cholestyramine / Generic mfg. - LARVOL DELTA

Propylthiouracil Induced Neutropenia in Thyroid Storm: A Case Requiring Urgent Total Thyroidectomy. (PubMed, Int Med Case Rep J) - "Bridging therapy with hydrocortisone, cholestyramine, Lugol's solution, was implemented once available, and low-dose carbimazole was cautiously reintroduced under close monitoring without recurrence of neutropenia. Once a euthyroid state was achieved, definitive management with a total thyroidectomy was performed without complications. This case highlights three key learning points: (1) agranulocytosis can occur very early during high-dose PTU therapy; (2) careful bridging strategies are essential to prevent rebound thyroid storm after antithyroid drug withdrawal; and (3) timely transition to definitive surgical management can be lifesaving when antithyroid drug intolerance occurs."

Journal • Agranulocytosis • Endocrine Disorders • Granulocytopenia • Grave’s Disease • Hematological Disorders • Neutropenia

Synergistic Hepatoprotection via SREBP-1c/PPAR-α, FXR/CYP7A1, and Insulin Signaling Modulation by Empagliflozin and Cholestyramine in STZ induced diabetic rats (APASL 2026) - No abstract available

Preclinical

Utilization of Intravenous Immunoglobulin for Basedow Paraplegia in Thyroid Storm (SCCM 2026) - "After 12 days of management with cholestyramine, dexamethasone, esmolol, and methimazole, thyroid hormone levels normalized, and sedation was stopped. Given the theorized immune-mediated aspect of BP, IVIG, a therapy utilized for immune-mediated myopathies, was trialed. In this case of thyrotoxic myopathy, normalization of thyroid hormone levels failed to resolve the paralysis, and muscle strength improved after a 5-day course of IVIG."

Atrial Fibrillation • Cardiovascular • CNS Disorders • Myasthenia Gravis • Myositis

Rethinking Our PLEXit Strategy in Thyroid Storm: When to Cut Our Losses on Medical Therapy Alone (SCCM 2026) - "Medical therapy includes methimazole or propylthiouracil, beta blocker, iodine, glucocorticoids, and cholestyramine...Despite treatment for thyroid storm with methimazole, esmolol, potassium iodide, hydrocortisone, and cholestyramine, she continued to deteriorate with worsening shock requiring multiple vasopressors, liver and kidney failure, and was subsequently intubated...We argue that PLEX should be considered earlier in medically refractory cases, such as in our patient, whose acute liver failure likely disrupted thyroid metabolism. Prompt initiation of PLEX could be a life-saving measure, and this case illustrates the importance of considering this intervention earlier in medically refractory thyroid storm."

Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Hepatology • Liver Failure • Metabolic Disorders • Nephrology • Pulmonary Disease • Renal Disease • Respiratory Diseases

THYROTOXICOSIS-INDUCED RIGHT VENTRICULAR DYSFUNCTION AND CHOLESTATIC LIVER INJURY (ACC 2026) - "She was treated with propylthiouracil (PTU), prednisone, cholestyramine, and diuretics. This case underscores the critical interplay between thyrotoxicosis and cardiovascular and hepatic complications. Thyrotoxicosis may unmask underlying cardiomyopathies. Prompt recognition and management of thyrotoxicosis with antithyroid therapy can lead to rapid improvement in organ function."

Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Endocrine Disorders • Grave’s Disease • Heart Failure • Hematological Malignancies • Hepatology • Liver Failure • Multiple Myeloma • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Smoldering Multiple Myeloma

Thyroid Storm With Multiorgan Dysfunction Mimicking Sepsis: Thionamide-Sparing Bridge to Delayed Carbimazole. (PubMed, Cureus) - "Given the hepatic dysfunction, initial management deferred thionamide therapy; treatment comprised propranolol, corticosteroids, cholestyramine, and lithium, along with supportive intensive care and empirical antibiotics. This case illustrates that thyroid storm can closely mimic sepsis with markedly elevated inflammatory biomarkers and may be complicated by severe hepatocellular injury. A thionamide-sparing approach, when thionamides are contraindicated (e.g., agranulocytosis, hypersensitivity reactions, or severe hepatic dysfunction), utilizing lithium and cholestyramine can effectively serve as a bridging strategy, facilitating postponement of thionamide therapy when immediate antithyroid treatment is contraindicated."

