Can an 89-year-old patient take Colestid (Colestipol) with Lialda (Mesalamine)?

Colestid (Colestipol) and Lialda (Mesalamine) Interaction in an 89-Year-Old Patient

Colestid (colestipol) should not be taken at the same time as Lialda (mesalamine) - they should be administered at least 4 hours apart to avoid potential interference with Lialda absorption. 1

Medication Mechanisms and Concerns

Colestid (Colestipol)

• Mechanism: Colestipol is a bile acid sequestrant (BAS) that binds bile acids in the intestine, preventing reabsorption 1
• Purpose: Used to lower LDL cholesterol in primary hyperlipidemia 1
• Key concern: Colestipol can bind to and decrease absorption of many medications 1

Lialda (Mesalamine)

• Mechanism: Delayed-release 5-aminosalicylate formulation that delivers anti-inflammatory medication to the colon 1
• Purpose: Treatment of mild-to-moderate ulcerative colitis 1

Administration Recommendations

Timing Separation

• Administer Lialda at least 4 hours before Colestid 1
• This timing separation is critical to ensure proper absorption of Lialda 1

Dosing Schedule Example

1. Morning: Take Lialda with breakfast
2. Evening: Take Colestid with dinner (at least 4 hours after Lialda)

Colestipol Administration

• Typical dosage: 2-16g/day orally, given once or in divided doses 1
• Can be taken with meals and liquid to improve tolerability 1

Mesalamine Administration

• Lialda (1200mg tablets) can be taken once daily 1
• Once-daily dosing has similar pharmacokinetics to multiple daily dosing regimens 2

Monitoring and Precautions

Watch for:

• Constipation: Most common side effect of Colestid 1, 3
• GI symptoms: Dyspepsia, nausea, bloating 1, 3
• Medication efficacy: Ensure both medications are achieving desired effects 1

Special Considerations for Elderly Patients

• Constipation risk: Higher in elderly patients; ensure adequate hydration and fiber intake 3
• Polypharmacy: Review all medications for additional potential interactions 1
• Renal function: Consider age-related decline in renal function when dosing mesalamine 1

Common Pitfalls to Avoid

1. Same-time administration: Never give Colestid and Lialda simultaneously 1
2. Inadequate separation: Failure to maintain 4-hour separation may reduce Lialda efficacy 1
3. Dehydration: Colestid can cause constipation, which may be worsened by inadequate fluid intake 1
4. Medication non-adherence: Complex timing requirements may reduce compliance; provide clear written instructions 4

Alternative Considerations

If medication timing becomes too complex or adherence is challenging:

• Consider colesevelam (Welchol) instead of colestipol, as it has fewer drug interactions 3, 4
• Discuss with the prescribing physician whether alternative lipid-lowering strategies might be appropriate for this 89-year-old patient 1, 5

By carefully timing the administration of these medications and monitoring for side effects, an 89-year-old patient can safely take both Colestid and Lialda.