Xenical cost in russia

Xenical, Alli
tetrahydrolipstatin
Monograph
a601244
Negligible
>99%
In the GI tract
1 to 2 hours
Fecal
100.167.400
C29H53NO5
495.735 g/mol

Orlistat is a drug designed to treat obesity. It is marketed as a prescription drug under the trade name Xenical by Roche in most countries, and is sold over-the-counter as Alli by GlaxoSmithKline in the United Kingdom and the United States. Its primary function is preventing the absorption of fats from the human diet by acting as a lipase inhibitor, thereby reducing caloric intake. It is intended for use in conjunction with a healthcare provider-supervised reduced-calorie diet.

Orlistat is the saturated derivative of lipstatin, a potent natural inhibitor of pancreatic lipases isolated from the bacterium Streptomyces toxytricini. However, due to its relative simplicity and stability, orlistat was chosen over lipstatin for development as an anti-obesity drug.

The effectiveness of orlistat in promoting weight loss is definite but modest. Pooled data from clinical trials suggest that people given orlistat in addition to lifestyle modifications, such as diet and exercise, lose about 2–3 kilograms (4.4–6.6 lb) more than those not taking the drug over the course of a year. Orlistat also modestly reduces blood pressure and appears to prevent the onset of type 2 diabetes, whether from the weight loss itself or to other effects. In a large randomized controlled trial, orlistat was found to reduce the incidence of diabetes by nearly 40% in obese people.

Benefits aside, however, orlistat is notorious for its gastrointestinal side effects (sometimes referred to as treatment effects), which can include steatorrhea (oily, loose stools). They decrease with time, however, and are the most frequently reported adverse effects of the drug. In Australia, the United States and the European Union, orlistat is available for sale without a prescription. Over-the-counter approval was controversial in the United States, with consumer advocacy group Public Citizen repeatedly opposing it on safety and efficacy grounds.Generic formulations of orlistat are available in some countries. In Australia it is listed as an S3 medication and so is available over the counter in pharmacies.

Medical uses

Orlistat is used for the treatment of obesity. The amount of weight loss achieved with orlistat varies. In one-year clinical trials, between 35.5% and 54.8% of subjects achieved a 5% or greater decrease in body mass, although not all of this mass was necessarily fat. Between 16.4% and 24.8% achieved at least a 10% decrease in body fat. After orlistat was stopped, a significant number of subjects regained weight—up to 35% of the weight they had lost.

The incidence of type 2 diabetes in an obese population over four years is decreased with orlistat (6.2%) compared to placebo (9.0%). Long-term use of orlistat also leads to a very modest reduction in blood pressure (mean reductions of 2.5 and 1.9 mmHg in systolic and diastolic blood pressure respectively).

Contraindications

Orlistat is contraindicated in:

  • Malabsorption
  • Hypersensitivity to orlistat
  • Reduced gallbladder function (e.g. after cholecystectomy)
  • Pregnancy and breastfeeding
  • Use caution with: obstructed bile duct, impaired liver function, and pancreatic disease

Side effects

The primary side effects of the drug are gastrointestinal-related, and include steatorrhea (oily, loose stools with excessive flatus due to unabsorbed fats reaching the large intestine), fecal incontinence and frequent or urgent bowel movements. GlaxoSmithKline recommends that all users be cautious of the possible side effects until they “have a sense of any treatment effects”. To minimize these effects, foods with high fat content should be avoided; the manufacturer advises consumers to follow a low-fat, reduced-calorie diet. Oily stools and flatulence can be controlled by reducing the dietary fat content to somewhere in the region of 15 grams per meal. The manual for Alli makes it clear that orlistat treatment involves aversion therapy, encouraging the user to associate eating fat with unpleasant treatment effects.

According to Roche, side effects are most severe when beginning therapy and may decrease in frequency with time; this is supported by the results of the XENDOS study, which found that 36% of people had gastrointestinal adverse effects during their fourth year of taking orlistat, whereas 91% of study subjects had experienced at least one GI-related side effect during the first year of treatment. It has also been suggested that the decrease in side effects over time may be associated with long-term compliance with a low-fat diet.

