Colestilan ( INN, trade name BindRen) is a medication that acts as a phosphate binder and [1 ] bile acid sequestrant. [2 ]
Clinical use [ edit ]
Colestilan is used for the treatment of
hyperphosphataemia (too high phosphate concentrations in the blood serum) in patients undergoing dialysis, including peritoneal dialysis. [1 ] [3 ]
Contraindications [ edit ]
Colestilan is contraindicated in patients with bowel obstruction.
Interactions [ edit ]
The substance can inhibit the resorption of other drugs, as well as fat soluble vitamins (
A, D, E, K) and folate, from the gut. Resulting lower blood levels can be clinically problematic with [1 ] immunosuppressant and antiepileptic drugs. [3 ]
Adverse effects [ edit ]
Adverse effects include
gastrointestinal problems such as constipation, as well as vitamin and calcium deficiency. Vitamin K deficiency sometimes causes gastrointestinal bleeding. [1 ] [3 ]
Chemistry and mechanism of action [ edit ]
Colestilan is a cross-linked
copolymer of 2-methylimidazole and epichlorohydrin and works as an anion exchanger resin with affinity to phosphate, bile acid anions and urate. It binds these anions in the gut and removes them from the enterohepatic circulation. Colestilan is not absorbed from the gut, but is excreted together with the bound anions. [1 ]
-imidazole (left) and epichlorohydrin (right)
References [ edit ]
^ a b c d e A. Klement (11 November 2013). "Dialysepflichtig – weniger Phosphat mit BindRen". Österreichische Apothekerzeitung (in German) (23/2013): 28f.
^ Handelsman, Y. (2011). "Role of Bile Acid Sequestrants in the Treatment of Type 2 Diabetes". Diabetes Care 34: S244–S250. doi: 10.2337/dc11-s237. PMID 21525463.
^ a b c d Haberfeld, H, ed. (2013). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag.