Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: colestipol
BRAND NAME: Colestid
DRUG CLASS AND MECHANISM: Colestipol is an oral cholesterol-lowering drug
that is not absorbed from the intestine into the body. Rather, it works by
binding to bile acids in the intestine and promoting the elimination of bile
acids in the stool. Bile acids are formed in the liver from cholesterol,
secreted into bile and with the bile enter the intestine. Most of the bile acids
are reabsorbed from the intestine back into the body to be cycled again through
the liver and bile. By promoting the elimination of bile acids, colestipol
forces the liver to convert more cholesterol into bile acids in order to replace
the lost bile acids. This reduces the levels of cholesterol within the body.
Colestipol works similarly to cholestyramine (Questran). Colestipol was approved
by the FDA in 1977.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Granules: 5 gm/ packet or bulk (5gm/teaspoonful) in canisters.
Tablets: 1 gm.
STORAGE: Tablets and granules should be stored at room temperature, 20
to 25 C
(68 to 77 F).
PRESCRIBED FOR: Colestipol is used together with dietary modifications for
the treatment of high blood cholesterol levels. Other less common uses include
treatment of diarrhea due to increased intestinal bile acids after some types of
intestinal surgery and treatment of itching associated with partial obstruction
to the flow of bile due to liver disease. The itching is believed to be due to
the accumulation of bile acids in the body.
DOSING: Colestipol is most often prescribed in 2 to 4 divided doses but may
also be prescribed once daily. The usual adult dose is 2-16 gm of tablets
administered once or twice daily or 5-30 grams of granules once daily or 4 times
daily.
Tablets should not be cut, crushed or chewed. Granules should be mixed in
three ounces of fluid (water or fruit juice).
DRUG INTERACTIONS: Colestipol binds many different compounds in the
gastrointestinal tract, thereby inhibiting their absorption into the body. For
example, colestipol can bind with and decrease the oral absorption of
carbamazepine (Tegretol), diuretics such as hydrochlorothiazide (found in
Dyazide, Maxzide) and furosemide (Lasix), propranolol (Inderal), tetracyclines,
and fat-soluble vitamins (vitamins A, D, and K). Colestipol can bind with and
inhibit the absorption of thyroid hormones. Colestipol also can bind with
ursodiol (Actigall, Urso).
Separating the doses of colestipol and these other compounds by
several hours should prevent binding with colestipol. Generally, other drugs
should be administered one hour before colestipol or 4 hours after colestipol is
administered.
Colestipol binds to vitamin K, a vitamin which is required by the liver to
make the factors that allow blood to clot. Colestipol, by reducing the action of
vitamin K, may exaggerate the effect of warfarin
(Coumadin), reducing the body's ability to
form blood clots. This interaction could lead to abnormal bleeding. On the other
hand, colestipol can bind with warfarin directly and inhibit the absorption of
warfarin. To avoid this interaction, doses of warfarin and colestipol should be
separated by at least 4-6 hours.
Colestipol is closely related to cholestyramine. Cholestyramine has been more
extensively studied than colestipol. Therefore, there are several drug
interactions which have been described with cholestyramine for which data is
lacking with colestipol. It would be prudent to assume that a similar
interactions exist for both drugs and to separate ingestion of colestipol from
the other drugs by several hours. These interactions with cholestyramine
include: acetaminophen (Tylenol), amiodarone (Cordarone), gemfibrozil (Lopid),
pravastatin (Pravachol), piroxicam (Feldene), imipramine (Tofranil), glipizide
(Glucotrol), and others.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Diarrhea - Read the causes of diarrhea including infections, parasites, food poisoning, medications, IBS, IBD, cancer, endocrine disease, fat malabsorption, laxative abuse and more.
- Bile Acid Sequestrants - Bile Acid Sequestrants are medications that lower ldl cholesterol levels.
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