Colestipol 1gm tab. Colestipol: Uses, Side Effects, and Dosage Guide for Cholesterol Management
What is colestipol used for. How does colestipol work to lower cholesterol. What are the potential side effects of taking colestipol. How should colestipol be taken for optimal effectiveness. What precautions should be considered when using colestipol. How does colestipol interact with other medications. What is the recommended dosage for colestipol.
Understanding Colestipol: A Powerful Cholesterol-Lowering Medication
Colestipol is a medication primarily prescribed to lower cholesterol levels in the blood. It belongs to a class of drugs known as bile acid-binding resins. By reducing cholesterol, colestipol plays a crucial role in decreasing the risk of strokes and heart attacks, which are often associated with high cholesterol levels.
How does colestipol work to lower cholesterol? Colestipol functions by removing bile acid from the body. In individuals with high cholesterol, this process stimulates the liver to produce more bile acid using cholesterol from the bloodstream. As a result, the overall cholesterol levels in the blood decrease.
Key Benefits of Colestipol
- Lowers blood cholesterol levels
- Reduces the risk of cardiovascular events
- Complements lifestyle changes for better heart health
It’s important to note that while colestipol is effective in managing cholesterol levels, it works best when combined with a proper diet and lifestyle changes. These additional measures include following a low-cholesterol/low-fat diet, regular exercise, weight management if overweight, and smoking cessation.
Proper Administration of Colestipol: Dosage and Guidelines
Colestipol is typically administered orally, with the dosage and frequency determined by a healthcare professional based on the individual’s medical condition and response to treatment. What is the recommended dosage for colestipol? The usual dosage ranges from 1 to 2 times daily, but it’s crucial to follow your doctor’s specific instructions.
Key Points for Taking Colestipol
- Take each tablet with plenty of liquid (water or juice)
- Swallow tablets whole – do not crush, chew, or break
- If prescribed multiple tablets, take them one at a time
- Maintain a consistent schedule, taking the medication at the same time(s) each day
How should colestipol be taken for optimal effectiveness? To maximize the benefits of colestipol, it’s essential to take it regularly and as prescribed. Your doctor may start you on a lower dose and gradually increase it to minimize side effects. It’s important to continue taking colestipol even if you feel well, as high cholesterol often doesn’t cause noticeable symptoms.
Potential Side Effects and Management Strategies
Like all medications, colestipol can cause side effects. What are the potential side effects of taking colestipol? Common side effects include:
- Constipation
- Stomach or abdominal pain
- Gas
- Nausea
- Vomiting
To manage constipation, which is a common side effect, consider increasing your dietary fiber intake, staying well-hydrated, and engaging in regular exercise. In some cases, your doctor may recommend a laxative to alleviate this symptom.
While most side effects are mild, it’s crucial to be aware of potential serious side effects. Seek immediate medical attention if you experience:
- Difficulty swallowing
- Chest pain or pressure
- Severe stomach or abdominal pain
- Unusual bleeding or bruising
- Rapid breathing
- Confusion
Although rare, a serious allergic reaction to colestipol is possible. Symptoms of a severe allergic reaction may include rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing. If you notice any of these symptoms, seek immediate medical help.
Precautions and Considerations When Using Colestipol
What precautions should be considered when using colestipol? Before starting colestipol treatment, it’s essential to inform your healthcare provider about any allergies, medical conditions, or medications you’re currently taking. This information helps prevent potential complications and ensures the safe use of colestipol.
Important Considerations
- Inform your doctor about any swallowing problems, constipation, hemorrhoids, or kidney disease
- Discuss the potential need for vitamin supplementation, as colestipol can interfere with the absorption of certain nutrients
- Inform all healthcare providers about your use of colestipol before any surgical procedures
- Exercise caution if you’re pregnant or breastfeeding, as colestipol may affect nutrient absorption
Older adults may be more sensitive to the side effects of colestipol, particularly constipation. If you’re in this age group, your doctor may monitor you more closely and adjust your dosage if necessary.
