colestipol


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Related to colestipol: colestipol hydrochloride

colestipol

 [ko-les´tĭ-pol]
an anion exchange resin used as adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolemia.

colestipol

(koe-les-ti-pole) ,

Colestid

(trade name)

Classification

Therapeutic: lipid lowering agents
Pharmacologic: bile acid sequestrants
Pregnancy Category: UK

Indications

Management of primary hypercholesterolemia.Pruritus associated with elevated levels of bile acids.Diarrhea associated with excess bile acids.

Action

Binds bile acids in the GI tract, forming an insoluble complex. Result is increased clearance of cholesterol.

Therapeutic effects

Decreased plasma cholesterol and LDL.
Decreased pruritus.

Pharmacokinetics

Absorption: Action takes place in the GI tract. No absorption occurs.
Distribution: No distribution.
Metabolism and Excretion: After binding bile acids, insoluble complex is eliminated in the feces.
Half-life: Unknown.

Time/action profile (hypocholesterolemic effects)

ROUTEONSETPEAKDURATION
PO24–48 hr1 mo1 mo

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Complete biliary obstruction;Some products contain aspartame and should be avoided in patients with phenylketonuria.
Use Cautiously in: History of constipation.
Exercise Extreme Caution in: Pediatric: May cause potentially fatal intestinal obstruction in children.

Adverse Reactions/Side Effects

Ear, Eye, Nose, Throat

  • irritation of the tongue

Gastrointestinal

  • abdominal discomfort (most frequent)
  • constipation (most frequent)
  • nausea (most frequent)
  • fecal impaction
  • flatulence
  • hemorrhoids
  • perianal irritation
  • steatorrhea
  • vomiting

Dermatologic

  • irritation
  • rashes

Fluid and Electrolyte

  • hyperchloremic acidosis

Metabolic

  • vitamin A, D, and K deficiency

Interactions

Drug-Drug interaction

May decrease absorption/effects of orally administered acetaminophen, amiodarone, clindamycin, clofibrate, digoxin, diuretics, gemfibrozil, glipizide, corticosteroids, imipramine, mycophenolate, methotrexate, methyldopa, niacin, NSAIDs, penicillin, phenytoin, phosphates, propranolol, tetracyclines, tolbutamide, thyroid preparations, ursodiol, warfarin, and fat-soluble vitamins (A, D, E, and K).May decrease absorption of other orally administered medications.

Route/Dosage

Oral (Adults) Granules—5 g 1–2 times daily, may be increased q 1–2 mo up to 30 g/day in 1–2 doses. Tablets—2 g 1–2 times daily, may be increased q 1–2 mo up to 16 g/day in 1–2 doses.

Availability

Granules for suspensionunflavored: 5 g/packet or scoop
Flavored granules for suspension with aspartameorange flavor: 5 g/packet or scoop
Tablets: 1 g

Nursing implications

Nursing assessment

  • Hypercholesterolemia: Obtain a diet history, especially in regard to fat consumption.
  • Pruritus: Assess severity of itching and skin integrity. Dose may be decreased when relief of pruritus occurs.
  • Diarrhea: Assess frequency, amount, and consistency of stools.
  • Lab Test Considerations: Serum cholesterol and triglyceride levels should be evaluated before initiating, frequently during first few months and periodically throughout therapy. Discontinue medication if paradoxical increase in cholesterol level occurs.
    • May cause an increase in AST, ALT, phosphorus, chloride, and alkaline phosphatase and a decrease in serum calcium, sodium, and potassium levels.
    • May also cause prolonged PT.

Potential Nursing Diagnoses

Constipation (Side Effects)
Noncompliance (Patient/Family Teaching)

Implementation

  • Parenteral or water-miscible forms of fat-soluble vitamins (A, D, K) and folic acid may be ordered for patients on chronic therapy.
  • Oral: Administer before meals.
    • Scoops for powdered preparations may not be exchangable between products.
    • Administer other medications 1 hr before or 4–6 hr after the administration of this medication.
    • Colestipol tablets should be swallowed whole; do not crush, break, or chew.

