Bristol-Myers Squibb (BMS) are currently the only supplier of colestyramine and they are facing manufacturing difficulties. Questran is now out of stock and no further supplies are expected before BMS transfer the product to Cheplapharm at the end of July 2019. It is not yet confirmed when the new manufacturer will be in a position to make supplies available. Supplies of Questran Light are currently available and able to support demand for patients who take Questran or Questran Light sachets. The Emergency Order Process through Alliance Healthcare has been lifted and supplies should be available through normal wholesaler routes. BMS are also transferring Questran Light to Cheplapharm, but it is hoped that this will not impact adversely on continuity of supplies.

The supply situation for the alternative bile acid sequestrants is outlined below:

• Cholestagel (colesevelam): currently out of stock. Resupply date 16th July.
• Colestid Orange (colestipol) 5g granules: currently in stock but will be out of stock from mid-July and not expected back until October 2019.
• Colestid (colestipol) granules 5g (plain): currently in stock but only sufficient to support the patients currently taking the colestipol either as plain granules or as Colestid Orange.

This memo advises on management options until the shortage resolves.