Usual Adult Dose for Hyperlipoproteinemia

Tablets:

• Initial dose: 2 g orally once or twice a day
• Maintenance dose: 2 to 16 g once a day or in divided doses

• Dose increases of 2 g once or twice a day should occur at 1 to 2 month intervals.
• If desired therapeutic effect on low density lipoprotein (LDL) cholesterol is not obtained at a dose of 2 to 16 g per day with good compliance and acceptable side effects, combined therapy or alternate treatment should be considered.

• Initial dose: 5 g (1 packet or 1 level scoop) orally once or twice a day
• Maintenance dose: 5 to 30 g (1 to 6 packets or level scoops) orally once a day or in divided doses

• Incremental dose increases should occur at a rate of 1 dose per day at 1 to 2 month intervals.
• If desired therapeutic effect is not obtained at 1 to 6 doses per day with good compliance and acceptable side effects, combined therapy or alternate treatment should be considered.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Patients with preexisting constipation:

• Tablets: Initiate with 2 g orally once or twice a day; if the initial dose is well tolerated, the dose may be increased as needed by a further 2 to 4 g per day at monthly intervals with periodic monitoring of serum lipoproteins.
• Granules: Initiate with 5 g (1 packet or 1 level scoop) orally once a day for 5 to 7 days; increasing to twice a day with monitoring of constipation and of serum lipoproteins, at least twice, 4 to 6 weeks apart; if the initial dose is well tolerated, the dose may be increased as needed by one dose/day (at monthly intervals) with periodic monitoring of serum lipoproteins.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Tablets: Swallow tablets one at a time with plenty of water or other appropriate liquid; swallow whole and do not cut, crush, or chew tablets.
• Granules: Do not take in dry form; always mix with water or other fluids prior to ingestion.
• Other medications should be taken at least 1 hour before or 4 hours after colestipol to avoid impeding their absorption.

• Mix the prescribed amount with 3 ounces or more with water or other beverage, including a heavy or pulpy juice, and stir to uniform consistency and drink.
• May be taken mixed with milk in hot or regular breakfast cereals or soups that have a high fluid content; may also be added to fruits that are pulpy such as crushed pineapple, pears, peaches, or fruit cocktail.
• May also be mixed with carbonated beverages, however, this may be associated with gastrointestinal complaints.
• Rinse glass with a small amount of additional beverage to be sure all medication is taken.

• Prior to initiating therapy, define the type of hyperlipoproteinemia, institute a trial of diet and weight reduction, and establish baseline serum total cholesterol, LDL cholesterol, and triglyceride levels.
• A significant rise in triglyceride levels should be considered as indication for dose reduction, drug discontinuation, or combined or alternate therapy.

• Metabolic: Baseline serum total cholesterol, LDL cholesterol, and triglyceride levels should be obtained and then periodically measured during therapy.

• Difficulty swallowing and obstruction of the esophagus has rarely been reported; however, if a tablet gets stuck after you swallow it, you may notice pressure or discomfort. If this happens to you, do not take another dose and contact your doctor.