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Cholesterol that has been transferred to HDL is esterified and the cholesteryl ester is transferred back to IDL by cholesteryl ester transfer protein in exchange for triglyceride
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The most important adverse effects of LDL-apheresis include: hypotension, abdominal pain, nausea, vomiting, vertigo and headache, hypocalcaemia, iron deficiency anaemia, allergic reactions, haemolysis, and thrombocytopenia

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An overdose of this combination may lead to gastrointestinal discomfort, nausea, or metallic taste