The effects of colestipol when combined with clofibrate in the treatment of severe hyperlipidemia. Short-term and long-term studies.

Twenty-two patients suffering from hyperlipidemia and receiving therapy consisting of a lipid-lowering diet and clofibrate (1 g X 2) were in addition given colestipol hydrochloride (5 g X 3) (Colestid, Upjohn) in a randomized, cross-over study for 2 periods of 6 weeks. Both the cholesterol and the triglyceride concentrations in very low density lipoproteins remained unchanged during the colestipol treatment. The cholesterol concentration in low density lipoproteins decreased by 23% (P < 0.001) and increased in high density lipoproteins by 4% (P < 0.01). In a second part of the project, the effects on the lipoprotein lipids of 15 g of colestipol divided into 1, 2 or 3 daily doses were studied when added to ongoing therapy with clofibrate (1 g X 2) and lipid-lowering diet. When the colespitol was divided into 2 or 3 daily doses, the effects were manifested equally but were less pronounced when 1 dose per day was given. In a third study, 14 patients who were treated with a combination of lipid-lowering diet, clofibrate (1 g X 2) and colestipol hydrochloride (15 g daily) were followed over a 2-year period, during which time the serum cholesterol and triglyceride concentrations were maintained at a reduced level. The fasting blood glucose and serum insulin concentrations were increased during colestipol treatment. Such treatment should therefore not be given to patients with impaired glucose tolerance.