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Topic Contents

Colestipol

Drug Information

Colestipol is a bile acid sequestrant (prevents absorption of bile acids in the digestive system). Bile acids may facilitate the absorption of cholesterol. Colestipol is one of many drugs used to lower cholesterol levels in people with high blood cholesterol .

Common brand names:

Colestid, Colestid Flavored

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Beta-Carotene

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene .1

  • Folic Acid

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .2 , 3 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.4

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 5 Whether these same interactions would occur with colestipol is not known.

  • Vitamin A

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .6 , 7 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.8

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 9 Whether these same interactions would occur with colestipol is not known.

  • Vitamin D

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .10 , 11 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.12

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 13 Whether these same interactions would occur with colestipol is not known.

  • Vitamin E

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .14 , 15 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.16

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 17 Whether these same interactions would occur with colestipol is not known.

  • Vitamin K

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .18 , 19 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.20

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 21 Whether these same interactions would occur with colestipol is not known.

  • Calcium

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .22 , 23 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.24

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 25 Whether these same interactions would occur with colestipol is not known.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Carotenoids

    Use of colestipol for six months has been shown to significantly lower blood levels of carotenoids including beta-carotene .26

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Zinc

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .27 , 28 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.29

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 30 Whether these same interactions would occur with colestipol is not known.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • Milk Thistle

    Milk thistle’s (Silybum marianum) major flavonoids, known collectively as silymarin, have shown synergistic actions with the chemotherapy drugs cisplatin and doxorubicin (Adriamycin®) in test tubes.31 Silymarin also offsets the kidney toxicity of cisplatin in animals.32 Silymarin has not yet been studied in humans treated with cisplatin. There is some evidence that silymarin may not interfere with some chemotherapy in humans with cancer.33

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required 

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88–91.

2. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

3. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

4. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

5. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

6. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

7. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

8. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

9. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

10. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

11. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

12. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

13. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

14. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

15. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

16. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

17. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

18. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

19. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

20. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

21. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

22. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

23. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

24. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

25. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

26. Probstfield JL, Lin T, Peters J, Hunninghake DB. Carotenoids and vitamin A: The effect of hypocholesterolemic agents on serum levels. Metabolism 1985;34:88–91.

27. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224 [review].

28. Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

29. Threlkeld DS(ed). Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L.

30. Watkins DW, Cassidy MM, Khalafi R, Vahouny GV. Calcium and zinc balances in rats chronically fed the bile salt-sequestrant cholestyramine (Questran). Fed Proc 1983;42:819.

31. Scambia G, De Vincenzo R, Ranelletti FO, et al. Antiproliferative effect of silybin on gynaecological malignancies: Synergism with cisplatin and doxorubicin. Eur J Cancer 1996;32A:877–82.

32. Gaedeke J, Fels LM, Bokemeyer C, et al. Cisplatin nephrotoxicity and protection by silibinin. Nephrol Dial Transplant 1996;11:55–62.

33. Invernizzi R, Bernuzzi S, Ciani D, Ascari E. Silymarine during maintenance therapy of acute promyelocytic leukemia. Haemotologia 1993;78:340–1.

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