Hepacol

Introduction
Hepacol is used to lower cholesterol and to reduce the risk of heart disease. Cholesterol is a fatty substance that builds up in your blood vessels and causes narrowing, which may lead to a heart attack or stroke. Hepacol may also be used to treat itching seen in certain types of liver disease and to relieve some types of diarrhea. This medicine may be used alone or in combination with other medicines. It may be taken with a meal or on an empty stomach. You can take it at any time of day but try to take it at the same time each day. Most people with high cholesterol do not feel ill, but if you stop taking this medicine, your condition could get worse. This may lead to your cholesterol levels creeping up again and increase your risk of heart disease and stroke. It is important to have your cholesterol levels checked regularly. This medicine is only one part of a treatment program which should also include a healthy diet, regular exercise, smoking cessation, moderation of alcohol intake and weight reduction. You can eat normally while taking this medicine, but try to avoid foods that are high in fat. Common side effects of this medicine include constipation and gas. These are usually mild and disappear after a short time. Before taking it, let your doctor know if you are suffering from any liver or kidney disease. Pregnant and breastfeeding women should consult the doctor before taking this medicine.

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Uses of Hepacol
High cholesterol
Side effects of Hepacol
Common
Constipation
How to use Hepacol
Take this medicine in the dose and duration as advised by your doctor. Check the label for directions before use. Empty the granules in a glass of water/milk, stir it and consume immediately. Hepacol may be taken with or without food, but it is better to take it at a fixed time.
How Hepacol works
Hepacol is a bile acid binding agent. It removes bile acids from the body. The liver then produce more bile acids using cholesterol, as a result, the levels of cholesterol in the body is lowered.
What if you forget to take Hepacol?
If you miss a dose of Hepacol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
Always take it with food and a full glass of water.
It may interfere with the absorption of vitamins such as A, D and K. Take supplements of these vitamins as suggested by your doctor.
It can delay or decrease the absorption of certain medicines. Any other medicine should be taken 1 hour before or 4 hours after taking Choltran Powder for Oral Suspension.
Brief Description
Indication
Bile acid-induced diarrhoea; Hyperlipidaemias, Pruritus associated w/ partial biliary obstruction or primary biliary cirrhosis
Administration
May be taken with or without food. Do not take in the dry form. Mix w/ 150 mL of water or fruit juice, stir to a uniform consistency before taking. Reconstitution: Mix the powder w/ 60-180 mL of water or another noncarbonated beverage (e.g. fruit juice) and stir to a uniform consistency. Alternatively, it may also be mixed w/ skimmed milk, thin soup or a pulpy fruit w/ high moisture content (e.g. applesauce or crushed pineapple).

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Adult Dose
Hyperlipidaemias Adult: 12-24 g daily in single dose or up to 4 divided doses. Bile acid-induced diarrhoea Adult: 12-24 g daily in single dose or up to 4 divided doses. Pruritus associated with partial biliary obstruction or primary biliary cirrhosis Adult: 4-8 g daily.

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Child Dose
Hyperlipidaemias Child: >6 yr: 240 mg/kg daily in divided doses. Bile acid-induced diarrhoea Child: >6 yr: 240 mg/kg daily in divided doses. Pruritus associated with partial biliary obstruction or primary biliary cirrhosis Child: >6 yr: 240 mg/kg daily in divided doses.

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Contraindication
Complete biliary obstruction; hypersensitivity.
Mode of Action
Colestyramine binds with bile acids to form an insoluble complex which is excreted in the feces, resulting in increased loss of bile acid, thus increasing the oxidation of cholesterol to bile acids.
Precaution
Admin as a suspension in water or a flavored vehicle to minimise risk of oesophageal obstruction. May interfere with absorption of fat-soluble vitamins and folic acid and prolonged use may be associated with an increased bleeding tendency. Pregnancy; lactation. Lactation: Drug does not enter breast milk; use with caution because of potential vitamin loss in mother

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Side Effect
Constipation; faecal impaction; haemorrhoids; abdominal discomfort or pain; heartburn; flatulence; nausea; vomiting; diarrhoea; increased bleeding tendency (chronic use); osteoporosis; steatorrhoea (high doses); skin rashes; pruritus of the tongue, skin and perianal region; hyperchloraemic acidosis.
Pregnancy Category Note
Pregnancy category: C Lactation: Drug does not enter breast milk; use with caution because of potential vitamin loss in mother

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Interaction
Delayed or reduced absorption of folic acid, thiazide diuretics, propranolol, digoxin and related glycosides, loperamide, phenylbutazone, barbiturates, oestrogens, progestogens, thyroid hormones, warfarin and other coumarin-derivative anticoagulants, iron salts, deferasirox and some antibacterials (e.g. tetracycline, penicillin G). May prevent absorption of fat-soluble vit. Slightly decreased rate of absorption of clofibrate. May interfere w/ absorption of oral phosphate supplements.