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The Department of Health and Social Service (DHSC) has issued an alert notifying the shortage of bile acid sequestrants.

The drugs including colestyramine powder for oral suspension 4g (Questran and Questran Light), colesevelam (Cholestagel), and colestipol (Colestid) are facing availability issues, following the divestment of the Questran range from Bristol-Myers Squibb to Cheplapharm last year, the alert said.

The stock availability of these medicines as of November 2020 is given below:

Questran Light of Cheplapharm is fully available in pharmacy shelves
Questran manufactured by Cheplapharm is out of stock. The product is expected to return to pharmacies after August 2021
Colestyramine light 4g sachets of Mylan is available in the market
Cholestagel (colesevelam) 625mg tablets of Sanofi are in stock
Colestid (colestipol) plain of Pfizer is available for consumption
Colestid (colestipol) Orange of Pfizer is out of stock and resupply is expected from April 2021

Community pharmacies have been asked to check their current stock and levels of use and discuss the situation with relevant specialists to highlight that supply of these agents may be limited over the next few months and patients may need to be switched between agents.

For patients with pruritus due to liver or biliary problems who do not achieve adequate benefit from treatment with a bile acid sequestrant, there are a number of alternative treatments available including menthol in aqueous cream, rifampicin, ondansetron and sertraline. Specialist advice may be needed to ensure that symptom control is maintained.

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