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.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

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.
Drug Guide, © 2015 Farlex and Partners

colestipol

A BILE ACID SEQUESTRANT drug used to treat abnormally high levels of lipoproteins. A brand name is Colestid.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Budesonide is a locally acting corticosteroid that Puma believes targets the inflammation identified in a preclinical model of neratinib-induced diarrhea and colestipol is a bile acid sequestrant that Puma believes targets potential bile acid malabsorption that could result from such inflammation.
More recently, rounded structures have been occasionally described with BAS, specifically colestipol (26) (Figure 6).
Reports of fetal harm have not been located for the other two agents in this class, but there is only one case report involving five women for colesevelam and no reports for colestipol. Nevertheless, both of these drugs have the potential to cause fetal hemorrhage if they are taken for prolonged periods in pregnancy.
There are four classes of lipid-lowering drugs in the market: the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (the "statins"), the fibrates (gemfibrozil, clofibrate, and fenofibrate), niacin/nicotinic acid, and the bile acid binding resins (colestipol and cholestyramine).
* Cholesterol-lowering drugs: Colestipol (Colestid), cholestyramine (Questran), and colsevelam (Welchol)
Diclofenac bioavailability can be reduced by a variety of agents including colestipol, cholestyramine (Al-Balla et al., 1994) and aspirin (Todd and Sorkin, 1988), but can be increased by other drugs such as diosmin, likely by inhibition of CYP2C9 (Rajnarayana et al., 2007).
Based on the differential diagnosis, he was initially managed with soluble fiber, colestipol, and loperamide, which achieved constipation.
Bile acid sequestrants (cholestyramine, colestipol, colesevelam) may reduce blood glucose and increase triglycerides, and careful monitoring should be done in people with diabetes.
The three main bile acid sequestrants currently prescribed in the United States are cholestyramine resin (Questran), colestipol (Colestid) and colesevalam (WelChol).
Such studies include the Cholesterol Lowering Atherosclerosis Study (CLAS) using colestipol plus nicotinic acid with coronary artery plaque regression demonstrated by quantitative coronary angiography.