Colestid granules are used to treat primary hypercholesterolaemia to lower high levels of cholesterol and other fats (triglycerides) in the blood and reduce risk of coronary heart disease (CHD), including heart attack and angina that can be caused by high cholesterol. There are usually no symptoms for high cholesterol, which may be due to lifestyle (high-fat diet and lack of exercise) or can be inherited (familial hypercholesterolaemia). Colestid granules are used in the absence of symptoms in conjunction with a low-fat diet, if diet alone is not sufficient to lower cholesterol levels, and can be used as monotherapy or in conjunction with other cholesterol lowering medications.
Colestid granules contain colestipol, which is an anion exchange resin that binds to bile acids in the small intestine. Bile acids are derivatives of cholesterol and are a component of bile, which is produced in the liver and secreted from the liver and gall bladder into the small intestines. Bile also interacts with cholesterol from the diet, which becomes emulsified and soluble due to the detergent-like properties of the bile acids and this makes absorption of cholesterol easier. Large amounts of bile acids are secreted into the small intestine in response to food ingestion, but most of it enters the blood and returns to the liver via the portal vein for re-use and this is known as enterohepatic recirculation. Cholesterol is needed by the body for many functions such as building cell membranes, producing certain hormones and transporting fat soluble vitamins around the body. However, if there is more cholesterol than the body needs, it becomes deposited in the artery walls where it can build up, blocking the arteries and causing hardened areas called plaque, which increases risk of heart disease. Colestipol in Colestid granules binds to bile acids forming a complex that is excreted in the faeces and removing the bile acids from the enterohepatic circulation. This results in less cholesterol being absorbed and a significant reduction in low density lipoprotein (LDL-C), known as “bad” cholesterol as it distributes cholesterol and deposits it in the arteries. Also more of the endogenous cholesterol produced by the liver is used up in bile acid synthesis. Reduced levels of cholesterol can be seen within a month of using Colestid granules.
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