Consumer medicine information

Colestid Granules for Oral Suspension

Colestipol hydrochloride

BRAND INFORMATION

Brand name

Colestid Granules for Oral Suspension

Active ingredient

Colestipol hydrochloride

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Colestid Granules for Oral Suspension.

What is in this leaflet

This leaflet answers some common questions about COLESTID. It does not contain all the available information.

It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking COLESTID against the benefits this medicine is expected to have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine.

You may need to read it again.

What COLESTID is used for

What COLESTID does

COLESTID helps to lower blood cholesterol levels. It should be used in conjunction with a low fat diet.

Everyone has cholesterol in their blood. It's a type of blood fat needed by the body for many things, such as building the lining of cells, making bile acids (which help to digest food) and some hormones. However, too much cholesterol can be a problem.

COLESTID does not reduce the amount of cholesterol that comes from the fat in food. Therefore, you should also follow a low fat diet and start other measures, such as exercise and weight control.

In most people, there are no symptoms of high cholesterol. Your doctor can measure your cholesterol with a simple blood test.

How COLESTID works

COLESTID contains colestipol hydrochloride which is a kind of resin.

COLESTID works in the intestine by trapping bile acids and preventing them from being reabsorbed. COLESTID is not absorbed into the body, but passes through the intestine, drawing bile acids out in the process. The decrease in the bile acids recirculation leads to an increase in producing new bile acids by the liver from cholesterol, hence a decrease in cholesterol level in the blood.

Your doctor may have prescribed COLESTID for another reason.

Ask your doctor if you have any questions about why COLESTID has been prescribed for you.

There is no evidence that COLESTID is addictive.

This medicine is available only with a doctor's prescription.

Use in Children

COLESTID is not recommended to be taken by children.

Before you take COLESTID

When you must not take it

Do not take COLESTID if you have an allergy to COLESTID or any medicine containing colestipol hydrochloride, or any of the ingredients listed at the end of this leaflet.

Some of the symptoms of an allergic reaction may include:

  • shortness of breath
  • wheezing or difficulty breathing
  • swelling of the face, lips, tongue or other parts of the body
  • rash, itching or hives on the skin.

Do not take COLESTID if the packaging is torn or shows signs of tampering.

Do not take COLESTID if the expiry date (EXP) printed on the pack has passed.

Ask your doctor if you are not sure whether you should start taking COLESTID.

Before you start to take it

Tell your doctor if:

  1. if you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
  2. if you are pregnant or intend to become pregnant.
    Your doctor will discuss the risks and benefits of taking COLESTID during pregnancy.
  3. if you are breast-feeding or intend to breast-feed.
    Your doctor will discuss the risks and benefits of taking COLESTID when breast-feeding.
  4. you have or have had any of the following medical conditions:
  • an underactive thyroid gland
  • diabetes
  • kidney or liver disease
  • problems with bleeding or bruising
  • constipation.
  1. you are taking any fat soluble vitamins, such as vitamins A, D and K, or folic acid supplements.
  2. you drink alcohol regularly.

If you have not told your doctor about any of the above, tell them before you take any COLESTID.

Taking other medicines

Tell your doctor if you are taking any other medicines, including:

  • all prescription medicines
  • all medicines, vitamins, herbal supplements or natural therapies you buy without a prescription from a pharmacy, supermarket, naturopath or health food shop.

Some medicines may be affected by COLESTID or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines. Your doctor will advise you.

Tell your doctor or pharmacist if you are taking any of the following:

  • propranolol (e,g, INDERAL or DERALIN), digoxin (e.g. LANOXIN), medicines used for treating heart problems
  • gemfibrozil (e.g. LOPID or JEZIL), a medicine used to lower cholesterol
  • chlorothiazide, hydrochlorothiazide or frusemide, diuretics used to remove fluid from the body, also known as water tablets
  • tetracycline or penicillin G, medicines for bacterial infections
  • oral phosphate supplements
  • mycophenolic acid or mycophenolate mofetil, a medicine used to suppress the immune system.

Your doctor or pharmacist may have more information on medicines to be careful with or avoid while taking COLESTID.

How to take COLESTID

Follow all directions given to you by your doctor or pharmacist carefully.

They may differ from the information contained in this leaflet.

If you do not understand the instructions on the box/bottle, ask your doctor or pharmacist for help.

