Angina

Xenical similar drugs. Xenical tablets and its analogues for weight loss

Weight correction – this is a difficult and lengthy process. Some people are forced to control their body weight throughout their lives.

To lose weight, you need to change your diet and lifestyle. If this is not enough, diet pills are required.

The accumulation of extra pounds is caused by poor nutrition, overeating, lack of physical activity, metabolic disorders, hereditary predisposition, chronic stress and fatigue.

Weight loss drug Xenical blocks the absorption of fats in the body. As a result, your own fat fiber is consumed, and your weight gradually decreases.

Compound

Xenical is produced by two large pharmaceutical companies ROCHE in Switzerland and Italy.

The release form of the drug is a bluish hard capsule of 120 mg of active substance each.

Markings are in English XENICAL(Xenical), packaged in blisters of 21 pieces, there can be 1-4 blisters in a package.

The main active ingredient of Xenical is orlistat , an inhibitor of gastrointestinal lipases.

When taking this medicine, the human body does not produce specific food enzymes that decompose fats. As a result, triglycerides contained in food do not enter the bloodstream and are not stored in reserve, but are excreted directly along with feces.

An energy deficit occurs, which leads to the consumption of the body's own fat reserves. A concomitant positive effect is manifested in a decrease in blood cholesterol and normalization of insulin levels.

Experts compare the mechanism of action of Xenical with the effect of low-fat, low-calorie diets.

Excipients are binders that ensure the shape and stability of the granules, fillers and disintegrants that promote better dissolution of the drug in the stomach. Fine titanium dioxide and indigo carmine are used as dyes.

There are food preservatives - gelatin, starch, talc, natural dietary fiber in the form of microcrystalline cellulose.

The drug is not absorbed into the blood, therefore it has no effect on internal organs and is not addictive.

Price

Xenical was developed to reduce weight and maintain weight loss results in obese people.

In Europe this drug is sold in pharmacies Requires a doctor's prescription .

You can buy Xenical without a prescription in Russia, but it is better to contact a specialist who will sensibly assess your figure and health status, help you create a nutrition plan and exercise schedule, and, if necessary, prescribe pills.

How much Xenical costs depends on the location of the pharmacy, pricing policy, and supplies. The average price for a drug is from 1000 to 2000 rubles . You can buy it.

Indications for use

The main indication for the use of Xenical is overweight, if it is more than 30 kg.

The presented medicine is used in the treatment of diseases in which obesity - This is a characteristic accompanying symptom.

Xenical is prescribed for diabetes mellitus, metabolic syndrome, arterial hypertension, atherosclerosis, and metabolic disorders.

Drug assistance in losing weight becomes necessary when fat deposition occurs on internal organs and secretory glands. Most often, this is evidenced by a large belly hanging down.

Instructions for use

For proper and long-term weight loss, experts recommend switching to a healthy and balanced diet, giving up bad habits, and playing sports.

At the same time, Xenical will help move weight off the ground, teach the body to get energy from the right foods, and adjust the caloric content of the diet.

An important rule is the supply of sufficient volume liquids .

Water is necessary for Xenical to work efficiently and quickly in the body. It prevents dehydration, suppresses appetite, and promotes cleansing.

The manufacturer warns that dose increase the drug does not affect its effectiveness.

How to take Xenical:

a single dose is equal to 1 capsule-tablet of the drug;
taken during meals or after, no later than an hour later;
per day, it is permissible to use from 1 to 3 capsules with each meal;
if the amount of fat in the diet is reduced, then the dose may be minimal;
The medicine is taken for a three-month course.

The instructions for the drug contain information that Xenical, along with fats removes fat-soluble vitamins from the body necessary to maintain health and maintain normal functioning.

On the advice of specialists and, taking this fact into account, together with Xenical you should take a multivitamin complex.

It is desirable that the vitamin complex contains beta-carotene, vitamins A, E and D, group K.

Reviews of those losing weight

Natalya 42 years old, Vladivostok:

Excess weight has been my big problem since childhood. In my life I have tried everything - diets, from simple to extreme, fasting, special clothes that promote weight loss, earrings for weight loss, pills, hypnosis.

I bought Xenical on the advice of a nutritionist friend. The weight came off slowly but steadily. I liked the drug and lost 9 kg in 3 months.

Side effects included loose stools and increased gas formation. Now I will take Xenical to maintain weight.

Zhanna 34 years old, Voronezh:

I recovered after pregnancy and breastfeeding. I ate practically nothing, and my weight stayed the same. I met a friend and was surprised at how beautiful she looked. She said that Xenical helps her lose weight.