On 26 May 2010, the U.S. Food and Drug Administration (FDA) approved a revised label for Xenical to include new safety information about cases of severe liver injury that have been reported rarely with the use of this medication.

An analysis of over 900 orlistat users in Ontario showed that their rate of acute kidney injury was more than triple that of non-users. The putative mechanism for this effect is postulated to be excessive oxalate absorption from the gut and its subsequent deposition in the kidney, with excessive oxalate absorption being a known consequence of fat malabsorption.

An April 2013 study published in the British Medical Journal looked at 94,695 patients receiving orlistat in the UK between 1999 and 2011. This study showed no evidence of an increased risk of liver injury during treatment. They concluded:

The incidence of acute liver injury was higher in the periods both immediately before and immediately after the start of orlistat treatment. This suggests that the observed increased risks of liver injury linked to the start of treatment may reflect changes in health status associated with the decision to begin treatment rather than any causal effect of the drug.

Long-term

Despite a higher incidence of breast cancer amongst those taking orlistat in early, pooled clinical trial data—the analysis of which delayed FDA review of orlistat—a two-year study published in 1999 found similar rates between orlistat and placebo (0.54% versus 0.51%), and evidence that tumors predated treatment in 3 of the 4 participants who had them. There is evidence from an in vitro study to suggest that the introduction of specific varied preparations containing orlistat, namely the concurrent administration of orlistat and the monoclonal antibody trastuzumab, can induce cell death in breast cancer cells and block their growth.

Fecal fat excretion promotes colon carcinogenesis. In 2006 the results of 30-day study were published indicating that orlistat at a dosage of 200 mg/kg chow administered to rats consuming a high-fat chow and receiving two 25 mg/kg doses of the potent carcinogen 1,2-dimethylhydrazine produced significantly higher numbers of aberrant crypt foci (ACF) colon lesions than did the carcinogen plus high-fat chow without orlistat. ACF lesions are believed to be one of the earliest precursors of colon cancer.

Precautions

Absorption of fat-soluble vitamins and other fat-soluble nutrients is inhibited by the use of orlistat. A multivitamin tablet containing vitamins A,D, E, K, and beta-carotene should be taken once a day, at bedtime, when using orlistat.

Interactions

Orlistat may reduce plasma levels of ciclosporin (also known as “cyclosporin” or “cyclosporine”, trade names Sandimmune, Gengraf, Neoral, etc.), an immunosuppressive drug frequently used to prevent transplant rejection; the two drugs should therefore not be administered concomitantly. Orlistat can also impair absorption of the antiarrhythmic amiodarone. The MHRA has recently suggested that Orlistat could theoretically reduce the absorption of antiretroviral HIV medications.

Mechanism of action

Orlistat works by inhibiting gastric and pancreatic lipases, the enzymes that break down triglycerides in the intestine. When lipase activity is blocked, triglycerides from the diet are not hydrolyzed into absorbable free fatty acids, and instead are excreted unchanged. Only trace amounts of orlistat are absorbed systemically; the primary effect is local lipase inhibition within the GI tract after an oral dose. The primary route of elimination is through the feces.

Orlistat was also recently found to inhibit the thioesterase domain of fatty acid synthase (FAS), an enzyme involved in the proliferation of cancer cells but not normal cells. However, potential side effects of Orlistat, such as inhibition of other cellular off-targets or poor bioavailability, might hamper its application as an effective antitumor agent. One profiling study undertook a chemical proteomics approach to look for new cellular targets of orlistat, including its off-targets. Orlistat also show potential activities mycobacteria and Trypanosoma brucei parasite (see further reading).

At the standard prescription dose of 120 mg three times daily before meals, orlistat prevents approximately 30% of dietary fat from being absorbed, and about 25% at the standard over-the-counter dose of 60 mg. Higher doses do not produce more potent effects.