Patient/Family Teaching

  • Instruct patient to take medication exactly as directed; do not skip doses or double up on missed doses.
  • Instruct patient to take medication before meals. Colestipol can be mixed with water, juice, or carbonated beverages. Slowly stir in a large glass. Rinse glass with small amount of additional beverage to ensure all medication is taken. May also mix with highly fluid soups, cereals, or pulpy fruits (applesauce, crushed pineapple). Allow powder to sit on fluid and hydrate for 1–2 min before mixing. Do not take dry.
  • Advise patient that this medication should be used in conjunction with diet restrictions (fat, cholesterol, carbohydrates, alcohol), exercise, and cessation of smoking.
  • Explain that constipation may occur. Increase in fluids and bulk in diet, exercise, stool softeners, and laxatives may be required to minimize the constipating effects. Instruct patient to notify health care professional if constipation, nausea, flatulence, and heartburn persist or if stools become frothy and foul smelling.
  • Advise patient to notify health care professional if unusual bleeding or bruising; petechiae; or black, tarry stools occur. Treatment with vitamin K may be necessary.

Evaluation/Desired Outcomes

  • Decrease in serum LDL cholesterol levels. Therapy is usually discontinued if the clinical response remains poor after 3 mo of therapy.
  • Decrease in severity of pruritus. Relief usually occurs 1–3 wk after therapy is initiated.
  • Decrease in frequency and severity of diarrhea.

colestipol

/co·les·ti·pol/ (ko-les´tĭ-pol) an anion exchange resin that binds bile acids in the intestines to form a complex that is excreted in the feces; administered in the form of the hydrochloride salt as an antihyperlipoproteinemic.

colestipol

A BILE ACID SEQUESTRANT drug used to treat abnormally high levels of lipoproteins. A brand name is Colestid.
References in periodicals archive ?
The effects of cholestyramine and colestipol on the absorption of diclofenac in man.
Very intensive lipid therapy with lovastatin, niacin and colestipol for prevention of death and myocardial infarction: a 10-year Familial Atherosclerosis Treatment Study (FATS) follow up [abstract].
The available BAS include the conventional sequestrants, cholestyramine and colestipol, and the specifically engineered BAS, colesevelam hydrochloride (HCl) (Table 1).
Bile acid sequestrants--cholestyramine (Questran and various other names), colestipol (Colestid), and colesevelam (WelChol)--are anion exchange resins that form insoluble complexes with bile acids in the intestine.
Watch especially for decreased frequency of stools when anticholinergics, antidepressants, anti-psychotics, antidiarrheal, diuretics, NSAIDs, iron, calcium, zinc or bismuth salts, salts, colestipol, cholestyramine, Kayexalate or cold and sinus medications are started.
While NCEP recommends cholestyramine, colestipol, gemfibrozil, lovastatin, niacin and probucol for these men, the cost-effectiveness of these drugs was not considered when the original drug recommendations were made," said John Eisenberg, M.
Psyllium can improve regularity if you already take a cholesterol-lowering drug, such as cholestyramine or colestipol, that tends to be constipating.
Lovastatin $900 Niacin (by prescription) $700 Cholestyramine or colestipol $500-550 Gemfibrosil or probucol $375 Niacin (over-the-counter) $50
Bile acid sequestrants--One type of cholesterol-lowering medication, including cholestyramine and colestipol.
lovastatin joins other cholesterol-lowering drugs like nicotinic acid and colestipol (SN: 6/27/87, p.
1995) Plantaginis ovatae Colestipol semen (POS) Organ transplantation Hypericum perforatum Cyclosporinc (Ernst 2002) Skin erythema Hypericum perforatum UVB, UVA, visible Pigmentation Skin type (LI 160) light, solar II,III (Schempp el al.
In contrast to the average 18% additional reduction with 10 mg of ezetimibe, colestipol can also provide an 18% LDL reduction, but it requires 30,000 mg of the drug for the same percent reduction, and cholestyramine at 24,000 mg/day also will give an 18% average LDL reduction.