Colestipol (Colestid) Uses

Colestipol is used to treat high blood cholesterol levels, specifically high levels of low-density lipoprotein (LDL) or bad cholesterol. This medication works in conjunction with dietary therapy, which consists of a healthy, low-fat, low-cholesterol diet. Elevated serum total cholesterol and high levels of LDL (bad) cholesterol are major risk factors for atherosclerotic vascular disease (coronary artery disease or heart disease). 

There may be other uses of colestipol—your pharmacist or doctor can give you further drug information.

Colestipol (Colestid) Mechanism of Action

Colestipol hydrochloride belongs to a group of drugs called bile acid sequestrants or bile acid binding resins. It works by removing bile acid from the intestines. Colestipol binds bile acids and forms a substance that is excreted with stool. It is worth noting that colestipol works as adjunctive therapy to a proper diet (low-cholesterol, low-fat diet).

Bile acids are substances that are made from cholesterol in the liver and are the main way that the body breaks down cholesterol. During normal fat absorption and digestion, bile acids are secreted into the intestines from the liver and gallbladder in bile and digestive enzymes. Bile acids emulsify fat and lipid materials present in the gut and help the body absorb fat. Most bile acids are then reabsorbed from the intestines and returned to the liver. Very small amounts of bile acids remain in the blood circulation. 

Colestipol hydrochloride administration leads to the binding of bile acids and their removal from the body in the stool. With more bile acid secreted in stool, there is increased hepatic synthesis (production of cholesterol in the liver) and increased breakdown of cholesterol to bile acids. As a result, there is a decrease in low-density lipoprotein or LDL, and serum cholesterol levels fall.

Colestipol (Colestid) Doses

Colestipol comes in the form of tablets and granules for suspension. Each tablet contains 1 gram of micronized colestipol hydrochloride. One packet or a scoop of Colestid Granules or Colestid Flavored Granules contains 5 grams of colestipol hydrochloride.

The recommended dose of colestipol tablets in adults is 2 to 16 grams per day, taken as a single dose or in divided doses. The usual starting dose is 2 grams 1-2 times per day. This dose can be increased by 2 grams every 1-2 months. 

The recommended dose of colestipol granules in adults is 1-6 packets or scoops per day, taken as a single dose or in divided doses. The usual starting dose is 1 dose 1-2 times per day. This dose may be increased by 1 dose every 1-2 months. 

You will need to be carefully monitored clinically during treatment with colestipol. Your doctor will order an initial blood test to establish baseline serum total cholesterol as well as LDL-C, triglycerides, and HDL-C. They will obtain regular lipid profiles (blood tests) to check blood cholesterol levels during therapy and adjust your colestipol dose based on the results of these tests. This is per guidelines from the National Cholesterol Education Program (NCEP).

Your provider may consider drug discontinuation or combined or alternate therapy with other cholesterol-lowering drugs if the desired therapeutic effect is not obtained at a dose of colestipol 2 to 16 grams per day along with good dietary and drug compliance (taking colestipol regularly with diet and weight reduction). This is because excessive doses of lipid altering agents such as colestipol can interfere with the absorption and normal digestion of fats and fat soluble vitamins.