I decided to try it too. The result on the scale is minus 4 kg in 3 weeks. This is just great! I keep losing weight, because I have 16 extra kg. Along with the medication, I switched to proper nutrition, I run in the morning, and I almost completely eliminated sweets and alcohol.

Irina 28 years old, St. Petersburg:

I have congenital diabetes, and by heredity there is a predisposition to obesity.

I heard about Xenical from Malysheva’s program on Channel One. I bought it at the pharmacy and started taking it. The weight began to decrease little by little, I noticed that my intestines were working better, the effect of the pills was obvious. In one week I lost 2 kg and became more cheerful.

Now my result is minus 14 kg in 2 months. I am happy with the medicine and with myself. Xenical really helps you lose weight.

Pharmacological action

Xenical is a powerful, specific and reversible inhibitor of gastrointestinal lipases with a long-lasting effect. Its therapeutic effect occurs in the lumen of the stomach and small intestine and consists of the formation of a covalent bond with the active serine site of gastric and pancreatic lipases. The inactivated enzyme then loses the ability to break down food fats, which come in the form of triglycerides, into absorbable free fatty acids and monoglycerides. Since unsplit triglycerides are not absorbed, the resulting decrease in caloric intake into the body leads to a decrease in body weight. Thus, the therapeutic effect of the drug is carried out without absorption into the systemic circulation.

Based on fecal fat results, the effects of orlistat begin 24 to 48 hours after dosing. After discontinuation of the drug, the fat content in stool usually returns to pre-therapy levels within 48-72 hours.

Efficiency

Obese patients

In clinical studies, patients taking orlistat experienced greater weight loss compared to patients on diet therapy. Weight loss began within the first 2 weeks after the start of treatment and lasted from 6 to 12 months, even in patients with a negative response to diet therapy. Over the course of 2 years, there was a statistically significant improvement in the profile of metabolic risk factors associated with obesity. In addition, compared to placebo, there was a significant reduction in body fat. Orlistat is effective in preventing weight gain. Re-gain of body weight, no more than 25% of what was lost, was observed in approximately half of the patients, and in half of these patients, no re-gain of body weight was observed or even a further decrease was observed.

Patients with obesity and type 2 diabetes mellitus
In clinical studies of 6 months to 1 year, overweight or obese patients with type 2 diabetes treated with orlistat experienced greater weight loss compared with patients treated with diet therapy alone. Body weight loss occurred mainly due to a decrease in the amount of fat in the body. It should be noted that before the start of the study, despite taking hypoglycemic agents, patients often had insufficient glycemic control. However, with orlistat therapy, a statistically and clinically significant improvement in glycemic control was observed. In addition, during orlistat therapy, a decrease in doses of hypoglycemic agents, insulin concentrations, and a decrease in insulin resistance were observed.

Reducing the risk of developing type 2 diabetes in obese patients

In a 4-year clinical study, orlistat was shown to significantly reduce the risk of developing type 2 diabetes (by approximately 37% compared to placebo). The degree of risk reduction was even greater in patients with baseline impaired glucose tolerance (approximately 45%). There was greater weight loss in the orlistat treatment group compared to the placebo group. Maintaining body weight at a new level was observed throughout the entire study period. Moreover, compared with placebo, patients treated with orlistat showed a significant improvement in their metabolic risk factor profile.

Pubertal obesity

In a 1-year clinical trial in obese adolescents, orlistat was associated with a decrease in body mass index compared with placebo, which even increased body mass index. In addition, patients in the orlistat group showed a decrease in fat mass and waist and hip circumference compared to the placebo group. Also, patients receiving orlistat therapy experienced a significant reduction in diastolic blood pressure compared to the placebo group.

Preclinical safety data

Based on preclinical data, no additional risks to patients were identified regarding the safety profile, toxicity, genotoxicity, carcinogenicity and reproductive toxicity. Animal studies also showed no teratogenic effect. Due to the lack of a teratogenic effect in animals, it is unlikely to be detected in humans.

Pharmacokinetics

Suction

In volunteers with normal body weight and obesity, systemic exposure to the drug is minimal. After a single oral dose of 360 mg, unchanged orlistat could not be detected in plasma, which means that its concentrations are below 5 ng/ml.

In general, after taking therapeutic doses, it was possible to detect unchanged orlistat in plasma only in rare cases, and its concentrations were extremely low (<10 нг/мл или 0.02 мкмоль). Признаки кумуляции отсутствовали, что подтверждает, что всасывание препарата минимально.