How much to take

Your doctor will tell you how much you need to take each day. This may depend on your age, your condition and whether or not you are taking any other medicines.

The recommended total daily dose is 15 - 30 grams (3 - 6 sachets).

COLESTID granules should be taken in divided doses, two to four times daily.

How to take it

COLESTID should never be taken in its dry form and should always be mixed with a liquid. This is to avoid accidental inhaling or throat discomfort.

Preparing your medicine:
To prepare COLESTID as a liquid, add the granules to one large glass (100 - 150 mL) or more of milk, flavoured milk, soft drink or your favourite fruit juice, such as orange, tomato or pineapple juice. It can also be added to water, but other liquids taste better.

Stir the mixture until the granules are completely mixed (COLESTID will not dissolve in the liquid). Rinse the glass with a small amount of the same liquid, to make sure all the COLESTID is taken.

COLESTID may also be taken with milk in hot or regular breakfast cereals, or even mixed in soups that have a high liquid content, such as tomato or chicken noodle soup. COLESTID is most palatable when added to pulpy fruits, such as pineapple, pears, peaches or fruit cocktail.

When to take it

Take your medicine at about the same time each day.

Taking it at the same time each day will have the best effect. It will also help you remember when to take it.

If you are taking any other medicines, they should be taken one hour before or four hours after COLESTID.

How long to take it

COLESTID helps lower your cholesterol. It does not cure your condition. Therefore, you must continue to take it as directed by your doctor if you expect to lower your cholesterol and keep it down. You may have to take cholesterol-lowering medicine for the rest of your life. If you stop taking COLESTID, your cholesterol levels may rise again.

Do not stop taking COLESTID suddenly.

Your doctor may need to change the dose of your other medicines if you stop COLESTID, so you should only stop when your doctor tells you to.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking it as you would normally.

If you are not sure whether to skip the dose, talk to your doctor or pharmacist.

Do not take a double dose to make up for the dose that you missed.

If you have trouble remembering to take your tablets, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26), or go to casualty at your nearest hospital, if you think that you or anyone else may have taken too much COLESTID. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention. Keep telephone numbers of these places handy.

It is important that you do not take more COLESTID than your doctor has prescribed. Overdosage could cause bowel obstruction, however this has never been reported. If you do take more than you have been prescribed, contact your doctor for advice.

If a child accidentally swallows your COLESTID granules, contact your nearest hospital or Poisons Information Centre immediately.

While you are taking COLESTID

Things you must do

Keep all of your doctor's appointments so that your progress can be checked.

Your doctor will ask you to have regular blood test. Your liver function will be tested from time to time while you are taking COLESTID to make sure the medicine is working and to prevent unwanted side effects.

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking COLESTID.

Tell any other doctors, dentists, and pharmacists who treat you that you are taking this medicine.

If you become pregnant while you are taking COLESTID tell your doctor.

Things you must not do

Do not give COLESTID to anyone else, even if they have the same condition as you.

Do not take COLESTID to treat any other complaints unless your doctor tells you to.

Do not stop taking your medicine or lower the dosage without checking with your doctor.

Things to be careful of

Avoid drinking large quantities of alcohol.

Drinking large quantities of alcohol may increase your chance of COLESTID causing liver problems.

Be careful driving or operating machinery until you know how COLESTID affects you.

COLESTID generally does not cause any problems with your ability to drive a car or operate machinery. However, as with many other medicines, COLESTID may cause dizziness in some people.

Things that would be helpful for your conditions

Lowering high cholesterol can help reduce your chances of having Coronary Heart Disease (CHD). However, your chances of having CHD may be increased by several other factors including high blood pressure, cigarette smoking, diabetes, excess weight, family history of CHD, being a male and being a woman who has reached menopause.

Some self help measures suggested below may help your condition and help reduce your chances of having CHD. Talk to your doctor, pharmacist, or dietician about these measures and for more information.

  • Diet - continue the low fat diet recommended by your doctor, dietician or pharmacist.
  • Weight - your doctor may advise you to lose weight if you are overweight.
  • Exercise - make exercise a part of your routine - walking is good. Ask your doctor for advice before starting exercise.
  • Smoking - smoking increases the risk of you suffering from heart problems. Your doctor will advise you to stop smoking.
  • Alcohol - excessive alcohol intake can raise your cholesterol levels or affect your liver function, which could increase the chance of you getting unwanted side effects. Your doctor may discuss with you whether you should reduce the amount of alcohol you drink.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking COLESTID.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.

