Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
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.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Cholesterol is the most common type of steroid in the body. The treatment of elevated cholesterol involves not only diet but also weight loss, regular exercise, and medications. By understanding your cholesterol profile you can better manage your cholesterol levels.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Stool
(feces) is most commonly brown in color, and many people become curious or
concerned when the color of their stool changes. Most stool-to-stool changes in
color have little meaning; however, some changes, particularly if the changes
are consistent from stool-to-stool and not present in only one stool, can be
important.
What causes normal stool color?
The color of stool is normally due to the presence of bile, specifically, the
bilirubin in bile. Bilirubin is formed from
hemoglobin after hemoglobin is
released from red blood cells during their destruction, a part of the normal
process of replacing the red blood cells in blood. The released hemoglobin is
modified chemically and removed from the blood by the
liver. In the liver the
chemically changed hemoglobin (called bilirubin) is attached to other chemicals
and secreted from the cells of the liver into bile. Depending on the
conc...
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