If your bilirubin is elevated (3.5 mg/dL), Choltran (cholestyramine) should only be used under a doctor’s supervision, because the correct dose depends on your liver condition, other health issues, and any medications you are taking. Self-use can cause side effects like constipation or reduced absorption of vitamins. While it may help relieve itching, Choltran does not treat the underlying liver problem, so careful medical monitoring is essential to ensure safe and effective use.