Colestipol (Colestid) is an older medication known as a bile acid sequestrant.
Colestipol was and still is marketed as Colestid by Pharmacia & Upjohn, but it's old enough to also have a generic form.
Colestipol (Colestid) is one of the safer cholesterol-lowering medications as it works within the intestines themselves rather than being absorbed into the bloodstream.
Bile acids are synthesized from cholesterol in the gall bladder. Then, they're secreted into the intestines and serve to aid digestion of dietary cholesterol. They're then reabsorbed into the body at the end of the small intestine and get recycled through the body to be used again.
By taking a bile acid sequestrant such as colestipol, in effect you're getting double action. The medication binds the bile acids from the gall bladder, which both helps prevent the digestion of dietary cholesterol and keeps the bile acids from being reabsorbed at the end of the small intestine. Then, the gall bladder has to use more cholesterol to create more bile acids to make up for what wasn't recycled, and a lot of dietary cholesterol just passes through your bowel movements instead of getting absorbed into the blood.
Colestipol is indicated as an addition to diet modification for reducing total-C and LDL-C in people who suffer from primary hypercholesterolemia and who don't respond well enough to diet alone.
Colestipol (Colestid) has been shown to reduce LDL-C levels up to 10.4% and offers a 19% reduction in the risk of fatal coronary events and non-fatal heart attacks combined. Primary hypercholesterolemia means that the high cholesterol levels are not caused by something else, such as badly controlled diabetes, hypothyroidism, other medications, alcoholism, and so on.
Colestipol usually doesn't affect triglyceride levels one way or the other, but has been known to raise them in a few people, so it's not a good choice for people with elevated triglyceride levels.
Colestipol has not been studied in pregnant or nursing mothers, nor in children of any age.
While it should be relatively safe, should be and proven to be are not the same thing. For that reason, new mothers and children should talk extensively with their doctors before taking this to see if there's any other way to do it.
Cholestyramine, another member of the bile acid sequestrant class, has been tested on children and proven relatively safe and effective.
Colestipol should also not be taken by anybody who's allergic or sensitive to any part of the medication, or by people who suffer from complete biliary obstruction where bile is not being secreted at all into the intestines.
I know, some of this ought to be common sense, but I have to say it anyway for the people who don't have common sense.
On the bright side, because Colestipol (Colestid) is NOT absorbed into the bloodstream, colestipol is relatively safe for people who suffer from liver and kidney damage.
I wouldn't recommend taking anything without close monitoring in the case of liver and kidney damage, but colestipol may offer a solution when nothing else will work.
The recommendations for prescribing colestipol is at least six months of intense lifestyle change and counseling before starting on the medication, with shorter periods considered ok for people who have serious problems with their low-density lipoprotein cholesterol or who already have coronary heart disease.
Of course, those are the recommendations for every cholesterol lowering medication, so it's good to know in general.
Each tablet of Colestid, the most common brand name for colestipol, contains one gram of micronized colestipol hydrochloride, cellulose acetate phthalate, glyceryl triacetate, carnauba wax, hydroxypropyl methylcellulose, magnesium stearate, povidone and silicon dioxide.
These tablets are made in such a way as to release their contents slowly, so don't crush, cut or chew them as you'll make the medication dissolve too fast and dump its contents too early. This ingredients list only works for Colestid.
Any other brand name is, of course, going to have its own formula.
The other marketing name I could find for it was Cholestabyl, but I couldn't find an ingredients list or appearance for that one.
Colestipol isn't absorbed into the bloodstream to where anyone would notice. While a teensy amount may get through the intestinal wall, it's not enough to do anything in the rest of the body.
It takes about 24 hours to clear out of the body completely, and you'll notice LDL-C levels going down generally within a month of starting it.
Like most cholesterol lowering medications, colestipol is a treatment, not a cure, and your LDL-C levels will go back up to unhealthy elevations within a month of stopping the medication.
Always take colestipol with food, that will help keep constipation, diarrhea or gastrointestinal upset from really wrecking your day.
Of course, while colestipol doesn't have some of the truly upsetting interactions that other lipid-lowering medications can inflict, because its purpose is to chemically bind things, it can make other medications taken with it more difficult for your body to absorb.
Seeing as you actually need the effects of any prescription medication you're on, this effect can range from inconvenient to downright dangerous.
The most notable class this happens with is the anticoagulant medications, which are all taken in order to reduce the danger of blood clots in the body. This class includes anisindione, dicumarol, acenocoumarol and warfarin. If you're taking one of these medications and colestipol at the same time, you and your doctor have to work together to find the right dosage to get the correct effect out of both.
If you've already been through this dose adjustment process, never stop taking colestipol without telling your doctor first. If you're taking a dose of an anticoagulant that's been adjusted to work with colestipol, and suddenly you stop taking colestipol, suddenly you could have far too much anticoagulant getting into your bloodstream. Medication induced hemophilia is not a pleasant thing.
