medications
Prepared by: Dr. Wael El-Said
DBK pharm a
Competitors Competitors
… …
1. Reductil (Meredia)
Mechanism of action
Active ingredient:
Each REDUCTIL (MERIDIA) capsule contains 5
mg, 10 mg, and 15 mg of sibutramine
hydrochloride monohydrate.
Mechanism of action:
Sibutramine is a centrally acting appetite
suppressant. it produces its therapeutic effects
by inhibiting the reuptake of norepinephrine,
serotonin and dopamine.
Acting On CNS
CNS Toxicity
Dose?!
The recommended starting dose of MERIDIA
is 10mg administered once daily with or
without food.
If there is inadequate weight loss, the dose
may be titrated after four weeks to a total of
15 mg once daily.
Blood pressure and heart rate changes
should be taken into account when making
decisions regarding dose titration>
How to use it?!
Take by mouth exactly as directed by your doctor,
usually once daily. The full effect on weight may
require four to six weeks.
Do not increase your dose, take it more frequently or
use it for a longer period of time than prescribed
because this drug can be habit-forming.
Also, if used for a longer period of time, do not
suddenly stop using this drug without your doctor's
approval.
Over time, this drug may not work as well as it did at
the beginning. Consult your doctor if weight
increases.
Side effects:
Headache
30.3%
Side effects:
Hypertension,
Tachycardia &
arrhythmia 6.6%
Side effects:
Insomnia
10.7%
Side effects:
Injury accident
6%
Side effects:
Flu syndrome,
rhinitis &
pharyngitis 25.2%
Side effects:
Constipation
10.7%
Dizziness 7.0%
Increased appetite
8.7%
Side effects:
Side effects:
Side effects:
Side effects:
1. Common side effects
anxiety
dryness of mouth
headache
irritability or impatience
constipation
dizziness
nervousness
stuffy nose
difficulty sleeping
2. Less common side effects:
- abdominal pain - back pain
- increased sweating - increased
thirst
- indigestion - nausea
- change in sense of taste - diarrhea
- psychological depression
- Dysmenorrhea
convulsions (seizures)
mood swings
skin rash
weight gain
% of side effects
Contraindications:
MERIDIA is contraindicated in patients
receiving monoamine oxidase inhibitors
(MAOIs).
MERIDIA is contraindicated in patients who
have a major eating disorder (anorexia
nervosa or bulimia nervosa).
MERIDIA is contraindicated in patients
taking other centrally acting appetite
suppressant drugs.
See the difference with
Chitocal
No serious side effects.
No depression, anxiety or insomnia
No cardiac affection.
No mouth dryness.
No diet restriction is needed.
No dependence or intolerance.
Weight loss starts from the 1st week
No weight gain…..??!!!
No obsolete contraindications.
Simple speaking.. Chitocal
is:
Mechanism of action:
Xenical is an inhibitor of gastrointestinal lipases . It
exerts its therapeutic activity in the lumen of the
stomach and small intestine by forming a bond with
the active site of gastric and pancreatic lipases. The
inactivated enzyme is thus unable to hydrolyse
dietary fat, into absorbable free fatty acids and
monoglycerides. As undigested triglycerides are not
absorbed, the resulting caloric deficit has a positive
effect on the weight control..
Dose:
Complete disturbance of
the life style of the patient
Defecation urge
Toilet Shifted life style
Bad smell in the toilet for
long periods
Excessive Flatulence
with bad smell
Oil & stool spots
See the difference with
Chitocal
No Oily spotting.
No Fecal incontinence or urge.
No Flatulence (Actually decreases it).
No Fatty or oily stools.
No alteration in stool odor.
No alteration in defecation rate.
No low fat diet
Chitocal acts on both lipids & carbohydrates
Simply;
Competitors Competitors
… …
Chitoca
l
Non-Diet weight control
DBK pharma
Chitocal composition:
Chitosan gel
% of fat excretion
100
80
60
40
20
0
Low density Xenical 360mg/ high density
chitosan day Chitosan
1000mg/day 1000mg/day
Ascorbic Acid
. "Mechanism for the inhibition of fat digestion by chitosan and for the synergistic effect of
ascorbate." Biosci Biotechnol Biochem, 1995 May; Vol: 59; Number: 5; Page: 786-90;
Ascorbic Acid
• It is an Indian herbal.
• It is called The “ GURMAR” i.e. The sugar destroyer.
Gymnema Sylvestre
• It is an Indian herbal.
• It is called The “ GURMAR” i.e. The sugar destroyer.
• it competitively inhibits glucose absorption at its
receptors in the GIT
• Decreasing serum glucose increase glycolysis
increase gluconeogenesis Decrease body fat content
weight loss.
Gymnema Sylv. Do Blair like action
GL GL
GL
GL GL GL
Intestinal GL
wall GS GL
GS GL
GS
GS
GL GL
GL
GL
GS GL
Glucos
e
GL
GS
recepto GL
Blood stream r
To stools
GL
GL Glucose GS Gymnema sylvestre
Chitocal (Gymnema Sylvestre) & D.M.