Journal • Agranulocytosis • Atrial Fibrillation • Cardiovascular • Critical care • Endocrine Disorders • Gastrointestinal Disorder • Granulocytopenia • Grave’s Disease • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Liver Failure • Psychiatry • Septic Shock

Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant. (PubMed, Front Gastroenterol (Lausanne)) - "The patient exhibited fluctuating bilirubin levels refractory to initial therapies including corticosteroids, ursodeoxycholic acid, cholestyramine, and artificial liver support. This case highlights that genetic etiologies, particularly MYO5B-related disorders, should be considered in patients presenting with recurrent hyperbilirubinemia, pruritus, and hepatosplenomegaly after excluding common causes (viral, autoimmune, drug-induced, or tumor-related). Genetic testing for MYO5B mutations is warranted in cases of high bilirubin with normal/mildly elevated GGT levels, as early recognition is critical for timely intervention."

Journal • Cholestasis • Dermatology • Fibrosis • Hepatocellular Cancer • Hepatology • Immunology • Liver Cirrhosis • Liver Failure • Oncology • Pruritus • Solid Tumor

A Scalable COF-Based Sequestrant for Synergistic Bile Acid Modulation in Fatty Liver Disease. (PubMed, J Am Chem Soc) - "The adsorbent performance significantly surpasses that of the clinical drug cholestyramine, which targets only deprotonated BAs and often leads to nutrient loss, as validated by in vitro and in vivo experiments. Notably, in a high-fat-diet-induced MAFLD mouse model, a 10-week COF treatment markedly reduced serum levels of total cholesterol and low-density lipoprotein cholesterol as well as liver injury markers, thereby alleviating hepatic steatosis, inflammation, and overall liver damage. This study not only establishes COFs as a promising class of next-generation oral adsorbents but also offers a mechanistic blueprint for targeting metabolic disorders through molecularly engineered materials."

Journal • Dyslipidemia • Hepatology • Inflammation • Liver Failure • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease

From Bowel to Lung : the Unexpected Pulmonary Cause of a Relentless Diarrhea. (BWG 2026) - "Only loperamide (2 tablets/day) partially controlled her symptoms. She was then given cholestyramine for one week followed by budesonide, in line with management of microscopic colitis, but without clinical benefit...To conclude, although carcinoid syndrome is an uncommon condition, it remains an important differential diagnosis in patients presenting with unexplained chronic diarrhea. Recognizing this rare syndrome early is essential, as it enables appropriate hormonal assessment, imaging, and therapeutic planning to improve patient outcomes."

Anorexia • Carcinoid Syndrome • Carcinoid Tumor • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Lung Cancer • Neuroendocrine Tumor • Solid Tumor • CHGA • ELANE

DETECTING SAFETY SIGNALS OF BILE ACID THERAPEUTICS: A FDA FAERS-BASED PHARMACOVIGILANCE STUDY (ISPOR 2026) - "Chenodiol (Ctexli), a synthetic bile acid, recently repurposed to treat cerebrotendinous xanthomatosis (CTX) in adults, has a limited well-defined real world safety data...Safety signals were evaluated using established criteria based on the reporting odds ratio (ROR) and proportional reporting ratio (PRR), each with 95% confidence intervals, along with the chi-square statistic (χ²) and p-values, with signals defined as ROR and PRR > 2, a lower 95% CI bound > 1, χ² ≥ 3, and p < 0.005. Disproportionality analysis identified potential safety signals associated with chenodiol, cholestyramine, colesevelam, and colestipol... Chenodiol's recent approval for cerebrotendinous xanthomatosis exemplifies how existing medications can be re-evaluated for new indications, and other therapeutic options. Integrating real-world safety data from post-marketing surveillance is crucial to supporting these repurposing efforts and ensuring patient safety."

Adverse events • Clinical

Leflunomide for the Treatment of High-Risk Smoldering Multiple Myeloma in African-American and European-American Patients (clinicaltrials.gov) - P2 | N=27 | Active, not recruiting | Sponsor: City of Hope Medical Center | Recruiting ➔ Active, not recruiting | N=56 ➔ 27 | Trial completion date: Jul 2026 ➔ Jan 2027 | Trial primary completion date: Jul 2026 ➔ Jan 2027

Enrollment change • Enrollment closed • Trial completion date • Trial primary completion date • Hematological Malignancies • Multiple Myeloma • Oncology • Smoldering Multiple Myeloma

Diagnostic and Treatment Challenges in a 37-year-old male with Diplopia, Extremity Weakness, and Palpitations (AAN 2026) - "Once his respiratory status stabilized, through continuous monitoring of his negative inspiratory force levels, he was treated with cholestyramine and methimazole for his Graves' disease. In conclusion, this case highlights the nuanced clinical reasoning behind treatment selection when multiple autoimmune conditions, such as MG and Graves', occur with overlapping symptoms that warrants careful management of both. It highlights diagnostic criteria, complication prevention, and treatment methods for combined diagnoses."