Drug Interactions: Understanding Colestipol’s Impact on Other Medications
How does colestipol interact with other medications? Colestipol can significantly affect the absorption of other drugs, potentially altering their effectiveness. To minimize these interactions, it’s crucial to take other medications at least 1 hour before or 4 to 6 hours after taking colestipol.
Medications That May Interact with Colestipol
- Thyroid hormones
- Warfarin (a blood thinner)
- Certain antibiotics
- Digoxin (a heart medication)
- Oral contraceptives
Always inform your healthcare provider about all medications, including over-the-counter drugs and herbal supplements, that you’re taking. This information allows for proper adjustment of dosages and timing to ensure optimal effectiveness of all your medications.
Lifestyle Modifications to Enhance Colestipol’s Effectiveness
While colestipol is an effective medication for lowering cholesterol, its benefits are maximized when combined with lifestyle changes. What lifestyle modifications can enhance the effectiveness of colestipol?
Key Lifestyle Changes
- Adopt a heart-healthy diet low in saturated fats and cholesterol
- Engage in regular physical activity (aim for at least 150 minutes of moderate-intensity exercise per week)
- Maintain a healthy weight or lose weight if overweight
- Quit smoking and limit alcohol consumption
- Manage stress through relaxation techniques or mindfulness practices
These lifestyle modifications not only enhance the cholesterol-lowering effects of colestipol but also contribute to overall cardiovascular health. Your healthcare provider can offer guidance on implementing these changes effectively and sustainably.
Monitoring and Follow-up: Ensuring Optimal Colestipol Treatment
Regular monitoring is crucial when taking colestipol to ensure its effectiveness and manage any potential side effects. How often should you follow up with your healthcare provider while on colestipol?
Typical Monitoring Schedule
- Initial follow-up: Usually within 4-6 weeks of starting treatment
- Lipid panel tests: Every 3-6 months or as recommended by your doctor
- Annual physical examination: To assess overall health and medication effects
During these check-ups, your doctor will evaluate your cholesterol levels, assess any side effects, and may adjust your dosage if necessary. It’s important to attend all scheduled appointments and to report any concerns or new symptoms promptly.
Long-term Outlook: Living with Colestipol Treatment
What can patients expect in terms of long-term colestipol use? Colestipol is often prescribed as a long-term treatment for managing cholesterol levels. While it effectively lowers cholesterol, it does not cure the underlying condition that causes high cholesterol.
Long-term Considerations
- Consistent medication adherence is crucial for maintaining lowered cholesterol levels
- Regular monitoring of cholesterol levels and overall health is necessary
- Lifestyle modifications should be maintained alongside medication use
- Potential long-term side effects should be discussed with your healthcare provider
Many patients successfully manage their cholesterol levels with colestipol for years. However, it’s important to maintain open communication with your healthcare provider about any concerns or changes in your health status over time.
In conclusion, colestipol is a valuable tool in the management of high cholesterol and the prevention of cardiovascular diseases. By understanding its proper use, potential side effects, and the importance of complementary lifestyle changes, patients can maximize the benefits of this medication and improve their overall heart health. Regular follow-ups with healthcare providers ensure that the treatment remains effective and safe over the long term.
Colestipol Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
Colestipol is used along with a proper diet to lower cholesterol in the blood. Lowering cholesterol helps decrease the risk for strokes and heart attacks.In addition to a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.This medication is known as a bile acid-binding resin. It works by removing bile acid from the body. In people with high cholesterol, this causes the liver to make more bile acid by using cholesterol in the blood. This helps to lower the cholesterol levels.
How to use colestipol oral
Take this medication by mouth as directed by your doctor, usually 1 to 2 times a day. If your dose is more than 1 tablet, take the tablets one at a time. Do not try to swallow more than one tablet at once. Take each tablet with plenty of liquid (such as water, juice). Swallow each tablet whole. Do not crush, chew, or break the tablets. If you have difficulty swallowing the tablet whole, consult your doctor.