Do not be alarmed by the list of side effects.

You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor if...

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • constipation
  • abdominal pain
  • belching
  • gas in the stomach and bowel
  • nausea
  • vomiting
  • diarrhoea
  • indigestion
  • heartburn
  • muscle, joint or back pains
  • headache
  • migraine
  • lightheadedness
  • sleeplessness
  • skin rash
  • swelling of the hands and feet
  • fatigue
  • loss of appetite
  • feeling weak
  • feeling anxious

The above list includes the more common side effects of your medicine. They are usually mild and short-lived.

Tell your doctor as soon as possible if...

Tell your doctor as soon as possible if you notice any of the following:

  • fast heart beat
  • shortness of breath
  • blood in stools
  • haemorrhoids
  • strong muscle pain
  • strong abdominal pain
  • sign of liver disease such as yellowing of the skin and eyes and dark coloured urine.

The above list includes serious side effects that may require medical attention. Serious side effects are rare.

Go to hospital if...

Tell your doctor immediately or go to Accident and Emergency at your nearest hospital, if you notice any of the following:

  • symptoms of allergy such as skin rash, itching, swelling of the face, lips, mouth, tongue, throat or neck which may cause difficulty in swallowing or breathing
  • chest pain.

The above list includes very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are very rare.

Tell your doctor or pharmacist if you notice anything else that is making you feel unwell.

Other side effects not listed above may also occur in some people.

After taking COLESTID

Storage

Keep COLESTID in a cool dry place where the temperature stays below 30°C.

Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills.

Heat and dampness can destroy some medicines.

Keep it where young children cannot reach it.

A locked cupboard at least one-and-a-half metres above the ground is good place to store medicines.

Disposal

If your doctor tells you to stop taking the medicine or the sachets have passed their expiry date, ask your pharmacist what to do with any sachets that are left over.

Product Description

What it looks like

Each COLESTID sachet contains pale yellow granules.

COLESTID is available in packs containing 120 foil sachets (4 boxes of 30 sachets).

Ingredients

Each sachet of COLESTID Granules for Oral Suspension contains 5 grams of colestipol hydrochloride as the active ingredient.

COLESTID also contains the following inactive ingredient: silica (silicon dioxide).

COLESTID does not contain gluten, lactose, sucrose, tartrazine or any other azo dyes.

Supplier

COLESTID is supplied in Australia by:
Pfizer Australia Pty Ltd
ABN 50 008 422 348
38-42 Wharf Road
West Ryde NSW 2114
Australia
Toll Free number: 1800 675 229

Australian Registration Number

  • AUST R 12283

This leaflet was revised in December 2013.

© Pfizer Australia Pty Ltd 2013.

®Registered Trademark

BRAND INFORMATION

Brand name

Colestid Granules for Oral Suspension

Active ingredient

Colestipol hydrochloride

Schedule

S4

 

Name of the medicine

Colestipol hydrochloride.

Excipients

Silicon dioxide.

Description

Colestid is an insoluble, high molecular weight basic anion exchange copolymer of diethylenetriamine and 1-chloro-2,3-epoxypropane, with approximately 1 out of 5 amine nitrogens protonated (chloride form). It is a light yellow water insoluble resin which is hygroscopic and swells when suspended in water or aqueous fluids. Colestid is tasteless and odourless.