Legal status

Packaging of orlistat (Xenical) 120 mg capsules, as sold in Canada

Orlistat has historically been available by prescription only, and this situation continues in Canada. In Australia, the European Union, and the United States, certain formulations of orlistat have been approved for sale without a prescription.

In 2009, Roche began recruiting in Russia for a clinical trial of Xenical in obese teenagers between the ages of 12 and 14.

Australia and New Zealand

In Australia and New Zealand, orlistat is currently available over-the-counter in 120 mg size (84 capsules to the pack). Initially available only with a prescription, it was reclassified as a “Pharmacist Only Medicine” in October 2003. In 2007 the Committee decided to keep orlistat as a Schedule 3 drug, but withdrew its authorization of direct-to-consumer Xenical advertising, stating this “increased pressure on pharmacists to provide orlistat to consumers…this in turn had the potential to result in inappropriate patterns of use”. Xenical has recently began being advertised direct-to-customers again.

United States

On 23 January 2006, a U.S. Food and Drug Administration advisory panel voted 11 to 3 to recommend the approval of an OTC formulation of orlistat, to be marketed under the name alli by GlaxoSmithKline. Approval was granted on 7 February 2007, and alli became the first weight loss drug officially sanctioned by the U.S. government for over-the-counter use. Consumer advocacy organization Public Citizen opposed over-the-counter approval for orlistat.

Alli became available in the U.S. in June 2007. It is sold as 60 mg capsules—half the dosage of prescription orlistat.

European Union

On 21 January 2009, the European Medicines Agency granted approval for the sale of orlistat without a prescription.

Generic formulations

U.S. patent protection for Xenical, originally to end on 18 June 2004, was extended by five years (until 2009) by the U.S. Patent and Trademark Office. The extension was granted on 20 July 2002, and expired on 18 June 2009.

Generic orlistat is available in Iran under the brand Venustat manufactured by Aburaihan Pharmaceutical co., in India, under the brands Orlean (Eris), Vyfat, Olistat, Obelit, Orlica and Reeshape. In Russia, orlistat is available under the brand names Xenical (Hoffmann–La Roche), Orsoten/Orsoten Slim (KRKA d. d.) and Xenalten (OBL-Pharm). In Austria, orlistat is available under the brand name Slimox. In Malaysia, orlistat is available under the brand name Cuvarlix and is marketed by Pharmaniaga.

Society and culture

Cost

At times, such as in spring 2012, orlistat has come into short supply, with consequent price increases because of nonavailability of one of the drug’s components.

Counterfeit products

In January 2010, the U.S. Food and Drug Administration issued an alert stating that some counterfeit versions of Alli sold over the Internet contain no orlistat, and instead contain the weight-loss drug sibutramine. The concentration of sibutramine in these counterfeit products is at least twice the amount recommended for weight loss.