Distribution

Vd cannot be determined because the drug is very poorly absorbed. In vitro, orlistat is more than 99% bound to plasma proteins (mainly lipoproteins and albumin). In minimal quantities, orlistat can penetrate red blood cells.

Metabolism

Judging by the data obtained in animal experiments, orlistat metabolism occurs mainly in the intestinal wall. In a study in obese individuals, it was found that approximately 42% of the minimal fraction of the drug that is subject to systemic absorption is accounted for by two main metabolites - M1 (a four-membered hydrolyzed lactone ring) and M3 (M1 with a cleaved N-formylleucine residue).

Molecules M1 and M3 have an open b-lactone ring and inhibit lipase extremely weakly (1000 and 2500 times weaker, respectively, than orlistat). Given this low inhibitory activity and low plasma concentrations (average 26 ng/ml and 108 ng/ml, respectively) after therapeutic doses, these metabolites are considered pharmacologically inactive.

Removal

Studies in individuals with normal and overweight have shown that the main route of elimination is excretion of unabsorbed drug in the feces. About 97% of the administered dose of the drug was excreted in feces, with 83% as unchanged orlistat.

The cumulative renal excretion of all substances structurally related to orlistat is less than 2% of the administered dose. The time until the drug is completely eliminated from the body (with feces and urine) is 3-5 days. The ratio of orlistat elimination routes in volunteers with normal and overweight was the same. Both orlistat and metabolites M1 and M3 can be excreted in the bile.

Pharmacokinetics in special clinical groups

Plasma concentrations of orlistat and its metabolites (M1 and M3) in children do not differ from those in adults when comparing the same doses of the drug. Daily fecal fat excretion was 27% of dietary intake during orlistat therapy and 7% when receiving placebo.

Indications

- long-term therapy for obese or overweight patients, incl. having risk factors associated with obesity, in combination with a moderately hypocaloric diet;

- in combination with hypoglycemic drugs (metformin, sulfonylurea derivatives and/or insulin) or a moderately hypocaloric diet in patients with type 2 diabetes mellitus who are overweight or obese.

Dosage regimen

Long-term therapy of obese or overweight patients, including those with risk factors associated with obesity, in combination with a moderately hypocaloric diet at adults and children over 12 years old

In combination with hypoglycemic drugs (metformin, sulfonylureas and/or insulin) or a moderately hypocaloric diet in patients with type 2 diabetes mellitus who are overweight or obese: atadults The recommended dose of orlistat is one 120 mg capsule with each main meal (during meals or no later than one hour after meals).

If meals are skipped or if the food does not contain fat, then Xenical can also be skipped.

The drug should be taken in combination with a balanced, moderately hypocaloric diet containing no more than 30% of calories in the form of fat. The daily intake of fats, carbohydrates and proteins must be divided into three main meals.

Efficacy and safety of the drug Xenical patients with impaired liver and/or kidney function, as well as elderly and pediatric patients (under 12 years old) have not been studied.

Side effect

Clinical trial data

The following categories are used to describe the frequency of adverse reactions: very often (≥1/10), often (≥1/100,<1/10), нечасто (≥1/1000, <1/100), редко (≥1/10000, <1/1000) и очень редко (<1/10000), включая отдельные случаи.

Adverse reactions to orlistat occurred mainly from the gastrointestinal tract and were due to the pharmacological effect of the drug, which interferes with the absorption of dietary fats. Very often, phenomena such as oily discharge from the rectum, the release of gases with some discharge, an imperative urge to defecate, steatorrhea, increased frequency of bowel movements, loose stools, flatulence, pain or discomfort in the abdomen were noted.

Their frequency increases with increasing fat content in the diet. Patients should be informed of the possibility of gastrointestinal adverse reactions and taught how to manage them through better diet, especially regarding the amount of fat contained in the diet. Adopting a low-fat diet reduces the likelihood of gastrointestinal side effects and thereby helps patients control and regulate their fat intake.

As a rule, these adverse reactions are mild and transient. They occurred in the early stages of treatment (in the first 3 months), and most patients had no more than one episode of such reactions.

When treated with Xenical, the following adverse events from the gastrointestinal tract often occur: “soft” stools, pain or discomfort in the rectum, fecal incontinence, bloating, dental damage, gum damage.

Also noted very often were: headaches, upper respiratory tract infections, flu; often: lower respiratory tract infections, urinary tract infections, dysmenorrhea, anxiety, weakness.