CNS Disorders • Dysphonia • Endocrine Disorders • Gastrointestinal Disorder • Grave’s Disease • Immunology • Insomnia • Myasthenia Gravis • Sleep Disorder

Beyond Atrial Fibrillation: A Case of Thyrotoxicosis-Associated Ischemic Stroke in a Young Patient. (PubMed, Cureus) - "Postoperatively, she developed refractory fever, extreme tachycardia, and hypertension despite broad-spectrum antibiotics for presumed sepsis. Endocrine workup confirmed thyroid storm, and the patient was treated aggressively with propylthiouracil, cholestyramine, and bisoprolol in addition to stress-dose glucocorticoids. Subsequent labs uncovered refractory hypercalcemia, prompting further evaluation that confirmed hyperparathyroidism. Emerging evidence further implicates thyroid dysfunction in coagulation pathway dysregulation, which may predispose patients to thromboembolic events independent of cardiac arrhythmias. This case underscores the importance of considering thyrotoxicosis in cryptogenic stroke, even without AF, and highlights gaps in current guidelines regarding anticoagulation therapy for this high-risk population."

Journal • Atrial Fibrillation • Cardiovascular • Endocrine Disorders • Hematological Disorders • Hypertension • Infectious Disease • Ischemic stroke • Metabolic Disorders • Septic Shock • Vascular Neurology

Evaluating the real-world safety of cholestyramine for the treatment of hyperlipidemia: disproportionality analysis of FAERS data. (PubMed, Front Med (Lausanne)) - "This study also underscores the importance of early detection of adverse reactions associated with cholestyramine. By providing insights into both known and potential adverse reactionsin real-world settings, the findings offer enhanced safety information to assist clinicians in prescribing cholestyramine for conditions such as hypercholesterolemia, cholestasis-associated pruritus, and bile acid diarrhea."

Journal • Real-world evidence • Cardiovascular • Cholestasis • Constipation • Dermatology • Dyslipidemia • Fibrosis • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hepatology • Immunology • Metabolic Disorders • Musculoskeletal Diseases • Ophthalmology • Orthopedics • Osteoporosis • Primary Biliary Cholangitis • Pruritus • Rheumatology

Peripartum Management of Refractory Graves' Thyrotoxicosis. (PubMed, Cureus) - "We present the case of a 39-year-old woman with severe, persistent Graves' thyrotoxicosis refractory to high-dose propylthiouracil (PTU), whose clinical course was complicated by pregnancy and postpartum deterioration...Definitive management options were limited by a highly vascular thyroid gland, significant myopathy, intolerance to cholestyramine, and psychiatric comorbidities. Surgery was deemed high risk, and RAI therapy was ultimately chosen, with careful pre- and post-treatment using high-dose propranolol to mitigate the risk of thyroid storm...This case emphasizes the complexities of managing refractory Graves' thyrotoxicosis in the peripartum period, particularly when conventional therapies fail, and definitive interventions carry elevated risk. It also highlights the importance of a multidisciplinary, patient-centered approach and the need for individualized management strategies in challenging clinical scenarios."

Journal • Cardiovascular • CNS Disorders • Depression • Endocrine Disorders • Grave’s Disease • Hypertension • Immunology • Myositis • Psychiatry

Structural characterization and functional evaluation of a heteropolysaccharide from large-fruited hawthorn (Malus doumeri (bois) Chev.). (PubMed, Int J Biol Macromol) - "MDPS exhibited excellent bile acid-binding capacity, with its binding effects on the taurocholic acid being close to that of the positive control cholestyramine...Overall, MDPS possesses a unique chemical structure and exhibits excellent biological activities, including high bile acid binding capacity and α-glucosidase inhibitory activity, suggesting its potential for downregulating blood lipids and blood glucose. This study provides a theoretical and practical foundation for the utilization of Malus doumeri fruit resources and the development of high-value-added functional food ingredients."

Journal

Refractory Intrahepatic Cholestasis of Pregnancy in Twin Gestation Managed With Ursodeoxycholic Acid and Adjunctive Cholestyramine: A Case Report. (PubMed, Cureus) - "Postnatally, the maternal condition was stable, and biochemical parameters normalized rapidly within 72 hours postpartum. Pruritus resolved completely, confirming the diagnosis of ICP."

Journal • Cholestasis • Critical care • Dermatology • Hepatology • Immunology • Infectious Disease • Inflammation • Pain • Pruritus

A multinational survey assessing the impact and burden of pruritus on patients with primary sclerosing cholangitis. (PubMed, Hepatol Commun) - "Cholestatic pruritus in PSC has a major adverse impact on QoL, interferes with daily activities, and is inadequately treated in the majority of respondents. These unmet needs highlight the importance of developing safe/effective antipruritic treatments for PSC."

