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 known when the new manufacturer will be in a position to make supplies available. Supplies of Questran Light are available using an Emergency Order Process through Alliance and it is currently not clear when the Emergency Order Process will be lifted. BMS are also transferring this product to Cheplapharm at the end of July and again it is not clear when they will be in a position to make supplies available.

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

• Cholestagel (colesevelam): currently in stock but supplies are expected to be limited in the near future.
• Colestid Orange (colestipol) 5g granules: currently in stock but will be out of stock from the 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.