The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. It may take several weeks before you get the full benefit of this drug.
Colestipol may decrease your absorption of other medications. Take your other medications as directed by your doctor, usually at least 1 hour before or 4 to 6 hours after colestipol. Ask your doctor or pharmacist for more information or if you have any questions.
Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. Keep taking this medication even if you feel well. Most people with high cholesterol do not feel sick.
Side Effects
Constipation, stomach/abdominal pain, gas, nausea, and vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: difficulty swallowing, chest pain/pressure, severe stomach/abdominal pain, unusual bleeding/bruising, rapid breathing, confusion.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking colestipol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: swallowing problems, constipation, hemorrhoids, kidney disease.
Because this drug can interfere with the absorption of certain nutrients (such as folic acid, fat-soluble vitamins including A, D, E, K), your doctor may direct you to take a multivitamin supplement. Consult your doctor for more information.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially constipation.
During pregnancy, this medication should be used only when clearly needed. It may affect the absorption of certain nutrients. Discuss the risks and benefits with your doctor.
This medication is unlikely to pass into breast milk. However, it may affect the absorption of certain nutrients. Consult your doctor before breast-feeding.
Interactions
See also How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: “blood thinners” (such as warfarin), mycophenolate, raloxifene.
Does colestipol oral interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach/abdominal pain.
Do not share this medication with others.
Lab and/or medical tests (such as blood cholesterol/triglyceride levels, vitamin levels) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Images
colestipol 1 gram tablet
Color: yellowShape: ovalImprint: CZ
This medicine is a yellow, oval, film-coated, tablet imprinted with “CZ”.
colestipol 1 gram tablet
Color: yellowShape: ellipticalImprint: G 450
This medicine is a yellow, oval, film-coated, tablet imprinted with “CZ”.
colestipol 1 gram tablet
Color: off-whiteShape: ovalImprint: G
This medicine is a yellow, oval, film-coated, tablet imprinted with “CZ”.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Colestipol: MedlinePlus Drug Information
pronounced as (koe les’ ti pole)
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Colestipol is used along with diet changes to decrease the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol (‘bad cholesterol’) in certain people with high cholesterol. Colestipol is in a class of medications called bile acid sequestrants. It works by binding bile acids in your intestines to form a product that is removed from the body.
Colestipol comes as tablets and granules to take by mouth. The tablets are usually taken once or twice daily. The granules are usually taken one to six times daily. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take colestipol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Unless otherwise instructed, take all other medications at least 1 hour before or 4 hours after you take colestipol because it can interfere with their absorption.
Swallow the tablets whole with a glass of water or another liquid; do not chew, split, or crush them.
Your doctor may gradually increase your dose at 1 to 2 month intervals, depending on your response.
Continue to take colestipol even if you feel well. Do not stop taking colestipol without talking to your doctor.
Do not take the granules dry. Add them to at least 3 ounces (90 milliliters) of a liquid (e.g., fruit juice, water, milk, or soft drink) and stir until completely mixed. If you use a carbonated beverage, mix it slowly in a large glass to minimize foaming. After taking the dose, rinse the glass with a small amount of additional liquid and drink it to be sure that you receive the entire dose.
Colestipol also may be mixed with hot or regular breakfast cereals, thin soups (e.g., tomato and chicken noodle), or pulpy fruit (e.g., crushed pineapple, pears, peaches, and fruit cocktail).
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Before taking colestipol,
- tell your doctor and pharmacist if you are allergic to colestipol, any other medications, or any of the ingredients in colestipol preparations. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Pacerone), antibiotics, anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven), digitoxin, digoxin (Lanoxin), diuretics (‘water pills’), iron, loperamide (Imodium), mycophenolate (Cellcept), oral diabetes medications, phenobarbital, phenylbutazone, propranolol (Inderal, Innopran), and thyroid medications. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had unusual bleeding, an underactive thyroid gland, heart or intestinal disease, or if you have hemorrhoids.
