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Yes No Dr. Mahendra Narwaria Dr. Sanjay Patolia Dr. Surendra Ugale Ahmedabad Rajkot Surat Hyderabad
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Medicine for Weight Loss
Medicine RIMONABANT SIBUTRAMINE ORLISTAT TOPRAMATE WITH PHENTERMINE
Mechanism & Action Mechanism & Action *Blocks the cannabinoid -1 receptors results in central and metabolic peripheral effects, which results in decreasing food intake. *Blocks the cannabinoid -1 receptors results in central and metabolic peripheral effects, which results in decreasing food intake.
*Centrally acting serotonin norepinephnine reuptake inhibitor structurally
*Reduces the reuptake of serotonin, norepinephrine, dopamine there by increasing the levels of these substances in helping enhance satiety.
*It blocks some of fat that you eat, keeping it from the being absorbed by your body.
*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.
*Phentermine is an appetite suppressant similar to an amphetamine. Topiramate is a seizure medication, also called an anticonvulsant.
It may work by decreasing your appetite, by increasing the amount of energy used by your body, or by affecting certain parts of the brain..
DOSAGE Orally The usual dose is one 20mg tablet to be taken once daily. 10 mg orally once a day. 120 mg orally three times a day with each main meal containing fat. The dose may be taken during the meal or within 1 hour of completing the meal. At first, one tablet of 3.75 milligrams (mg) of phentermine and 23 mg of topiramate once a day for 14 days. After 14 days, your doctor may increase your dose to 7.5 mg of phentermine and 46 mg of topiramate once a day. Then, your doctor may increase your dose as needed up to 15 mg of phentermine and 92 mg of topiramate.
EXPECTED RESULT *Weight loss & reduced waist circumference.
*Improvement in lipid & glucose metabolism.
Presents weight gain associated with smoking cessation.
*Improvement in cardiovascular & metabolic risk factors.
*5-10 % reduction from their baseline weight with life style modifications. *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 due to weight loss itself or to other effects; in a larger randomized controlled trial, orlistat was found to reduce the incidence of diabetes by nearly 40% in obese people. * In clinical trials, people treated with the highest dose of phentermine/topiramate ER in combination with a program of diet and exercise lost 10% to 11% of their body weight compared to 1% to 2% for those who received placebo.[1] In addition, 62% to 70% of subjects receiving the recommended dose or top dose of phentermine/topiramate ER achieved ≥5% weight by week 56 (ITT-LOCF) compared to 17% to 21% of those receiving a sugar pill.[1]
COMMON SIDE EFFECTS *Mild GI effects (nausea & diarrhea)
*Dizziness.
*Upper resp. infection.
*Psychiatric Side effects
*GI effects: nausea, upset stomach, constipation, strange taste in mouth.
*Trouble sleeping, dizziness, drowsiness, menstrual cramps/ pains
Increase BP, cardiac arrhythmias.
*Mental change (confusion, Depression, suicidal thoughts)
Seizures, melena, hematemesis, Chest pain, fever, jaundice etc.
*Fatty/oily stool.
*Gas & oily discharge.
*Inability to control stool/ bowel movements.
Stomach pain/ nausea/ rectal pain.
*Severe pain in lower back.
*Blood in urine painful micturition
*Kidney problems.
Shortness of breath
*Nausea, upper stomach pain, itching, loss of appetite, clay colored stools, jaundice.
*dizziness;
constipation;
*numbness or tingly feeling;
*sleep problems (insomnia); or
dry mouth, changes in your sense of taste.
* Back pain
*change in taste
*ear congestion
*fear or nervousness
*loss of voice
*memory problems
*pain or tenderness around the eyes and cheekbones
*sneezing
*stuffy or runny nose
*trouble sleeping
CURRENT STATUS Banned from 11th December 2009 by Ministry of Health & Family welfare due to increased risk of psychiatric side effects. Banned by ministry of health & family welfare from 10/02/2011 Available as OTC and prescribed treatment with specific precautions *In 2012 the U.S. Food and Drug Administration approved phentermine/topiramate ER as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of at least 30 kg/m², or at least 27 kg/m² (overweight) in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia.[1][3] Phentermine/topiramate ER is available in certified retail pharmacies nationwide and also available through a certified mail-order pharmacy network.[