with more serious risks like nutritional deficiencies. It is important to adhere strictly to dosing instructions to avoid complications, and consultation with a healthcare provider is recommended to ensure safety and effectiveness.

Product Overview

Colestid, containing the active ingredient colestipol hydrochloride, is a cholesterol-lowering medication classified as a bile acid sequestrant. It is FDA-approved for treating high cholesterol, a condition that increases the risk of heart disease. By binding to bile acids in the intestine, Colestid prevents their absorption into the bloodstream. The liver needs bile acids to digest fats and then uses cholesterol from the blood to produce more bile acids, effectively lowering blood cholesterol levels.

Colestid is available in granules (bottles and packets) and tablet forms, each containing 5 grams and 1 gram of colestipol. The typical starting dose for adults is one packet or a scoop of granules once or twice daily or one to two tablets twice daily, adjusted based on individual response and cholesterol levels. It is suitable for adults, particularly those who cannot take statins. However, its use in pediatric patients is not recommended without specific advice from a healthcare provider.

Common side effects include nausea, constipation, and gas. Serious side effects may include severe constipation, gastrointestinal blockage, and nutritional deficiencies due to impaired absorption of fat-soluble vitamins. Patients are advised to follow dosing instructions closely to prevent issues such as choking from dry granules and interactions with other medications. Colestid should be stored at room temperature, away from moisture and direct light. In case of a missed dose, take it as soon as possible unless it is near the time for the next dose. Never double the dose. In case of suspected overdose, seek immediate medical attention. Before starting Colestid, consult with a healthcare provider to understand all potential risks and benefits.

Uses of Colestid

• Treats high-cholesterol

How to Use Colestid?

Dosage

Here are the available forms and strengths for Colestid:

Granules, bottle

• 5gms

Granules, packets

• 5gms

Tablet

• 1gms

Recommended Dosage for Different Patients

For Adults with High Cholesterol

• Initial Dose: The usual starting dose for adults is one packet or one scoop (5 grams of colestipol) once or twice a day or one tablet (1 gram) twice a day.
• Maintenance Dose: Depending on the patient’s response and cholesterol levels, the dose may gradually increase. The typical maintenance dose ranges from 2 to 16 grams daily, divided into one or two doses. It should not exceed 30 grams per day.

Special Considerations

• Elderly Patients: Start with the lower end of the dosing range due to the greater frequency of decreased hepatic, renal, or cardiac function and concomitant disease or other drug therapy in elderly patients. The dose may be adjusted based on efficacy and tolerability.
• Patients with Constipation: Start with a low dose to minimize the risk of exacerbating constipation. Adjust the dose gradually based on tolerance and therapeutic response.
• Patients Taking Other Medications: Since Colestid can interfere with the absorption of many other medications, it should be taken at least 1 hour before or 4 hours after other medicines.

For Pediatric Patients

• The safety and effectiveness of Colestid in pediatric patients have not been established, so it is generally not recommended for children unless specifically prescribed by a healthcare provider.

Monitoring and Adjustments

• Regular monitoring of cholesterol levels is recommended to adjust the dosage of Colestid as necessary.
• Patients should be assessed regularly for dietary adherence and other non-pharmacological interventions, such as exercise and weight management, which can influence drug effectiveness.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Never take it in its dry form, as it could cause choking.
• Add the prescribed amount of Colestid to 3 ounces or more of water, milk, flavored drink, or your favorite juice.
• If using a carbonated drink, mix the powder slowly in a large glass to prevent excessive foaming.
• Stir until it is completely mixed (it won’t dissolve) before drinking.
• After consuming the liquid with the medicine, rinse the glass with a little more liquid to ensure you get all the medicine.
• You can also mix Colestid with milk in hot or regular breakfast cereals or thin soups like tomato or chicken noodle soup. Alternatively, add it to pulpy fruits such as crushed pineapple, pears, peaches, or cocktails.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Colestid Work?

Colestid, known generically as colestipol, is a cholesterol-lowering medication that belongs to a class of drugs known as bile acid sequestrants. It works by binding to bile acids in the intestine, preventing their reabsorption into the bloodstream. Since bile acids are made from cholesterol, the liver needs to use more cholesterol to make new bile acids, thus lowering cholesterol levels in the blood. This mechanism helps reduce low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol, and can be beneficial in reducing the risk of heart disease when used alongside diet and lifestyle changes.

Important Safety Information

Side Effects

Common side effects of this medication may include:

• Nausea
• Gas
• Burping
• Constipation
• Hemorrhoids

Serious side effects of this medication may include:

• Severe constipation
• Severe stomach pain
• Black, bloody, or tarry stools
• Unexplained bruising or bleeding
• Allergic reaction (such as rash, itching, swelling, severe dizziness, or difficulty breathing)

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Vitamin Absorption and Pregnancy: Colestipol (Colestid) binds to bile acids, which are essential for fat breakdown. This action may interfere with the normal absorption of fats and essential nutrients like folic acid and vitamins A, D, E, and K. Such deficiencies are particularly significant during pregnancy. If you are pregnant, planning to become pregnant, or breastfeeding, inform your healthcare provider before starting or continuing Colestid.
• Bleeding: Long-term use of Colestid may increase the risk of bleeding. Report any signs of bleeding, such as unusual bruising, black or bloody stools, bleeding gums, blood in your urine, or persistent bleeding from cuts, as well as any symptoms of dizziness or unusual weakness, to your healthcare provider immediately.
• Constipation: To manage this side effect, increase your intake of fluids, engage in regular physical activity, and consider adding more fiber to your diet. If these measures do not help, a stool softener or laxative may be necessary. Discuss persistent constipation with your healthcare provider.
• Drug Interactions: This medication may interfere with the absorption of other medications due to its bile acid-binding properties. To avoid interactions, take different medications at least one hour before or four hours after Colestid. Always consult your healthcare provider or pharmacist to determine the best medication timing.
• Choking Hazard: Do not consume Colestid granules in their dry form, as they pose a choking risk. Always mix the granules with water or another suitable liquid before ingestion.
• Phenylketonuria (PKU): The flavored variants of Colestid contain phenylalanine, which may be harmful if you have phenylketonuria (PKU). Discuss alternative treatments with your healthcare provider if you have PKU to avoid adverse health effects.