- if you are taking gemfibrozil (Lopid), take it 2 hours before or 2 hours after colestipol.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking colestipol, call your doctor.
Eat a low-fat, low-cholesterol diet. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. You can also visit the National Cholesterol Education Program (NCEP) website for additional dietary information at http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf.
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.
Colestipol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- constipation
- belching
- nausea
- vomiting
- gas
Some side effects can be serious. If you experience the following symptom, call your doctor immediately:
- unusual bleeding (such as bleeding from the gums or rectum)
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www. fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
- Colestid®
- Colestid® Flavored Granules
- Colestid® Granules
Last Revised – 09/15/2018
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Activated charcoal+­, bile+­, stinging nettle leaves+­, garlic bulb
Farmgroup
Cholagogues and enzymes
Composition
One coated tablet contains: dried bulbs – 40,000 mg, nettle leaves – 5,000 mg, activated charcoal – 25,000 mg.
Excipients: magnesium oxide, potato starch, talc, polysorbate (tween-80), calcium stearate, microcrystalline cellulose, primogel, shell composition: sucrose (sugar), magnesium hydroxycarbonate (basic magnesium carbonate), titanium dioxide, povidone (polyvinylpyrrolidone low molecular weight medical 12600+2700, K-17), talc, solid paraffin, vaseline oil, beeswax, polysorbate (tween-80).
Pharmacological action
Combined preparation. Choleretic (cholekinetic and choleretic) agent, reduces the processes of putrefaction and fermentation in the intestine. It enhances the secretory function of liver cells, reflexively increases the secretory and motor activity of the organs of the gastrointestinal tract.
Increases the formation of bile and bile acids. The action of bile is due to the reflex effect on the secretory function of the liver parenchyma. Bile also enhances the secretory and motor functions of the gastrointestinal tract. Substances contained in garlic enhance the secretory and motor function of the gastrointestinal tract, stimulate the secretion of bile. Nettle leaves have choleretic and anti-inflammatory properties. Activated charcoal is an adsorbent that binds toxic substances in the gastrointestinal tract.
Pharmacokinetics
The active ingredients of the drug are well absorbed in the gastrointestinal tract. Cholic and chenodeoxycholic acids contained in the preparation undergo 7-alpha-dehydroxylation in the intestine. Chenodeoxycholic acid, in addition, is metabolized in the liver: conjugated with amino acids, secreted into bile, from where it is again excreted into the intestine, then partially reabsorbed, the rest is excreted through the intestine.
Indications for use
As part of complex therapy: chronic reactive hepatitis, cholangitis, acalculous (non-calculous) cholecystitis, biliary dyskinesia of the hypokinetic type, atonic constipation, postcholecystectomy syndrome.
Contraindications
Increased sensitivity to the components of the drug, calculous cholecystitis, obstructive jaundice, acute hepatitis, acute and subacute liver dystrophy, peptic ulcer of the stomach and duodenum (in the phase of exacerbation), acute enterocolite, acute pancreatitis, sugar shortage, shortage of sugar PS/isomaltase , fructose intolerance, glucose-galactose malabsorption, children under 12 years of age.
Precautions
In diabetic patients and in persons on a low carbohydrate diet.
Use during pregnancy and during breastfeeding
During pregnancy and during breastfeeding, the use of the drug is possible on the recommendation of a doctor and only if the expected benefit to the mother outweighs the potential risk to the fetus and child.
Special instructions
The preparation contains sucrose, which should be taken into account in patients with diabetes mellitus. One tablet contains about 0.1 g of sucrose (sugar), which corresponds to 0.01 XE, the maximum daily dose of the drug contains about 0.8 g of sucrose (sugar), which corresponds to 0.08 XE.
