colestipol


Also found in: Dictionary, Wikipedia.
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 ?
6%; for the 120 patients who received the combination of loperamide plus colestipol, the incidence of grade 3 diarrhea was 10.
More recently, rounded structures have been occasionally described with BAS, specifically colestipol (26) (Figure 6).
The effects of cholestyramine and colestipol on the absorption of diclofenac in man.
33) Patients were randomized to one of three groups: lovastatin 20 mg twice daily plus colestipol 30 g/day, IR niacin 1 g four times daily plus colestipol 30 g/day, or placebo plus colestipol 30/ gm daily.
Two other anti-cholesterol medications (cholestyramine [Questran[R]] and colestipol [Colestid[R]]) also decrease the absorption of ursodiol in the gastrointestinal tract (Hempfling, Dilger, & Beuers, 2003).
Bile acid sequestrants: Colestyramine and colestipol bind to bile acids in the small intestine and prevent their reabsorption across the gut wall.
memory problems (Crestor) and reduced Simvastatin energy levels (Zocor) Cholesterol Can reduce LDL by Diarrhea, absorption 18-20%; slightly headache, joint inhibitors decrease pain, nausea, Ezetimibe triglycerides; muscle aches (Zetia) slightly increase HDL; not proven to reduce heart disease or heart attacks Bile acid sequestrants Colesevelam Can reduce LDL by Nausea, (Welchol) about 15-30% heartburn, Colestipol constipation, (Colestid) stomach pain, Cholestyramine gas; may raise (Questran) triglycerides Niacin Can reduce LDL by Facial/neck (nicotinic about 20%; lowers flushing, liver acid) Niaspan triglycerides; abnormalities, (prescription) increases HDL gout, nausea, cholesterol diarrhea; may increase blood-sugar levels Source: Stanley Hazen, MD, PhD, Cleveland Clinic
These include ezetimibe, bile acid resins (ie, cholestyramine, colestipol, and colesevelam), niacin, fibrates (ie, fenofibrate, fenofibric acid, and gemfibrozil), and fish oils.
Avoid taking the cholesterol-lowering drugs colestipol (Colestid) and cholestyramine (Locholest, Prevalite, Questran) at the same time as you take niacin--take them at least four to six hours before or after you take niacin.
Drugs that influence thyroid function (29) Drugs that decrease TSH secretion Dopamine Glucocorticoids Ocreotide Drugs that decrease thyroid hormone secretion Lithium Iodide Amiodarone Drugs that increase thyroid hormone secretion Iodide Amiodarone Drugs that decrease T4 absorption Colestipol Cholestyramine Aluminium hydroxide Ferrous sulphate Drugs that affect thyroid hormone transport Oestrogen Tamoxifen Heroin Methadone Androgens Glucocorticoids Salicylates Anabolic steroids Drugs that increase hepatic metabolism of T4 and T3 Phenobarbitol Rifampicin Phenytoin Carbamazepine Decreased T4 5'-deiodinase activity Amiodarone Glucocorticoids Propylthoiuracil Beta-adrenergic antagonists Fig.
Note that cholestyramine and colestipol also deplete cholesterol.
Cholestyramine and colestipol are usually prepared as powders mixed with water or orange juice.