See also

  • Discovery and development of gastrointestinal lipase inhibitors

References

  1. ^ Zhi J, Melia AT, Eggers H, Joly R, Patel IH (1995). “Review of limited systemic absorption of orlistat, a lipase inhibitor, in healthy human volunteers”. J Clin Pharmacol. (11): 1103–8. doi:10.1002/j.1552-4604.1995.tb04034.x. PMID 8626884. 
  2. ^ Stylized with a lowercase a on the packaging, and a bar over the i (that is, “allī”), but capitalized conventionally in the manual.
  3. ^ Bodkin J, Humphries E, McLeod M (2003). “The total synthesis of (−)-tetrahydrolipstatin”. Australian Journal of Chemistry. (8): 795–803. doi:10.1071/CH03121. 
  4. ^ “What are the benefits?”. Retrieved 13 July 2013. 
  5. ^ Barbier P, Schneider F (1987). “Syntheses of tetrahydrolipstatin and absolute configuration of tetrahydrolipstatin and lipstatin”. Helvetica Chimica Acta. (1): 196–202. doi:10.1002/hlca.19870700124. 
  6. ^ Pommier A, Pons M, Kocienski P (1995). “The first total synthesis of (−)-lipstatin”. Journal of Organic Chemistry. (22): 7334–7339. doi:10.1021/jo00127a045. 
  7. ^ Padwal R, Li SK, Lau DC (2004). Padwal RS, ed. “Long-term pharmacotherapy for obesity and overweight”. Cochrane Database Syst Rev (3): CD004094. doi:10.1002/14651858.CD004094.pub2. PMID 15266516. 
  8. ^ a b c Torgerson J, Hauptman J, Boldrin M, Sjöström L (2004). “XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients”. Diabetes Care. (1): 155–61. doi:10.2337/diacare.27.1.155. PMID 14693982. 
  9. ^ “Orlistat Side Effects”. 
  10. ^ “POISONS STANDARD JUNE 2017”. Federal Register of Legislation. Therapeutic Goods Administration. June 2017. Retrieved 18 August 2017. 
  11. ^ a b c Schmid, Randolph E (9 February 2007). “FDA OKs First Nonprescription Diet Pill”. USA Today. Retrieved 9 June 2009. 
  12. ^
  13. ^ a b c “Xenical Pharmacology, Pharmacokinetics, Studies, Metabolism”. RxList.com. 2007. Archived from the original on 5 April 2007. Retrieved 16 March 2007. 
  14. ^ Siebenhofer, A; Jeitler, K; Horvath, K; Berghold, A; Siering, U; Semlitsch, T (28 March 2013). “Long-term effects of weight-reducing drugs in hypertensive patients”. The Cochrane Database of Systematic Reviews (3): CD007654. doi:10.1002/14651858.CD007654.pub3. PMID 23543553. 
  15. ^ a b c d Roche Pharmaceuticals (July 2008). “Xenical” (PDF). Roche. Retrieved 19 February 2007. 
  16. ^ “Treating Obesity”. NHS. Retrieved 13 July 2013. 
  17. ^ “myalli.com – what are treatment effects?”. Archived from the original on 25 June 2007. Retrieved 24 June 2007. 
  18. ^ Hall, Carla (15 June 2007). “New diet drug touches off a feeding frenzy”. Los Angeles Times. Archived from the original on 18 June 2007. Retrieved 20 June 2007. 
  19. ^ “FDA Approves alli (orlistat 60 mg capsules) Over-The-Counter” (PDF) (Press release). PRNewswire. 7 February 2007. Retrieved 8 April 2007. 
  20. ^ From page 12 of the Alli Companion Guide, 2007 edition: “They can be an incentive to keep from eating more fat than you really intend to.”
  21. ^ Mancini MC, Halpern A (2006). “Pharmacological treatment of obesity”. Arq Bras Endocrinol Metab. (2): 377–89. doi:10.1590/S0004-27302006000200024. PMID 16767304.  Free full text with registration
  22. ^ “FDA Drug Safety Communication: Completed safety review of Xenical/Alli (orlistat) and severe liver injury”. fda.gov
  23. ^
  24. ^ Douglas, Ian J; Julia Langham; Krishnan Bhaskaran; Ruth Brauer; Liam Smeeth (2013). “Orlistat and the risk of acute liver injury: self controlled case series study in UK Clinical Practice Research Datalink”. BMJ. : f1936. doi:10.1136/bmj.f1936. PMC 3624963 . PMID 23585064. 
  25. ^ Kolata, Gina (20 January 1999). “Obesity Drug Can Lead to Modest Weight Loss, Study Finds”. The New York Times. Retrieved 11 December 2007. 
  26. ^ Davidson MH, Hauptman J, DiGirolamo M, et al. (1999). “Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial”. JAMA. (3): 235–42. doi:10.1001/jama.281.3.235. PMID 9918478. 
