Adult: As tab: Initially, 2 g 1-2 times daily, increase by 2 g 1-2 times daily at 1-2 mth intervals. Maintenance: 2-16 g daily in 1 or divided doses. As granules for susp: Initially, 5 g 1-2 times daily, increased in 5-g increments at intervals of 1 mth. Max: 30 g daily in 1-2 divided doses.
Reconstitution
Mix contents of sachet to at least 100 mL of water or other suitable liquid (e.g. fruit juice, skimmed milk, non-carbonated beverage). Alternatively, it can be mixed w/ soups, cereals, pulpy fruits w/ a higher water content or yoghurt.
Special Precautions
Patient w/ GI dysfunction (e.g. constipation), phenylketonuria, limited thyroid reserve. Pregnancy and lactation.
Adverse Reactions
Constipation, faecal impaction, aggravation of haemorrhoids, abdominal discomfort (e.g. pain, cramping, distention), heartburn, flatulence, nausea, vomiting, diarrhoea, bloating, belching, indigestion, blood in stool; headache, migraine headache, sinus headache, dizziness, light-headedness, insomnia, anxiety, vertigo, drowsiness; rash, urticaria, dermatitis, muscle and joint pain, arthritis, backache, anorexia, fatigue, weakness, shortness of breath, swelling of the hands or feet; increased bleeding tendency (chronic use), hyperchloremic acidosis, transient and modest increases in serum AST, serum ALT and alkaline phosphatase concentrations.
Monitoring Parameters
Determine serum cholesterol and triglyceride concentrations prior to and regularly during therapy.
Overdosage
Symptoms: GI obstruction. Management: Dependent on the degree and location of obstruction and GI motility. Expert opinion is required.
Drug Interactions
May interfere w/ absorption of folic acid, oral phosphate supplements, and fats, preventing absorption of fat-soluble vit. Decreased absorption of tetracycline, penicillin G, hydrochlorothiazide, furosemide or gemfibrozil. May bind digoxin in the GI tract and impair its absorption. Decreased and/or delayed GI absorption of propranolol. May decrease serum concentration of mycophenolic acid.
Action
Description: Mechanism of Action: Colestipol binds w/ bile acids in the intestine to form an insoluble complex which is excreted in faeces, resulting in increased faecal loss of bile acid-bound LDL cholesterol. Pharmacokinetics: Absorption: Not absorbed. Excretion: Via faeces.
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