The study evaluated the safety of cholestyramine in real-world practice by analyzing all adverse event reports since 2004 in the FAERS database, where cholestyramine was identified as the primary suspect drug. Cholestyramine lowers LDL cholesterol levels and is used to treat primary hypercholesterolemia, pruritus in cholestasis (eg, primary biliary cirrhosis), and bile acid diarrhea. The analysis used BCPNN, MGPS, PRR and ROR methods to identify adverse reactions. Known effects from the package insert such as constipation, abdominal pain, bloating, steatorrhea, bleeding tendency, night blindness, hyperchloremic acidosis, osteoporosis, rashes, and local irritation from vitamin A, D, and K deficiency were confirmed. New adverse reactions outside the package insert were also reported, including GERD, irritable bowel syndrome, fecal abnormalities, blood glucose fluctuations, fractures teeth, off-label use and exacerbations of other diseases. The findings provide insight into safety and highlight the importance of early detection of adverse reactions in prescribing.[5]