Colesevelam

Colesevelam Mix die granules in liquids, soups, cereals, or pulpy fruits. Do not take dry. Mix the prescribed amount in a glassful of liquid. 

Colesevelam 625 mg tablets 3750-4375 mg/day as a single dose or divided twice daily, with meals colesevelam. Increasing fluid and dietary fiber intake may relieve constipation and bloating. Impair absorption of fat-soluble vitamins. 

Cholestyramine, colestipol, and colesevelam are the bile acidbinding resins or sequestrants (BAS) currently available in the United States. Resins are highly charged molecules that bind to bile adds (which are produced from cholesterol) in the gut. The resin-bile acid complex is then excreted in the feces. The loss of bile causes a compensatory conversion of hepatic cholesterol to bile, reducing hepatocellular stores of cholesterol resulting in an up-regulation of LDL receptors to replenish hepatocellular stores which then result in a decrease in serum cholesterol. Resins have been shown to reduce CHD events in patients without CHD.26... 

Bile Acid Resins (Cholestyramine, Colestipol, Colesevelam)... 

Colestid) Colesevelam (Welchol) 625-mg tablets 1,875 mg twice daily 4,375 mg... 

Colesevelam [22,23] 14-28 2-3 Caution in patients with fat-soluble vitamin deficiency... 

Colesevelam hydrochloride, 5 145 Colestid, molecular formula and structure, 5 14 It... 

Currently available BAS include cholestyramine, colestipol and colesevelam hydrochloride (colestimide). Cholestyramine comprises a long-chain polymer of styrene with divinylbenzene trimethylbenzylammonium groups, whereas colestipol is a long-chain polymer of l-chloro-2,3-epoxypropane with diethylenetriamine. Colesevelam HCl is poly(allylamine hydrochloride) cross-linked with epichlorohydrin and alkylated with 1-bromodecane and 6-bromo-hexyl-trimethylammonium bromide. Bile-acid binding is enhanced and stabilised in the latter compound by long hydrophobic sidechains, increased density of primary amines, and quaternary amine sidechains. For this reason, colesevelam HCl exhibits increased affinity, specificity and capacity to bind bile acids compared with the other BAS. Colesevelam HCl also binds dihydroxy and trihydroxy bile acids with equal affinity, contrasting with cholestyramine and colestipol that preferentially bind dihydroxy bile acids (CDCA and deoxycholic acid). The latter BAS can lead to an imbalance towards trihydroxy bile acids and a more hydrophilic bile-acid pool. 

Combination therapy - For maximal therapeutic effect in combination with an HMG-CoA reductase inhibitor, the recommended dose of colesevelam is 3 tablets taken twice daily with meals or 6 tablets taken once daily with a meal. Doses of 4 to 6 tablets/day have been shown to be safe and effective when coadministered with an HMG-CoA reductase inhibitor or when the 2 drugs are dosed apart. 

Hypersensitivity to bile acid sequestering resins or any components of the products complete biliary obstruction (cholestyramine only) bowel obstruction (colesevelam only). 

Colestipol and colesevelam - Safety and efficacy have not been established. 

Gl The safety and efficacy of colesevelam in patients with dysphagia, swallowing disorders, severe Gl motility disorders, or major Gl tract surgery have not been established. Use with caution. 

Combination colesevelam and an HMG-CoA reductase inhibitor is effective in further lowering serum total cholesterol and LDL-cholesterol levels beyond that... 

Colestipol, cholestyramine, and colesevelam are useful only for isolated increases in LDL. In patients who also have hypertriglyceridemia, VLDL levels may be further increased during treatment with resins. 

Colestipol and cholestyramine are available as granular preparations. A gradual increase of dosage of granules from 4 or 5 g/d to 20 g/d is recommended. Total dosages of 30-32 g/d may be needed for maximum effect. The usual dosage for a child is 10-20 g/d. Granular resins are mixed with juice or water and allowed to hydrate for 1 minute. Colestipol is also available in 1 g tablets that must be swallowed whole, with a maximum dose of 16 g daily. Colesevelam is available in 625 mg tablets. The maximum dose is six tablets daily. Resins should be taken in two or three doses with meals. They lack effect when taken between meals. 

Absorption of certain drugs, including those with neutral or cationic charge as well as anions, may be impaired by the resins. These include digitalis glycosides, thiazides, warfarin, tetracycline, thyroxine, iron salts, pravastatin, fluvastatin, folic acid, phenylbutazone, aspirin, and ascorbic acid. Any additional medication (except niacin) should be given 1 hour before or at least 2 hours after the resin to ensure adequate absorption. Colesevelam does not bind digoxin, warfarin, or reductase inhibitors. 

Oral 4 g packets anhydrous granules cholestyramine resin Colesevelam (Welchol)... 

Questran, Questran Light, Prevalite) Colesevelam (WelChol) Colestipol (Colestid) Ezetimibe (Zetia) Ezetimibe/Simvastatin (Vytorin)... 

Any additional medication (except niacin) should be given 1 hour before or at least 2 hours after the resin to ensure adequate absorption. Colesevelam does not bind digoxin, warfarin, or reductase inhibitors. 

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