Colestipol

Brand names

• Colestid

Usage

To reduce cholesterol in people with high blood levels of low-density lipoprotein (LDL), as part of a comprehensive treatment program that includes exercise and special diet.

How it works

Colestipol binds with bile acids in the intestine, forming an insoluble complex that is excreted in the feces. This process reduces the amount of bile acids in the blood. In response to the lower levels of bile acids, the liver converts more cholesterol to bile acids. As a consequence, the amount of cholesterol in liver cells declines, and the liver makes more receptors for LDL. The resulting increased removal of LDL from the blood lowers LDL cholesterol.

Side effects

Serious

Severe abdominal pain (a very rare reaction, indicating intestinal obstruction). Seek medical assistance immediately.

Common

Constipation, heartburn, bloating, belching, abdominal discomfort, irritation of the anal area, gas, diarrhea, nausea, vomiting.

Less common

Hives, rash, gallstones, muscle and joint pains, abnormal liver blood tests.

Possible interactions

Other medicaments:

Colestipol may decrease the effects of:

• acetaminophen (Tylenol); take 2 hours before colestipol.
• alendronate (Fosamax); take 2 hours before colestipol.
• aspirin; take 2 hours before colestipol.
• atorvastatin (Lipitor); take 2 hours before colestipol.
• cephalexin (Keflex); take 2 hours before colestipol.
• diclofenac (various); take 2 hours before colestipol.
• digitoxin and digoxin (Lanoxin); take 2 hours before colestipol.
• fibrates (Tricor, others); take 2 hours before colestipol or four to six hours after colestipol.
• folic acid; take 2 hours before colestipol.
• furosemide (Lasix); take 2 hours before colestipol or four to six hours after colestipol.
• hydrocortisone; take 2 hours before colestipol.
• iron preparations; take 2 to 3 hours before colestipol.
• leflunomide (Arava), take 2 hours before colestipol.
• penicillin G (Pentids); take 2 hours before colestipol.
• phenobarbital; take 2 hours before colestipol.
• pravastatin (Pravachol); take 2 hours before colestipol.
• tetracycline (Achromycin); take 2 hours before colestipol.
• oral antidiabetic medicaments.
• raloxifene (Evista), take 2 hours before colestipol.
• tetracycline (various), take 1 hour before or 4-6 hours after colestipol.
• thiazide diuretics; take 2 hours before colestipol.
• thyroxine; take 5 hours before colestipol.
• vancomycin (various oral forms); take 2 hours before colestipol or four to six hours after colestipol.
• vitamin B12.

Foods:

Avoid foods that tend to constipate (cheeses, etc.). Talk to your doctor if you are considering adding soy milk or other soy products to your diet.

Herbal medicines or minerals:

Some studies show garlic to reduce cholesterol. Since it probably works by a different mechanism than colestipol, the combination use may be reasonable if dosing is separated. Discuss this with your doctor. Soy milk may also offer some lowering of cholesterol. Current cholesterol therapy sets a goal for treatment, and these herbs may help reach that goal when combined with this prescription medicine. Talk to your doctor before combining any herbals with colestipol.
Ask your doctor if you need supplements of vitamins A, D, E and K, folic acid and calcium.

Discontinuation:

The dose of any toxic medicament combined with colestipol must be reduced when this medicament is stopped. Once colestipol is stopped, cholesterol levels usually return to pretreatment levels in 1 month.