Colestipol dosage

When administered with cholestyramine or colestipol there is a decreased absorption of the oral thyroid preparations. These drugs should not be administered within 4 of 6 hours of the thyroid hormones. When administered with the oral anticoagulants there is an increased risk of bleeding. It may be advantageous to decrease the dosage of the anticoagulant when a thyroid preparation is prescribed. There is a decreased effectiveness of the digitalis preparation if taken with a thyroid preparation. 

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. 

Hepatic enzyme inducers (for example, phenytoin) may increase hepatic degradation of levothyroxine, causing increased dosage requirements of levothyroxine. Concomitant use with somatrem may accelerate epiphyseal maturation. Intravenous phenytoin may release free thyroid from thyroglobulin. Cholestyramine and colestipol may decrease absorption. 

The powdered forms of cholestyramine (4 g/dose) and colestipol (5 g/dose) are either mixed with a fluid (water or juice) and drunk as a slurry or mixed with crushed ice in a blender. Ideally, patients should take the resins before breakfast and before supper, starting with one scoop or packet twice daily, and increasing the dosage after several weeks or longer as needed and as tolerated. Patients generally will not take more than two doses (scoops or packets) twice a day. 

Cholestyramine is available as a powder that is mixed with water, juice, or other noncarbonated beverages to create a slurry to drink. Patients should experiment with various liquids to find the most palatable combination however, patient acceptance and compliance with this dosage formulation can limit its use. Each packet or scoop of cholestyramine is equivalent to 4 g of cholestyramine. The recommended daily dose for the treatment of hypercholesterolemia is 8 to 16 grams (two to four packets or scoops) per day divided into two doses and taken with meals. The maximum daily dose for hypercholesterolemia is 24 g. Colestipol is available as either granules or... 

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