Pharmacology

Cholesterol is the major, and probably the sole, precursor of bile acids. During normal digestion, bile acids are secreted via the bile from the liver and gall bladder into the intestines. Bile acids emulsify the fat and lipid materials present in food, thus facilitating absorption. A major portion of the bile acids secreted is reabsorbed from the intestines and returned via the portal circulation to the liver, thus completing the enterohepatic cycle. Only very small amounts of bile acids are found in normal serum.
Colestid binds bile acids in the intestine, forming a complex that is excreted in the faeces. This nonsystemic action results in a partial removal of the bile acids from the enterohepatic circulation, preventing their reabsorption. Since Colestid is an anion exchange resin, the chloride anions of the resin can be replaced by other anions, usually those with a greater affinity for the resin than chloride ions.
Colestid is hydrophilic, but it is virtually water insoluble (99.75%) and it is not hydrolysed by digestive enzymes. The high molecular weight polymer in Colestid apparently is not absorbed. Less than 0.05% of 14C-labelled Colestid is excreted in the urine.
The increased faecal loss of bile acids due to Colestid administration leads to an increased oxidation of cholesterol to bile acids, a decrease in β-lipoprotein or low density lipoprotein serum levels, and a decrease in serum cholesterol levels. Although Colestid produces an increase in the hepatic synthesis of cholesterol in humans, serum cholesterol levels fall.
There is evidence to show that this fall in cholesterol is secondary to an increased rate of clearance of cholesterol rich lipoproteins (β or low density lipoproteins) from the plasma. Serum triglyceride levels may increase or remain unchanged in colestipol treated patients.
Treatment with colestipol hydrochloride results in a significant increase in lipoprotein LpAI. Lipoprotein LpAI is one of the two major lipoprotein particles within the high density lipoprotein (HDL) density range and has been shown in cell culture to promote cholesterol efflux or removal from cells. The significance of this finding has not been established in clinical studies.
The decline in serum cholesterol levels with Colestid treatment is usually evident by one month. When Colestid is discontinued, serum cholesterol levels usually return to baseline levels within one month. Cholesterol may rise even with continued use of Colestid and serum levels should be determined periodically to confirm that a favourable initial response is maintained.

Indications

Since no drug is innocuous, strict attention should be paid to the indications and contraindications, particularly when selecting drugs for chronic long-term use.
Colestid is indicated as adjunctive therapy to diet for the reduction of elevated serum cholesterol in patients with primary hypercholesterolaemia (elevated low density lipoprotein (LDL) cholesterol) who do not respond adequately to diet. Colestid has been shown to have no effect on or to increase triglyceride levels.
It has not been established whether the drug induced lowering of serum cholesterol or triglyceride levels has a beneficial effect, no effect, or a detrimental effect on the morbidity or mortality due to atherosclerosis including coronary heart disease. Investigations now in progress may yield an answer to this question.

Contraindications

Colestid is contraindicated in those individuals who have shown hypersensitivity to colestipol hydrochloride or any other components in the formulation.

Precautions

To avoid accidental inhalation or oesophageal distress, Colestid should not be taken in its dry form. Always mix Colestid with water or other fluids before ingesting.
Before instituting therapy with Colestid, diseases contributing to increased blood cholesterol such as hypothyroidism, diabetes mellitus especially poorly controlled cases, nephrotic syndrome, dysproteinaemias, other drug therapy, alcoholism and obstructive liver disease, should be looked for and specifically treated. The patient's current medications should be reviewed for their potential to increase serum LDL-cholesterol or total cholesterol.

Effect on vitamin absorption.

Because it sequesters bile acids, Colestid may interfere with normal fat absorption and thus may prevent absorption of folic acid and fat soluble vitamins such as A, D and K. If Colestid resin is to be given for long periods of time, supplemental vitamin A and D should be considered.

Hypoprothrombinaemia.

Chronic use of Colestid may be associated with an increased bleeding tendency due to hypoprothrombinaemia from vitamin K deficiency. This will usually respond promptly to parenteral vitamin K1 and recurrences can be prevented by oral administration of vitamin K1.

Elevation of serum triglycerides.

Serum cholesterol and triglyceride levels should be measured periodically to detect significant changes. Colestid may raise the serum triglycerides in long-term use and, in some patients, the cholesterol levels return to baseline or rise above baseline. A significant rise in triglyceride level should be considered as an indication for dose reduction, drug discontinuation, or combined or alternate therapy.

Constipation.

Colestid may produce or severely worsen pre-existing constipation. The dosage should be decreased in these patients since impaction may occur. Particular effort should be made to avoid constipation in patients with symptomatic coronary artery disease. Constipation associated with Colestid may aggravate haemorrhoids.

Hypothyroidism.

While there have been no reports of hypothyroidism induced in individuals with normal thyroid function, the theoretical possibility exists, particularly in patients with limited thyroid reserve.

Use in pregnancy.

(Category B2)
The physiological hyperlipidaemia of pregnancy does not require treatment.
The safe use of Colestid by pregnant women has not been established.
Due to its known interference with absorption of fat soluble vitamins, the use of Colestid in pregnancy or lactation or by women of childbearing age requires that the potential benefits of drug therapy be weighed against the possible hazards to the mother and child.