Of course, the same recommendation goes any time you take a medication concurrently with colestipol.
Colestipol (Colestid) also decreases the effects if digoxin, which is often prescribed to regulate the heart. Getting an overdose of digoxin is usually fatal as well, and if you stop taking colestipol suddenly it could happen.
On the not so fatal side, colestipol also decreases the effects of hydrocortisone, raloxifene, ursodeoxycholic acid, and thyroid hormones such as levothyroxine, liothryonine, and thyroglobulin.
Colestipol (Colestid) also delays and/or reduces the absorption of phenylbutazone, thiazide, acidic diuretics, basic propanolol (in the acid/base sense), tetracycline, penicillin G, phenobarbital, estrogens and progestins (aka oral contraceptives), and, last but not least, statin class medications.
The upshot is that colestipol interferes with the absorption and effects of many medications taken by mouth.
Some medications work well if you take the colestipol at a very different time, usually between one and four hours apart. I'd go with four to be on the safe side.
Other medications get bound up by colestipol no matter how you time it.
Your doctor should know all of the ins and outs of your particular medications, so work with him or her to find the best medication regimen for you.
Constipation is the most frequent complaint associated with colestipol.
Most of the time it's a temporary, transient side effect, but it can get really unpleasant when it's not.
Considering that colestipol is a long term maintenance medication, any constipation should be treated with dietary fiber, increased water intake and the odd stool softener when absolutely necessary instead of a steady intake of laxatives.
Laxatives can dehydrate you, interfere with your digestion, and cause all sorts of other dangerous side effects when used chronically.
If you can't take the constipation, if it just interferes with life too much, you may have to discontinue this medication and try another.
In addition, anybody who currently has coronary heart disease should avoid constipation of any kind, so it may not be a good idea to even start if you do.
Fecal impaction has been seen in a small number of cases.
Other side effects of Colestipol (Colestid) include abdominal discomfort (pain and cramping), intestinal gas (bloating and flatulence), indigestion, heartburn, diarrhea, loose stools, nausea and vomiting.
Another adverse side effect of Colestipol (Colestid) that you need to watch out for, is that colestipol can interfere with the absorption of some vitamins. A few vitamins are carried into your body with fat, and because colestipol interferes with fat absorption, you can lose vitamins A, D, E and K along the way.
Vitamin A deficiency is just generally unpleasant until it becomes fatal by interfering with red blood cells, Vitamin D deficiency leads to bone problems often referred to as rickets, and Vitamin K deficiency leads to a condition called hypothrombinemia, which basically means an increased tendency to bleed profusely from any bruise, cut or scrape. Vitamin E provides vital nutrients to skin, hair, and fingernails. None of them are fun to be without, so if you start feeling run down or under the weather talk to your doctor about suitable vitamin supplements before you get into dangerous levels of deficiencies.
No overdoses of colestipol have ever been reported, or at least not where I could find them.
If overdose were to occur, the biggest thing to watch out for would be the obstruction of the gastrointestinal tract by fecal matter based on the overdose effects of other bile acid sequestrants.
Colestid (brand name) pills are large yellow, elliptical, tablets imprinted with a "U". And they're big. So big that they warn in the patient literature that they might get stuck in your throat.
If you have too many problems swallowing them, you may want to talk to your doctor about it.
In addition, if you're supposed to be getting Colestid brand name pills, you open your bottle and they don't look like this description, call your pharmacist immediately. You might have gotten the generic form, which is going to look different, the company might have changed the appearance or size since they last published it, or you may have gotten the wrong medication. Pharmacies make mistakes too. So, do pay attention to what your medication is supposed to look like and call the pharmacy as soon as possible if it ever doesn't look right.
Store colestipol in any form at controlled room temperature 20° to 25° C (68° to 77° F). That doesn't mean that leaving it out on your nightstand overnight will render it useless, it just means try to keep it in a cool, dark place most of the time.
Protect it from ambient light and moisture by keeping the cap on and keeping it in the bottle it came in or similarly tinted plastic.
Colestipol offers one of the safer cholesterol lowering medications on the market today.
One of the really pleasant things about it is that it can often work in combination with other lipid-lowering medications like statins or fibrates.
However, like all medications, you need to pay close attention to its individual effects on you. Get as much information as you can on your condition and the possible help you can get for it to find the best combination of medication, diet and exercise for your particular circumstances and individual health.
You can contact the Pharmacia & Upjohn Company at:
Pharmacia & Upjohn Company
A subsidiary of Pharmacia Corporation
Kalamazoo, MI 49001, USA
Main Research and write by Loni Ice, Editing by Donald Urquhart