Can cholesterol medication cause constipation

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Cholesterol Medication and Constipation: An Overview

Atorvastatin and Constipation

Atorvastatin-Induced Constipation
Atorvastatin, a commonly prescribed statin for lowering cholesterol, has been reported to cause constipation in some patients. A case study involving a 72-year-old patient with hypercholesterolemia revealed that the administration of Atorvastatin 20 mg led to constipation and abdominal discomfort. Upon discontinuation of Atorvastatin and switching to Rosuvastatin, the symptoms of constipation were alleviated. The exact mechanisms behind this side effect are not fully understood, but potential factors include alterations in nitric oxide levels, inhibition of melvonic acid production, and a decrease in coenzyme Q10 levels .

Colestipol and Constipation

Cholesterol-Lowering Effect and Side Effects of Colestipol
Colestipol, a bile acid sequestrant used to lower cholesterol, has also been associated with constipation. In a study involving 66 hypercholesterolemic patients, 10 g of colestipol HCl administered twice daily resulted in a significant reduction in serum cholesterol levels. However, constipation was reported as a common side effect, affecting six patients on colestipol compared to three on placebo . This highlights the gastrointestinal side effects that can accompany the use of bile acid sequestrants.

Bile Acid Sequestrants and Gastrointestinal Effects

Safety Considerations with Bile Acid Sequestrants
Bile acid sequestrants, including cholestyramine, colestipol, and colesevelam, are known for their gastrointestinal side effects. These agents can lead to constipation and, in rare cases, intestinal obstruction. The newer bile acid sequestrant, colesevelam, has been designed to reduce these side effects by having greater specificity for bile acids, thereby minimizing drug interactions and the tendency for constipation .

Lovastatin and Constipation

Modified-Release Lovastatin for IBS-C
Lovastatin, another cholesterol-lowering drug, has been studied for its potential effects on constipation, particularly in patients with irritable bowel syndrome with constipation (IBS-C). Research indicates that a modified-release formulation of lovastatin targeting intestinal methanogens can inhibit methane production, which is associated with constipation, pain, and bloating in IBS-C patients. This innovative approach aims to deliver lovastatin to specific intestinal locations to alleviate constipation symptoms .

Conclusion

In summary, several cholesterol-lowering medications, including atorvastatin, colestipol, and other bile acid sequestrants, have been associated with constipation as a side effect. The mechanisms behind these effects vary and are not always fully understood. However, newer formulations and alternative medications are being developed to mitigate these gastrointestinal side effects while effectively managing cholesterol levels. Patients experiencing constipation from cholesterol medications should consult their healthcare provider for potential alternatives or supportive treatments.

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Most relevant research papers on this topic

Atorvastatin Induced Constipation

Atorvastatin may cause constipation by affecting nitric oxide levels, inhibiting melvonic acid production, and decreasing coenzyme Q10.

Case Report

2022·

0citations

·B. A. sai et al.

Cholesterol-lowering effect of colestipol hydrochloride given twice daily in hypercholesterolemic patients.

Colestipol hydrochloride, 10g twice daily, effectively lowers serum cholesterol in hypercholesterolemic patients, with the most common side effect being constipation.

RCT

1976·

13citations

·K. Gundersen et al.

Long-term supplementation of isomalto-oligosaccharides improved colonic microflora profile, bowel function, and blood cholesterol levels in constipated elderly people--a placebo-controlled, diet-controlled trial.

Isomaltoligosaccharide supplementation improves colonic microflora and bowel function in elderly individuals, but these benefits decrease after discontinuing the supplementation.

RCTHighly Cited

2011·

104citations

·C. Yen et al.

Development of a Modified-Release Formulation of Lovastatin Targeted to Intestinal Methanogens Implicated in Irritable Bowel Syndrome With Constipation.

A modified-release lovastatin formulation with enteric polymers shows promise in treating irritable bowel syndrome with constipation by targeting intestinal methanogens.

In Vitro Study

2018·

23citations

·S. Hubert et al.

Safety considerations with gastrointestinally active lipid-lowering drugs.

Gastrointestinally active lipid-lowering drugs, such as ezetimibe and colesevelam, have excellent systemic safety profiles when used alone or in combination with other lipid-lowering drugs.

Highly Cited

2007·

83citations

·T. Jacobson et al.

Effects of A3309, an Ileal Bile Acid Transporter Inhibitor, on Colonic Transit and Symptoms in Patients with Functional Constipation

A3309 accelerates colonic transit and loosens stool consistency in functional constipation patients, improving symptoms and reducing straining.

RCT

2011·

7citations

·B. Wong et al.

Intestinal transit, deoxycholic acid and the cholesterol saturation of bile--three inter-related factors.

Constipation or slow colonic transit may increase the risk of supersaturated bile, leading to gall stones, by altering the size of the deoxycholic acid pool and bile cholesterol saturation.

Non-RCTHighly Cited

1986·

168citations

·S. N. Marcus et al.

A randomized trial of the effects of flaxseed to manage constipation, weight, glycemia, and lipids in constipated patients with type 2 diabetes

Flaxseed cookies, when used as a snack, may help decrease constipation symptoms, weight, glycemic, and lipid levels in patients with type 2 diabetes.

RCTVery Rigorous Journal

2018·

38citations

·Noureddin Soltanian et al.

Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation

Opioid-induced constipation in the elderly is often underrecognized and undertreated, with new pharmacologic agents like methylnaltrexone and naloxegol potentially providing more effective treatment options.

Very Rigorous Journal

2016·

53citations

·S. Chokhavatia et al.

Relationship Between Constipation and Medication.

Constipation is common and can be caused by adverse drug reactions from various medications, including opioids, anticholinergic agents, and hypnotics.

Literature Review

2019·

19citations

·T. Ueki et al.

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