Influence on the ability to drive vehicles and mechanisms
The use of the drug does not affect the ability to drive vehicles and engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Dosage and administration
Inside, after meals.
Adults – 1-2 tablets 3-4 times a day.
Children over 12 years old – 1 tablet 3 times a day.
The course of treatment is 3-4 weeks. With exacerbation of diseases, 1 tablet 2-3 times a day for 1-2 months. Repeated courses of treatment are carried out with an interval of 3 months after consulting a doctor.
Consult a physician before using this medicine in children.
Side effects
Possible allergic reactions, diarrhea, increased activity of “liver” transaminases in the blood serum.
If any of the side effects listed in the instructions get worse, or you notice any other side effects not listed in the instructions, tell your doctor.
Overdose
No cases of overdose have been registered so far.
Possible symptoms: diarrhea, nausea, heartburn, pruritus, increased activity of “liver” transaminases in the blood.
Treatment: symptomatic.
Interaction with other drugs
Preparations containing aluminum hydroxide, cholestyramine, colestipol reduce absorption and reduce the effect of the drug. Simultaneous reception is impractical.
Simultaneous use of the drug with choleretic drugs of synthetic or plant origin increases bile formation.
The combination of the drug with laxative drugs leads to the elimination of constipation. The drug promotes better absorption of fat-soluble vitamins.
The use of the drug with antiseptics or chemotherapeutic agents in infectious processes in the liver or biliary tract improves the therapeutic efficacy of the latter.
Presentation
Tablets
coated tablets
Storage conditions
At a temperature not exceeding 25°C.
Expiration date
4 years
 ,
Rec. INN drug interaction Pharmacological actionAnti-absorption agent for bile acids and cholesterol in the intestine. When taken orally, it binds bile acids in the intestines, forming a complex that is excreted from the body with feces, which leads to a decrease in the absorption of bile acids from the intestines, as well as cholesterol. The synthesis of bile acids from cholesterol in the liver increases, which leads to a decrease in the level of total cholesterol and LDL in the blood plasma. Indications of the active substance |
E78.0 | Pure hypercholesterolemia |
Dosage regimen
The dose, regimen and duration of therapy is determined individually, depending on the clinical situation, the effectiveness of therapy and the age of the patient.
For adults, the initial dose is 5 g/day; in the future, the dose may be increased (by 5 g every 4-8 weeks).
The maximum daily dose of is 30 g.
Side effects when used in high doses – steatorrhea.
Dermatological reactions: rarely – urticaria, dermatitis.
Contraindications for use
Hypersensitivity to colestipol; children’s age up to 6 years.
Pregnancy and lactation
The safety of colestipol during pregnancy has not been established. The use of colestipol during pregnancy is not recommended.
Use in children
Contraindicated in children under 6 years of age.
Special instructions
Before starting therapy, the patient should be excluded from hypothyroidism, diabetes mellitus, dysproteinemia syndrome, obstructive conditions of the biliary tract. If in the presence of the listed diseases there is a need for treatment with colestipol, appropriate therapy should be carried out under the supervision of a physician. Control of the level of TG, cholesterol and lipoproteins must be carried out during the entire period of treatment.
Long-term use of colestipol can lead to vitamin A, D, E and K deficiencies.
Drug interactions
With simultaneous use with atorvastatin, a decrease in the concentration of atorvastatin in the blood plasma is possible, while the lipid-lowering effect is enhanced.
When co-administered with vancomycin, colestipol binds vancomycin in the intestine (this effect is much less pronounced than that of cholestyramine), which leads to a decrease in the effectiveness of vancomycin.
When co-administered with gemfibrozil, the absorption of gemfibrozil is reduced.
When used simultaneously with hydrocortisone, it is possible to reduce the absorption of hydrocortisone from the gastrointestinal tract.
When used simultaneously with hydrochlorothiazide, the absorption and diuretic effect of hydrochlorothiazide is reduced.
When taken at intervals of 1.