Tiqueside is the synthetic spirostane-based steroid glycoside. It precipitates cholesterol from micellar solution in vitro and reduces plasma cholesterol absorption in rats through a mechanism that is currently thought to be independent of either association of the saponin with the intestinal mucosal surface or absorption of the saponin molecule. As a consequence of this inhibition, tiqueside has been shown to reduce plasma cholesterol concentrations in cynomolgus monkeys. Inhibition of cholesterol absorption by tiqueside produces profound effects on cholesterol metabolism without affecting bile acid metabolism, and these changes lead to reductions primarily in plasma non-HDL cholesterol concentrations. Tiqueside produced a dose-dependent reduction in plasma LDL cholesterol levels in the hypercholesterolemic patients. In the mechanistic study, it decreased fractional cholesterol absorption rates and increased fecal neutral sterol excretion rates, changes associated with trends toward lower LDL cholesterol levels. Other lipoprotein levels were unaffected, as were fecal fat and bile acid excretion and fat-soluble vitamin absorption. Thus tiquesidedose-dependently inhibits cholesterol absorption in humans, resulting in a reduction in serum LDL cholesterol levels.