Generic Name: colestipol hydrochloride Brand Name: Colestiol Classification: Antihyperlipidemic, Bile acid sequestrant Suggested Dose: Adults

For suspension, 3- 30g/ day PO once or in divided dose two to four times a day. Start with 5g daily or BID PO, and increase in 5g/day increments at 1 to 2 months intervals. For tablets, 2- 16g/day PO in 1-2 divided doses; initially, 2g once or twice daily; increasing in 2g increments at 1 to 2 months intervals. Mode of Action: Binds bile acids in the GI tract, forming an insoluble complex. Results in clearance of Cholesterol. Indications: Adjunctive Therapy: Reduction of elevated serum cholesterol in patients with primary hypercholesterolemia ( increase LDL). Unlabeled Uses: Digitalis toxicity, hyperoxaluria, relief of pruritus associated with bile obstruction, hypothyroidism. Contraindications: 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: Pedia- May use potentially fatal intestinal obstruction in children. Drug Interactions: Drug- Drug: May decrease absorption/ effects of orally administered acetaminophen, amniodarone, clindamycin. Clofibrate, digoxin, diuretics, gemfibrozil, glipizade,

corticosteroids, imipramine, mycophenolate, methotrexate, methyldopa, niacin, NSAIDs,

penicillin, phenytoin, phosphates, thyroid preparations, ursodiol, warfarin, and fat-soluble vitamins (A, D, E, K). May decrease absorption of other orally administered medications Side Effects: CNS: Headache Dermatologic: Rashes of skin GI: Constipation , Exacerbationof hemorrhoids, abdominal pain Adverse Effects: CNS: Anxiety, vertigo, dizziness Dermatologic: Rashes and irritation of tongue, perianal area GI: Hematuria, dysuria, diuresis, abdominal discomfort, constipation, nausea Hematologic: Nursing Responsibilities: 1. Do not administer drug in drug in dry form. Mix in liquids, soups, cereals, or pulpy fruits. 2. Instruct patient to take medication exactly as directed; do not skip doses or double up on missed doses. 3. Instruct patient to take medication before meals. 4. Advise patient that colestipol should be uses in conjunction with diet restrictions ( fat, cholesterol, cabohydrates, alcohol), exercise, and cessation of smoking. 5. Explain that constipation may occur. 6. Increase in fluids and bulk in diet should be emphasized to minimize constipation. 7. Advise patient to notify health care professional if unusual bleeding or bruising; petechiae; or black tarry stool occur. Treatment with vitamin K may be necessary. 8. Monitor patients serum LDL cholesterol levels. Therapy is usually discontinued if the clinical response remains poor after 3 month of therapy. 9. Instruct patient to monitor/ note for frequency and severity of diarrhea if it occurs. 10. Make sure that patient swallows the whole tablet; do not crush, or chew them. Tablets should be taken with plenty of fluids.

Reference: Deglin, J.H. & Vallerand, A.H. (2008). Daviss Drug Guide For Nurses. 11th Edition. Philadelphia: F.A. Davis Company. Pp. 334-336. Karch, A.M. (2008). 2008 Lippincotts Nursing Drug Guide. Philadelphia: Wolters Kluwer Lippincott Williams & Wilkins. Pp. 319- 321.