Use in lactation.

The safety of Colestid has not been established in breastfeeding women. Caution should be exercised when prescribing to breastfeeding women.

Paediatric use.

Safety and effectiveness in children have not been established.

Genotoxicity.

In the Ames assay, Colestid was not mutagenic.

Carcinogenicity.

In studies conducted in rats in which cholestyramine resin (a bile acid sequestering agent similar to colestipol hydrochloride) was used as a tool to investigate the role of various intestinal factors, such as fat, bile salts and microbial flora, in the development of intestinal tumours induced by potent carcinogens, the incidence of such tumours was observed to be greater in cholestyramine resin treated rats than in control rats.
The relevance of this laboratory observation from studies in rats with cholestyramine resin to the clinical use of Colestid is not known. In the LRC-CPPT study referred to above, the total incidence of fatal and nonfatal neoplasms was similar in both treatment groups. When the many different categories of tumours are examined, various alimentary system cancers were somewhat more prevalent in the cholestyramine group. The small numbers and the multiple categories prevent conclusions from being drawn. Further follow-up of the LRC-CPPT participants by the sponsors of that study is planned for cause specific mortality and cancer morbidity.
When Colestid was administered in the diet to rats for 18 months, there was no evidence of any drug related intestinal tumour formation.

Interactions

Since Colestid is an anion exchange resin, it may have a strong affinity for anions other than the bile acids. In vitro studies have indicated that Colestid binds a number of drugs. Therefore, Colestid resin may delay or reduce the absorption of concomitant oral medication. The interval between the administration of Colestid and any other medication should be as long as possible. Patients should take other drugs at least one hour before or four hours after Colestid to avoid impeding their absorption.

Effect of Colestid on other medicines.

Propranolol.

Human studies have demonstrated that Colestid may decrease propranolol absorption. Effects on the absorption of other β-blockers have not been determined. Therefore, patients on propranolol should be observed when Colestid is either added to or deleted from a therapeutic regimen.

Chlorothiazide.

Studies in humans show that the absorption of chlorothiazide, as reflected in urinary excretion, is markedly decreased even when administered one hour before Colestid.

Tetracycline/ frusemide/ penicillin G/ hydrochlorothiazide/ gemfibrozil.

The absorption of tetracycline, frusemide, penicillin G (benzylpenicillin), hydrochlorothiazide and gemfibrozil was significantly decreased when given simultaneously with colestipol hydrochloride, however colestipol hydrochloride and gemfibrozil can be used in the same patient when administered two hours apart.

Digoxin/ digitoxin.

Particular caution should be observed with digitalis preparations since there are conflicting results for the effect of Colestid on the availability of digoxin and digitoxin. The potential for binding of these drugs if given concomitantly is present. Discontinuing Colestid could pose a hazard to health if a potentially toxic drug that is significantly bound to the resin has been titrated to a maintenance level while the patient was taking Colestid. The serum digoxin and digitoxin levels should be monitored during periods of administration or discontinuation of Colestid.

Oral phosphate supplements.

Bile acid binding resins may also interfere with the absorption of oral phosphate supplements.

Mycophenolic acid/ mycophenolate mofetil.

A study has shown that cholestyramine binds bile acids and reduces mycophenolic acid exposure. As colestipol also binds bile acids, colestipol may reduce mycophenolic acid exposure and potentially reduce efficacy of mycophenolate mofetil.

Medicines not affected by Colestid.

Concurrent administration of colestipol hydrochloride with phenytoin, aspirin, tolbutamide, clofibrate, methyldopa, nicotinic acid, clindamycin or warfarin does not affect the bioavailability of the respective drugs.

Adverse Effects

The most common adverse reactions are confined to the gastrointestinal tract. Constipation, reported by about one patient in ten, is the major single complaint and at times is severe. Most instances of constipation are mild, transient, and controlled with standard treatment. Some patients require decreased dosage or discontinuation of therapy.
The following table lists adverse events described by system organ class and frequency (very common ≥ 1/10; common ≥ 1/100 to < 1/10; uncommon ≥ 1/1000 to < 1/100; rare ≥ 1/10,000 to < 1/1000; very rare < 1/10,000).

Metabolism and nutrition disorders.

Uncommon: decreased appetite.