  27. ^ J. A. Menendez; L. Vellon; R. Lupu (2005). “Antitumoral actions of the anti-obesity drug orlistat (XenicalTM) in breast cancer cells: blockade of cell cycle progression, promotion of apoptotic cell death and PEA3-mediated transcriptional repression of Her2/neu (erbB-2) oncogene”. Annals of Oncology. (8): 1253–1267. doi:10.1093/annonc/mdi239. PMID 15870086. 
  28. ^ Garcia S, da Costa Barros L, Turatti A, Martinello F, Modiano P, Ribeiro-Silva A, de Oliveira Vespúcio M, Uyemura S (2006). “The anti-obesity agent Orlistat is associated to increase in colonic preneoplastic markers in rats treated with a chemical carcinogen”. Cancer Lett. (2): 221–4. doi:10.1016/j.canlet.2005.09.011. PMID 16377080. 
  29. ^ Takayama T, Katsuki S, Takahashi Y, Ohi M, Nojiri S, Sakamaki S, Kato J, Kogawa K, Miyake H, Niitsu Y (1998). “Aberrant crypt foci of the colon as precursors of adenoma and cancer” (PDF). N Engl J Med. (18): 1277–84. doi:10.1056/NEJM199810293391803. PMID 9791143. 
  30. ^ “Vitamin A”. 
  31. ^ Zhi J, Moore R, Kanitra L, Mulligan TE (2003). “Effects of orlistat, a lipase inhibitor, on the pharmacokinetics of three highly lipophilic drugs (amiodarone, fluoxetine, and simvastatin) in healthy volunteers”. J Clin Pharmacol. (4): 428–35. doi:10.1177/0091270003252236. PMID 12723464. 
  32. ^ “Orlistat: theoretical interaction with antiretroviral HIV medicines”. MHRA. 13 March 2014. Retrieved 16 November 2014. 
  33. ^ PDB: 2PX6​; Pemble CW, Johnson LC, Kridel SJ, Lowther WT (August 2007). “Crystal structure of the thioesterase domain of human fatty acid synthase inhibited by Orlistat”. Nat. Struct. Mol. Biol. (8): 704–9. doi:10.1038/nsmb1265. PMID 17618296. 
  34. ^ 2006 Physicians’ Desk Reference (PDR). Thomson PDR. 2006. ISBN 1-56363-527-5. 
  35. ^ “myalli.com – frequently asked questions”. GlaxoSmithKline. 2007. Archived from the original on 12 July 2007. Retrieved 18 August 2007. 
  36. ^ Parker-Pope, Tara. “Weighing the Pros and Cons Of New Fat-Blocking Drug Alli”, The Wall Street Journal, 19 June 2007, pp. D1. Retrieved on 2007-08-18.
  37. ^ a b “Chemists to provide obesity pill”. BBC News Online. 21 January 2009. Retrieved 22 January 2009. 
  38. ^ Clinical trial number NCT00940628 at ClinicalTrials.gov
  39. ^ “Scheduling of orlistat” (Press release). Australian Therapeutic Goods Administration. 22 February 2007. Retrieved 3 March 2007. 
  40. ^ “Panel Supports Offering Diet Pill Orlistat Over the Counter”. The Washington Post. 24 January 2006. pp. A02. Retrieved 10 August 2006. 
  41. ^ “FDA Approves Orlistat for Over-the-Counter Use” (Press release). U.S. Food and Drug Administration (FDA). 7 February 2007. Retrieved 7 February 2007. 
  42. ^ a b Saul, Stephanie (7 February 2007). “Weight-Loss Drug to Be Sold Over the Counter”. The New York Times. Retrieved 10 February 2007. 
  43. ^ “GlaxoSmithKline receives European Commission approval to market alli (orlistat 60mg)” (Press release). GlaxoSmithKline. 21 January 2009. Retrieved 22 January 2009. 
  44. ^ Rogan, James E. (30 July 2002). “Certificate Extending Patent Term Under 35 U.S.C. § 156” (PDF). United States Patent and Trademark Office. Retrieved 8 April 2007. 
  45. ^ “Drug Patent Expirations in June 2009”. DrugPatentWatch.com, in “Drug Patent Expirations in June 2009”. Biotech Blog. 1 June 2009. Retrieved 20 June 2009. 
  46. ^ Devarajan, Uma (1 March 2009). “Fatty issues”. The Deccan Chronicle. Retrieved 26 November 2009. 
  47. ^ Jeanne Whalen (20 April 2012). “Glaxo Sells Bulk of Over-the-Counter Drugs”. The Wall Street Journal. Glaxo said the issue wasn’t a lack of interested buyers, but manufacturing problems that have led to shortages of the diet pill and forced the company to delay the product’s sale. 
  48. ^ “Fake Alli diet pills can pose health risks”. CNN. 23 January 2010. Retrieved 24 January 2010. 