In patients with type 2 diabetes mellitus, the nature and frequency of adverse events were comparable to those in individuals without diabetes mellitus with overweight and obesity. The only new adverse events in patients with type 2 diabetes mellitus were hypoglycemic conditions occurring at an incidence of >2% and an incidence of ≥1% compared with placebo (which may have resulted from improved carbohydrate compensation) and a common occurrence of abdominal bloating.

In the 4-year clinical study, the overall safety profile did not differ from that obtained in the 1- and 2-year studies. At the same time, the overall incidence of adverse events from the gastrointestinal tract decreased annually over the 4-year period of taking the drug.

Post-marketing surveillance

Rare cases of allergic reactions have been described, the main clinical symptoms of which were itching, rash, urticaria, angioedema, bronchospasm and anaphylaxis.

Very rare cases of bullous rash, increased activity of transaminases and alkaline phosphatase, as well as isolated, possibly serious cases of hepatitis have been described (a cause-and-effect relationship with taking the drug Xenical ® or pathophysiological mechanisms of development have not been established).

With the simultaneous administration of Xenicali anticoagulants, cases of decreased prothrombin, increased international normalized ratio (INR) values and unbalanced anticoagulant therapy have been reported, which led to changes in hemostatic parameters.

Cases of rectal bleeding, diverticulitis, pancreatitis, cholelithiasis and oxalate nephropathy have been reported (incidence unknown).

When taking orlistat and antiepileptic drugs simultaneously, cases of seizures have been observed (see section “Interaction with other drugs”).

Contraindications for use

— chronic malabsorption syndrome;

- cholestasis;

- hypersensitivity to the drug or any other components contained in the capsule.

Use during pregnancy and breastfeeding

In animal reproductive toxicity studies, no teratogenic or embryotoxic effects of the drug were observed. In the absence of a teratogenic effect in animals, a similar effect in humans should not be expected. However because oflack of clinical data Xenical should not be prescribed to pregnant women.

The excretion of orlistat into breast milk has not been studied and should not be taken during breastfeeding.

Overdose

In clinical studies in individuals with normal body weight and obese patients, single doses of 800 mg or repeated doses of 400 mg 3 times a day for 15 days were not accompanied by the occurrence of significant adverse events. In addition, obese patients have experience using orlistat 240 mg 3 times a day for 6 months, which was not accompanied by a significant increase in the frequency of adverse events.

In cases of overdose of the drug Xenical, either the absence of adverse events was reported, or the adverse events did not differ from those observed when taking the drug in therapeutic doses.

In case of severe overdose of Xenical, it is recommended to monitor the patient for 24 hours. According to studies in humans and animals, any systemic effects that could be associated with the lipase inhibitory properties of orlistat should be quickly reversible.

Drug interactions

There were no interactions with amitriptyline, atorvastatin, biguanides, digoxin, fibrates, fluoxetine, losartan, phenytoin, oral contraceptives, phentermine, pravastatin, warfarin, nifedipine GITS (gastrointestinal therapeutic system) and nifedipine slow release, sibutramine or alcohol (based on drug interaction studies). However, it is necessary to monitor INR values during concomitant therapy with warfarin or other oral anticoagulants.

When taken simultaneously with the drug Xenical, a decrease in the absorption of vitamins D, E and betacarotene was noted. If multivitamins are recommended, they should be taken at least 2 hours after taking Xenical or before bedtime.

When taking the drug Xenical and cyclosporine simultaneously, a decrease in plasma concentrations of cyclosporine was observed, therefore, more frequent determination of plasma concentrations of cyclosporine is recommended when taking cyclosporine and the drug Xenical simultaneously.

When amiodarone was administered orally during therapy with Xenical, a decrease in the systemic exposure of amiodarone and desethylamiodarone was observed (by 25-30%), however, due to the complex pharmacokinetics of amiodarone, the clinical significance of this phenomenon is not clear. The addition of Xenical to long-term amiodarone therapy may result in a decrease in the therapeutic effect of amiodarone (no studies have been conducted).

The simultaneous use of Xenical and acarbose should be avoided due to the lack of data from pharmacokinetic studies.

Cases of seizures have been observed when taking orlistat and antiepileptic drugs simultaneously. A cause-and-effect relationship between the development of seizures and orlistat therapy has not been established. However, patients should be monitored for possible changes in seizure frequency and/or severity.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored at a temperature not exceeding 25°C in a place protected from moisture and out of reach of children.

