COLESTIPOL HYDROCHLORIDE
| COLESTIPOL HYDROCHLORIDE (koe-les'ti-pole) Cholestabyl  , Colestid, Lestid Classifications: antilipemic; bile acid sequestrant; Therapeutic: cholesterol-lowering agent; bile acid sequestrant Prototype: Cholestyramine Pregnancy Category: C |
Availability
1 g tablets; 5 g powder for suspension
Action
Insoluble chloride salt of a basic anion exchange resin with high molecular weight, which adsorbs and combines with intestinal bile acids in exchange for chloride ions to form an insoluble, nonabsorbable complex that is excreted in the feces.
Therapeutic Effect
Reduces circulating cholesterol and increases serum LDL removal rate. Serum triglycerides are not affected or are minimally increased.
Uses
Pruritus associated with partial biliary obstruction; biliary cirrhosis; also as adjunct to diet therapy of patient with primary hypercholesterolemia (type IIa hyperlipoproteinemia) or with coronary artery disease unresponsive to diet or other measures alone.
Unlabeled Uses
Digitoxin overdose and hyperoxaluria and to control postoperative diarrhea caused by excess bile acids in colon.
Contraindications
Complete biliary obstruction, biliary cirrhosis; hypersensitivity to bile acid sequestrants; renal disease; pregnancy (category C). Safe use in children not established.
Cautious Use
Hemorrhoids; bleeding disorders; malabsorption states; GI motility disorders, dysphagia; older adult.
Route & Dosage
| Hypercholesterolemia Adult: PO 15–30 g/d in 2–4 doses a.c. and h.s., or 1–2 tabs 1–2 times/d Digitalis Toxicity Adult: PO 10 g followed by 5 g q6–8h as needed |
Administration
Oral- Give 30 min before a meal when ordered a.c.
- Ensure that tablets are not chewed or crushed. They must be swallowed whole.
- Always mix granule form with liquids, juices, soups, cereals, or pulpy fruits. Add powder to at least 90 mL fluid. When carbonated drink is used, slowly stir in a large glass because excess foaming may occur. Rinse glass with small amount extra fluid to be sure all the drug is taken.
- Drugs given concomitantly should be scheduled at least 1 h before or 4 h after ingestion of colestipol to reduce interference with their absorption (see drug interactions).
- Store at 15°–30° C (59°–86° F) in tightly closed container unless otherwise instructed.
Adverse Effects (≥1%)
Body as a Whole: Joint and muscle pain, arthritis, shortness of breath. GI: Constipation, abdominal pain or distention, belching, flatulence, nausea, vomiting, diarrhea. Metabolic: Transient increases in liver enzyme tests, serum phosphorus and chloride; decreases in serum sodium and potassium. Skin: Dermatitis, urticaria.Interactions
Drug: Because it decreases the absorption from the GI tract of oral anticoagulants, digoxin, tetracyclines, penicillins, phenobarbital, thyroid hormones, thiazide diuretics, iron salts, fat-soluble vitamins (A, D, E, K), administer cholestyramine 4 h before or 2 h after these drugs. Can bind and affect absorption of any drug.Pharmacokinetics
Absorption: Not absorbed from GI tract. Elimination: In feces as insoluble complex.Nursing Implications
Assessment & Drug Effects
- Watch for changes in bowel elimination pattern. Constipation should not be allowed to persist without medical attention.
- Lab test: Monitor serum sodium and potassium levels. Monitor for and report S&S of hyponatremia and hypokalemia (see Appendix F).
Patient & Family Education
- Do not change the times for taking each drug, nor omit or increase doses. Any change in established regimens should be approved by the physician. It is important to keep to established regimens for colestipol and other drugs.
- If receiving prolonged therapy, report unusual bleeding (vitamin K deficiency). Colestipol prevents absorption of FAT-SOLUBLE VITAMINS (A, D, E, K).
- Do not use OTC drugs unless physician has given approval.
- Check with physician regarding permitted amount of alcohol intake.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; 
Prototype drug