Further reading

  • Boehm, Marcus F.; McClurg, Michael R.; Pathirana, Charles; Mangelsdorf, David; White, Steven K.; Hebert, Jonathan; Winn, David; Goldman, Mark E.; Heyman, Richard A. (1994). “Synthesis of high specific activity tritium-labeled -9-cis-retinoic acid and its application for identifying retinoids with unusual binding properties”. Journal of Medicinal Chemistry. (3): 408–14. doi:10.1021/jm00029a013. PMID 8308867. 
  • Hanessian, Stephen; Tehim, Ashok; Chen, Ping (1993). “Total synthesis of (−)-tetrahydrolipstatin”. The Journal of Organic Chemistry. (27): 7768. doi:10.1021/jo00079a022. 
  • Peng-Yu, Yang; Kai, Liu; Mun Hong, Ngai; J.Lear, Martin; R.Wenk, Markus; S.Qin, Yao (2010). “Activity-based proteome profiling of potential cellular targets of Orlistat−an FDA-approved drug with anti-tumor activities”. Journal of the American Chemical Society. (2): 656–66. doi:10.1021/ja907716f. PMID 20028024. 
  • Peng-Yu, Yang; Min, Wang; Kai, Liu; Mun Hong, Ngai; Omar, Sheriff; J.Lear, Martin; Siu Kwan, Sze; Cynthia Y., He; S.Qin, Yao (2012). “Parasite-based screening and proteome profiling reveal orlistat, an FDA-approved drug, as a potential anti Trypanosoma brucei agent”. Chemistry: A European Journal. (27): 8403–13. doi:10.1002/chem.201200482. PMID 22674877. 

External links

  • Official US Alli site from GlaxoSmithKline
  • Official UK Alli site from GlaxoSmithKline
  • Official Xenical site from Roche
  • Official Philippines (Asia) Xenical site from Roche
  • FDA Consumer Info at the Wayback Machine (archived 26 January 2008)

Transporter
(modulators) Enzyme
(modulators) Others

en.wikipedia.org

  • Drug Uses

    Xenical is a world recognized and proven by millions of people, suffering from obesity, in its ability to manage adiposis in adult and adolescent patients, age 12 and older.

    How to use Use Xenical as directed by your doctor.

    Read the chart on the medicine package. You may consider starting Xenical if your weight is the same or more than the weight shown for your height. Talk to your doctor or pharmacist if you have any questions.

    Take Xenical by mouth with each meal containing fat. Do not take more than 3 capsules daily.
    If a meal is missed or contains no fat, do not take a dose of Xenical.
    Xenical may decrease your absorption of vitamins. Take a multivitamin once a day at bedtime.
    Ask your health care provider any questions you may have about how to use Xenical.

    Drug Class and Mechanism Xenical is a weight loss medication that targets the absorption of fat in your body rather than suppressing your appetite. It is useful for long term use and has been shown to be effective for 1-2 years. Dietary fats are inhibited from being absorbed and this allows about 30% of the fat eaten in the meal to pass through the gut undigested. This helps you to reduce and maintain your weight, as well as to minimize any weight regain.

    Xenical can also help to improve risk factors, such as high blood pressure, high cholesterol and high blood sugar which, if not treated, could lead to other diseases such as hypertension and diabetes.