Psychiatric disorders.

Uncommon: insomnia.

Nervous system disorders.

Very common: migraine, sinus headache, headache.
Uncommon: dizziness.
Rare: anxiety, vertigo, drowsiness.

Cardiac disorders.

Uncommon: angina pectoris, tachycardia.

Respiratory, thoracic and mediastinal disorder.

Uncommon: dyspnoea.

Gastrointestinal disorder.

Very common: constipation, abdominal pain, abdominal discomfort.
Common: haematochezia, haemorrhoidal haemorrhage, abdominal distention, dyspepsia, nausea, vomiting, diarrhoea, flatulence.
Uncommon: belching, gastrointestinal bleeding, peptic ulcer, haemorrhoids.

Hepatobiliary disorders.

Uncommon: cholecystitis, cholelithiasis.

Skin and subcutaneous tissue disorders.

Common: rash.
Uncommon: urticaria, dermatitis.

Musculoskeletal and connective tissue disorders.

Common: arthritis, arthralgia, back pain, musculoskeletal pain, pain in extremity.

General disorders and administration site conditions.

Common: fatigue.
Uncommon: chest pain, oedema peripheral, asthenia.

Investigations.

Uncommon: alanine aminotransferase increased, aspartate aminotransferase increased, blood alkaline phosphatase increased.
Some patients have shown an increase in serum phosphorus and chloride with a decrease in sodium and potassium. Asthma and wheezing were not reported in the studies of Colestid but have been noted during treatment with other cholesterol lowering agents.

Dosage and Administration

For adults, Colestid is recommended in doses of 15-30 g/day taken in divided doses two to four times daily. To avoid accidental inhalation or oesophageal distress, Colestid should not be taken in its dry form. Colestid should always be mixed with water or other fluids before ingesting. Patients should take other drugs at least one hour before or four hours after Colestid to minimise possible interference with their absorption (see Interactions with Other Medicines).

Before Colestid administration.

1. Define the type of hyperlipoproteinaemia.
2. Institute a trial of diet and weight reduction.
3. Establish baseline serum cholesterol and triglyceride levels.

During Colestid administration.

1. The patient should be carefully monitored clinically, including serum cholesterol and triglyceride levels.
2. Failure of cholesterol to fall or significant rise in triglyceride level should be considered as indications to discontinue medication.

Mixing and administration guide.

Colestid should always be taken mixed in a liquid such as orange or tomato juice, water, milk or carbonated beverage. It may also be taken in soups or with cereals or pulpy fruits.
Colestid should never be taken in its dry form.

With beverages.

1. Add the prescribed amount of Colestid to a glassful (100-150 mL) of water, milk, flavoured drink or a favourite juice (orange, tomato, pineapple or other fruit juice).
2. Stir the mixture until the medication is completely mixed. (Colestid will not dissolve in the liquid.) Colestid may also be mixed with carbonated beverages, slowly stirred in a large glass. Rinse the glass with a small amount of additional beverage to make sure all the medication is taken.

With cereals, soups and fruits.

Colestid may be taken mixed with milk in hot or regular breakfast cereals, or even mixed in soups that have a high fluid content (tomato or chicken noodle soup). It may also be added to fruits that are pulpy such as crushed pineapple, pears, peaches or fruit cocktail.

Overdosage

Overdosage of Colestid has not been reported. Should overdosage occur, however, the chief potential harm would be obstruction of the gastrointestinal tract. The location of such potential obstruction, the degree of obstruction and the presence or absence of normal gut motility would determine treatment.
Monitor serum electrolytes and fluid status in all patients with persistent vomiting or symptomatic patients. Monitor liver enzymes after significant overdose. Assess bowel motion in all patients. If obstruction is ruled out, a polyethylene glycol electrolyte oral solution may be used to expedite the evacuation of colestipol resin. In minimal to moderate ingestions, increased fluid intake, fibre and stool softener should be instituted.
Colestipol is largely not absorbed in the gastrointestinal tract. Attempts at gastrointestinal decontamination are generally not warranted.
Contact the Poisons Information Centre on 131 126 for advice on the management of an overdose.

Presentation

Granules for oral suspension (light yellow, hydroscopic, water insoluble resin), 5 g: 120's (4 x 30's, foil sachets).

Storage

Store below 30°C.

Poison Schedule

S4.