Colestipol
COLESTID
What it isBile acid sequestrant; hyperlipidemia and bile acid diarrhea.
Why this oneNot absorbed, so it is usable in pregnancy, and the tablet form is more palatable than cholestyramine powder.
What limits itIt binds other drugs in the gut — separate all other dosing. Constipation; it raises triglycerides.
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Primary hyperlipidemia | Adults | 2 g QD or BID | 2–16 g/day (QD or divided) | 16 g/day |
Titration Increase by 2 g (QD or BID) at 1- or 2-month intervals
Renal Undefined
Hepatic Undefined
Instructions
- Take one tablet at a time and swallow whole with plenty of water or liquid
- Do not cut, crush, or chew tablets
- Take other drugs at least 1 hour before or 4 hours after colestipol
Cautions
- Constipation is the major complaint and may be severe; may aggravate hemorrhoids
- Rare esophageal obstruction with tablets
- May interfere with absorption of fat-soluble vitamins and concomitant drugs
Adverse reactions
- Constipation
- Abdominal discomfort, bloating, flatulence
- Indigestion, heartburn, diarrhea, nausea/vomiting
- Transient elevations of AST, ALT, alkaline phosphatase
Pregnancy Not systemically absorbed (<0.17%); may interfere with fat-soluble vitamin absorption; weigh benefit vs risk
Lactation Undefined
NO BOXED WARNINGS
Principal riskBinds other drugs in the gut; constipation
Cost, est. cash$5–$150/month
Generic entry2006
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
Mechanism of action: Colestipol ballicule