    Missed Dose If you miss a dose of Xenical, take it as soon as you remember. Continue taking it as directed by your doctor.

    Storage Store Xenical at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep Xenical out of the reach of children and away from pets.

    Warnings/Precautions

    Do not use Xenical if:

    you are allergic to any ingredient in Xenical;

    you are not overweight;
    you have problems absorbing food or bile flow problems (e.g., cholestasis);
    you have received an organ transplant;
    you take cyclosporine.
    Contact your doctor or health care provider right away if any of these things applies to you.

    Important :
    Do not take more than the recommended dose without checking with your doctor. Taking more than the recommended dose may not help you lose more weight. It may increase your risk of side effects.

    Proper diet and exercise are important in order to lose weight and keep it off. Follow the diet and exercise program given to you by your health care provider.
    Xenical may cause changes in your bowel or stool (e.g., gas with oily spotting, loose stools, more frequent stools). Eating a low-fat diet may help lessen these side effects.
    Tell your doctor or dentist that you take Xenical before you receive any medical or dental care, emergency care, or surgery.
    Diabetes patients – Xenical may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
    Xenical should not be used by children younger than 18 years old; safety and effectiveness  have not been confirmed in these children.
    Pregnancy and breast-feeding: do not take Xenical if you are pregnant. If you become pregnant, contact your doctor. It is not known if Xenical is found in breast milk. Do not breast-feed while taking Xenical.

    Possible Side Effects

    Check with your doctor if any of these most common side effects persist or become bothersome:

    diarrhea; gas with discharge; frequent or loose stools; oily spotting; trouble controlling bowel movements.

    Seek medical attention right away if any of these severe side effects occur:
    severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); severe or persistent stomach pain.

    More Information Xenical is to be used by prescription only. Do not share it with other people.

    If your symptoms do not improve or if they become worse, check with your doctor.

stsmihajlopupin.edu.rs

  • Drug Uses

    Xenical is a world recognized and proven by millions of people, suffering from obesity, in its ability to manage adiposis in adult and adolescent patients, age 12 and older.

    How to use Use Xenical as directed by your doctor.

    Read the chart on the medicine package. You may consider starting Xenical if your weight is the same or more than the weight shown for your height. Talk to your doctor or pharmacist if you have any questions.

    Take Xenical by mouth with each meal containing fat. Do not take more than 3 capsules daily.
    If a meal is missed or contains no fat, do not take a dose of Xenical.
    Xenical may decrease your absorption of vitamins. Take a multivitamin once a day at bedtime.
    Ask your health care provider any questions you may have about how to use Xenical.

    Drug Class and Mechanism Xenical is a weight loss medication that targets the absorption of fat in your body rather than suppressing your appetite. It is useful for long term use and has been shown to be effective for 1-2 years. Dietary fats are inhibited from being absorbed and this allows about 30% of the fat eaten in the meal to pass through the gut undigested. This helps you to reduce and maintain your weight, as well as to minimize any weight regain.

    Xenical can also help to improve risk factors, such as high blood pressure, high cholesterol and high blood sugar which, if not treated, could lead to other diseases such as hypertension and diabetes.

    Missed Dose If you miss a dose of Xenical, take it as soon as you remember. Continue taking it as directed by your doctor.

    Storage Store Xenical at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep in a tight, light-resistant container. Keep Xenical out of the reach of children and away from pets.

    Warnings/Precautions

    Do not use Xenical if:

    you are allergic to any ingredient in Xenical;

    you are not overweight;
    you have problems absorbing food or bile flow problems (e.g., cholestasis);
    you have received an organ transplant;
    you take cyclosporine.
    Contact your doctor or health care provider right away if any of these things applies to you.

    Important :
    Do not take more than the recommended dose without checking with your doctor. Taking more than the recommended dose may not help you lose more weight. It may increase your risk of side effects.