Journal • Cholestasis • CNS Disorders • Dermatology • Fatigue • Hepatology • Pruritus • Sleep Disorder • Transplantation

Hemichorea as the Initial Presentation of Graves' Disease. (PubMed, Cureus) - "Treatment with methimazole, propranolol, cholestyramine, hydrocortisone, and Lugol's iodine led to normalization of thyroid function and complete resolution of hemichorea on follow-up, supporting a causal link to thyrotoxicosis. This initial presentation may experience a delayed diagnosis, as hyperthyroidism is not typically the first consideration, and usually presents with other symptoms, such as palpitations, weight loss, heat intolerance, irritability, proptosis, and hyperhidrosis. Early recognition and proper diagnosis are essential, as treating the underlying disease may lead to rapid resolution of chorea and avoid unnecessary treatments."

Journal • CNS Disorders • Critical care • Dermatology • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Grave’s Disease • Movement Disorders

The long-acting anticoagulant rodenticide brodifacoum induces neuropathology in adult New Zealand White rabbits and is reduced by the bile sequestrant cholestyramine. (PubMed, Neurotoxicology) - "Daily treatment with the bile sequestrant cholestyramine, which accelerates LAAR clearance from the body, ameliorated brodifacoum -induced damage. These findings confirm that, despite daily vitamin K1 treatment, LAARs such as brodifacoum can induce neuropathology in adult animals and support the use of agents such as bile sequestrants to ameliorate those consequences."

Journal • Preclinical

Bile Acid Sequestration Attenuates Desulfovibrio-Induced Hepatic Injury. (PubMed, Microorganisms) - "Notably, the administration of cholestyramine attenuated these DSV-associated microbial shifts and further reduced overall species richness, confirming the integral role of BA dynamics in shaping the gut microbial community. Collectively, our research reveals the intricate link between DSV, BAs, and gut microbiota in liver injury, and suggests that modulation of BAs may hold therapeutic potential for DSV-associated liver hepatic conditions."

Journal • Hepatology • Liver Failure • CYP8B1

Leflunomide-induced pancytopenia and agranulocytosis resulting in septic shock: A case report. (PubMed, Medicine (Baltimore)) - "Clinicians should maintain a high index of suspicion for drug-induced bone-marrow suppression in patients receiving leflunomide who develop unexplained cytopenias. Early drug discontinuation, aggressive supportive therapy, and timely initiation of cholestyramine washout may improve outcomes in this rare but life-threatening complication."

Journal • Agranulocytosis • Critical care • Granulocytopenia • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Septic Shock

Dissecting the causal link between transient hypoglycemic coma and gut-brain axis imbalance - implications for diarrhea pathogenesis: A case report. (PubMed, Medicine (Baltimore)) - "This case illuminates a novel, self-limiting cerebro-enteral pathway activated by hypoglycemia, which we hypothesize is mediated by blood-brain barrier-disruption and corticotropin-releasing hormone-driven neurohumoral cascades. It underscores the need to consider central nervous system injury in the differential diagnosis of unexplained acute diarrhea and highlights the necessity for monitoring gastrointestinal symptoms post-hypoglycemia."

Journal • CNS Disorders • Diabetes • Hypoglycemia • Immunology • Metabolic Disorders • Pain • Type 2 Diabetes Mellitus • Vascular Neurology

Variation in microbiome and metabolites is associated with advantageous effects of cholestyramine on primary biliary cholangitis with pruritus. (PubMed, Microbiol Spectr) - "Enterobacteriaceae/long-chain fatty acids have been identified as a significant marker for predicting the efficiency of the response to cholestyramine.IMPORTANCEPruritus in primary biliary cholangitis arises from synergistic cholestasis and gut microbiome-metabolite dysregulation. Cholestyramine mitigates symptoms by modulating the microbiome-metabolite-host axis, highlighting its therapeutic potential through microbiota remodeling and metabolic homeostasis restoration."

Journal • Cholestasis • Dermatology • Hepatology • Immunology • Metabolic Disorders • Primary Biliary Cholangitis • Pruritus

Efficacy and Safety of Adjunctive Bile Acid Sequestrant Therapy for Thyrotoxicosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, Thyroid) - "MEDLINE, Embase, Web of Science, and Cochrane databases were searched from March 1971 to September 2025 for randomized controlled trials (RCTs) assessing adult non-critically ill patients with hyperthyroidism treated with standard therapy (thionamides and beta-blocker) plus adjunctive bile acid sequestrants (cholestyramine or colestipol) versus standard therapy alone. However, due to considerable heterogeneity and low quality of evidence, our results should be interpreted with caution. Larger, high-quality RCTs are needed to strengthen the evidence regarding the efficacy of adjunctive bile acid sequestrant therapy."

Journal • Retrospective data • Endocrine Disorders • Grave’s Disease