Precautions

• Allergies: Inform your doctor or pharmacist if you have any allergies, especially to colestipol, or have experienced reactions to other medications. This medication may also contain inactive ingredients that could trigger allergic reactions or other issues.
• Medical History: Disclose your complete medical history to your healthcare provider, particularly if you have had issues with swallowing, constipation, hemorrhoids, or kidney disease.
• Nutrient Absorption: Since colestipol can interfere with the absorption of certain nutrients such as folic acid and fat-soluble vitamins (A, D, E, K), your doctor might recommend a multivitamin supplement. Always consult your doctor for tailored advice.
• Surgical Procedures: Before undergoing any surgery, inform your surgeon or dentist about all the products you use, including prescription medications, over-the-counter drugs, and herbal supplements.
• Age-Related Sensitivity: Older adults may be more prone to experiencing side effects from this drug, particularly constipation.
• Pregnancy: Use this medication during pregnancy only if clearly necessary, as it may affect the absorption of essential nutrients. Discuss all potential risks and benefits with your doctor.
• Breastfeeding: While colestipol is unlikely to pass into breast milk, it could impact nutrient absorption. Consult your doctor before breastfeeding to ensure safety.

Contraindications 

• Hypersensitivity: Colestid is contraindicated for individuals with known hypersensitivity to colestipol or any of its ingredients.
• Complete Biliary Obstruction: Colestid should not be used by patients experiencing complete biliary obstruction, where bile is not being secreted into the intestine.
• Phenylketonuria (PKU) and Colestid Orange Granules: Individuals with phenylketonuria should avoid using Colestid Orange Granules, as they contain phenylalanine.

Missed Dose

If you’ve missed a dose of Colestid (micronized colestipol hydrochloride), here’s what you should take as soon as possible. However, if your next scheduled dose is approaching, skip the missed dose and return to your regular dosing schedule. Do not take a double dose to compensate for the missed one.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose 

Although there are no reported cases of Colestid overdose, the main concern would be the potential for gastrointestinal tract obstruction. If you suspect an overdose of Colestid, it is crucial to seek medical attention immediately.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

• Keep the medicine at room temperature.
• Do not refrigerate or freeze it.
• Store it in a closed container, away from heat, moisture, and direct light.
• Ensure it is out of the reach of children.
• If the medicine is expired or no longer needed, properly discard it.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Colestid Interactions

• Thyroid Hormones (e.g., levothyroxine): Colestid can reduce the absorption of thyroid hormones, potentially leading to reduced efficacy. It’s recommended to take thyroid hormone medications at least 4 hours before or after taking Colestid.
• Fat-Soluble Vitamins (A, D, E, K): Since Colestid interferes with fat absorption, it can also reduce the absorption of fat-soluble vitamins, possibly leading to deficiencies.
• Statins (e.g., simvastatin, atorvastatin): While Colestid can be used in combination with statins to enhance cholesterol-lowering effects, it can also affect the absorption of statins. Taking statins 1 hour before or 4 hours after Colestid can help avoid this interaction.
• Warfarin (Coumadin): Colestid can alter the effects of warfarin, an anticoagulant, either increasing or decreasing its effectiveness due to changes in vitamin K absorption, which is crucial for blood clotting.
• Digitalis (e.g., digoxin): Colestid can decrease the absorption of digoxin, which is used to treat heart conditions. Monitoring digoxin levels and efficacy when starting or adjusting Colestid treatment is advisable.
• Diuretics (e.g., hydrochlorothiazide): Absorption of certain diuretics can be reduced by Colestid, potentially diminishing their effectiveness in controlling blood pressure or fluid retention.
• Antibiotics (e.g., tetracycline, ciprofloxacin): Colestid can bind to these antibiotics in the gastrointestinal tract, reducing their effectiveness. It is recommended to take antibiotics at least 1 hour before or 4 hours after Colestid to minimize this interaction.

[Note: This isn’t a complete list, and there could be other drugs that interact with Colestid. Make sure to tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

Colestid Alternatives

• Questran (cholestyramine)
• Questran Light (cholestyramine)
• Welchol (colesevelam) 
• Zetia (ezetimibe)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Is it safe to discontinue Colestid?

It is important not to stop taking colestipol without consulting your healthcare provider. Discontinuing this medication could cause your blood cholesterol levels to rise, potentially increasing your risk of heart attacks and strokes.

What steps can I take to avoid constipation while on Colestid?

Colestid often leads to constipation. To help prevent this, ensure you drink ample water and consume a fiber-rich diet. If these measures are insufficient, consider using a stool softener or a laxative. If constipation persists and impacts your daily activities, discuss it with your healthcare provider.

Is Colestid available in a liquid form?

Colestid is not available in liquid form. It is produced as granules that must be mixed with a liquid before consumption to avoid a choking hazard. It’s crucial to follow the instructions on your prescription label carefully when preparing the mixture. If you have any questions about how to properly take the medication, consult your pharmacist for guidance.

What are the advantages of taking Colestid?

Colestid, a bile acid-binding resin, functions by eliminating bile acid from the body. For individuals with high cholesterol, it prompts the liver to use cholesterol from the blood to produce more bile acid. This process effectively reduces cholesterol levels, aiding in the management of high cholesterol.

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