    Proper diet and exercise are important in order to lose weight and keep it off. Follow the diet and exercise program given to you by your health care provider.
    Xenical may cause changes in your bowel or stool (e.g., gas with oily spotting, loose stools, more frequent stools). Eating a low-fat diet may help lessen these side effects.
    Tell your doctor or dentist that you take Xenical before you receive any medical or dental care, emergency care, or surgery.
    Diabetes patients – Xenical may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
    Xenical should not be used by children younger than 18 years old; safety and effectiveness  have not been confirmed in these children.
    Pregnancy and breast-feeding: do not take Xenical if you are pregnant. If you become pregnant, contact your doctor. It is not known if Xenical is found in breast milk. Do not breast-feed while taking Xenical.

    Possible Side Effects

    Check with your doctor if any of these most common side effects persist or become bothersome:

    diarrhea; gas with discharge; frequent or loose stools; oily spotting; trouble controlling bowel movements.

    Seek medical attention right away if any of these severe side effects occur:
    severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); severe or persistent stomach pain.

    More Information Xenical is to be used by prescription only. Do not share it with other people.

    If your symptoms do not improve or if they become worse, check with your doctor.

www.gradskimagazin.rs

  • Drug Name

    Alli (Orlistat) 

    Drug UsesAlli is the only FDA approved, over-the-counter weight loss product, represented as an innovative weight loss program. With Alli, you can lose about 50% more weight than with just dieting alone. 

    How to useFor overweight adults 18 and older, take 1 capsule with each meal containing fat. Use with a reduced calorie, low-fat diet and exercise program until you reach your weight loss goal. Most weight loss occurs in the first 6 months.

     

    Drug Class and MechanismAlli blocks about 25% of the fat you eat. Typically, enzymes in your intestines break down fat from food so your body can absorb the fat. But, the active ingredient in Alli attaches to some of these enzymes and prevents them from digesting about a quarter of the fat you eat. Because undigested fat can’t be absorbed, it passes out of your body instead of turning into calories. 

    Missed Dose

    If you miss a dose of Alli, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. 

    Storage

    Store Alli at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Alli out of the reach of children and away from pets.

    Warnings/Precautions

    Do not use Alli if:  you are allergic to any ingredient in Alli;

    you have gallbladder problems;
    you have cholestasis (a problem of bile flow from the liver to the intestines).
    Contact your doctor or health care provider right away if any of these apply to you.

    Important : Do not take more than the recommended dose without checking with your doctor. Exceeding the recommended dose will not make you lose more weight and may increase side effects.

    Tell your doctor or dentist that you take Alli before you receive any medical or dental care, emergency care, or surgery.
    Follow the diet program given to you by your health care provider. Your daily intake of fat should be divided evenly over 3 meals.
    Eating a meal high in fat while taking Alli increases the risk of side effects involving the stomach and intestines.
    Diabetes patients – Alli may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
    Additional monitoring of your dose or condition may be needed if you are taking amiodarone.
    Alli should not be used in children younger than 12 years old; safety and effectiveness in these children have not been confirmed.
    Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Alli while you are pregnant. It is not known if Alli is found in breast milk. Do not breast-feed while taking Alli.

    Possible Side Effects

    Check with your doctor if any of these most common side effects persist or become bothersome: 

    bowel movement urgency; gas with discharge; inability to control bowel movements; increased number of bowel movements; oily discharge; oily or fatty stools; oily spotting.
    Seek medical attention right away if any of these severe side effects occur:
    severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); severe or persistent stomach pain.

    More InformationMany individuals really need help with their dieting and Alli can make them the whole process a lot easier, since alli is not just a diet pill, it’s actually a weight loss program, a plan to follow, a way to learn how to eat healthy and how to do healthy things for their body, to feel and function better. The one thing that Alli does very well is that it teaches you how to start eating low-fat foods, because Alli works with fats in your body. It blocks them from being absorbed by your digestive system and when that happens, your body does not store fat anymore; it gets rid of it effectively, through your digestive system.

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