Shelf life - 3 years. Do not use after the expiration date stated on the package.

Special instructions

Xenical is effective in terms of long-term control of body weight (loss of body weight and its maintenance at a new level, prevention of re-gain of body weight). Treatment with Xenical leads to an improvement in the profile of risk factors and diseases associated with obesity, including hypercholesterolemia, type 2 diabetes mellitus, impaired glucose tolerance, hyperinsulinemia, arterial hypertension, and a decrease in the amount of visceral fat.

When used in combination with hypoglycemic drugs such as metformin, sulfonylureas and/or insulin in patients with type 2 diabetes mellitus who are overweight (body mass index (BMI) ≥28 kg/m2) or obese (BMI ≥30 kg/m2) m 2), Xenical in combination with a moderately hypocaloric diet provides an additional improvement in the compensation of carbohydrate metabolism.

In clinical studies, the majority of patients had concentrations of vitamins A, D, E, K and betacarotene within the normal range during four years of orlistat therapy. A multivitamin may be prescribed to ensure adequate intake of all nutrients.

The patient should receive a balanced, moderately hypocaloric diet containing no more than 30% of calories in the form of fat. A diet rich in fruits and vegetables is recommended. The daily intake of fats, carbohydrates and proteins must be divided into three main meals.

The likelihood of adverse reactions from the gastrointestinal tract may increase if Xenical is taken on a diet rich in fat (for example, 2000 kcal/day, of which more than 30% in the form of fat, which equals approximately 67 g of fat). Daily fat intake should be divided into three main meals. If Xenical is taken with a meal very rich in fat, the likelihood of gastrointestinal reactions increases.

In patients with type 2 diabetes mellitus, a decrease in body weight during treatment with Xenical is accompanied by an improvement in the compensation of carbohydrate metabolism, which may allow or require a reduction in the dose of hypoglycemic drugs (for example, sulfonylurea derivatives).

Xenical is an original weight loss product that affects the metabolism of fats in the intestines. It was he who was one of the first to come to the aid of women and men who dreamed of finding a thin waist. However, its significant drawback is its high price.

Let's find out whether there are analogues cheaper than Xenical, what is the difference between them and how to save money on a medicine for weight loss without harm to health.

The capsules are produced by a Swiss company. Contains a gastrointestinal lipase inhibitor - orlistat.

The mechanism of action is due to a specific effect on enzymes that break down fats. By combining with lipases, orlistat neutralizes them, causing them to lose their ability to break down fats contained in food. Thus, fats are excreted unchanged from the intestines along with feces.

Under the influence of the medication, the number of calories entering the body decreases, and body weight gradually decreases.

The use of capsules is justified for the treatment of overweight and obese patients, including those with type 2 diabetes mellitus.

Pay attention! For diabetes, the medicine is combined with hypoglycemic agents.

Losing weight with Xenical is contraindicated in patients with cholestasis, chronic malabsorption syndrome, or hypersensitivity to the components of the drug.

Capsules are not recommended for children, adolescents under 18 years of age, pregnant women, and nursing mothers due to lack of data.

The drug is taken with food, 3 times a day. If there are no fats in the food, then taking the medicine can be skipped.

Pay attention! Exceeding the dosage does not speed up the weight loss process!

Advantages of Xenical:

Local action- the drug is active only in the lumen of the stomach and small intestine and is not absorbed into the blood. This allows it to be used to treat patients with chronic diseases.
Fast and long-lasting pharmacological effect- develops after 24 hours, persists for 72 hours.

Packages containing 21, 42 and 84 capsules are available.

Their cost is respectively 900 rubles, 1700 rubles, 3300 rubles.

Xenical's analogs

The original medicine can be replaced with other drugs for weight loss:

generics (contain a substance identical to Xenical);
medicines from other pharmacological groups.

GENERICS

The Russian pharmaceutical market offers imported and domestically produced orlistat.

Table of comparative characteristics of generics:

Name, country of origin	Form	Cost, rub.	Differences
Name, country of origin	Form	Cost, rub.	Advantages	Flaws
Listata, Russia	Film-coated tablets containing 120 mg of active substance. Packaged in packages of 30, 60, 90 pcs.	1050-2500	price	lack of safety information
Orlistat, Russia	Capsules containing 60 or 120 mg. Packaged in boxes of 42 and 84 capsules	500-1000	low price	difficult to find in pharmacies; lack of clinical trials confirming the safety and effectiveness of the drug; worse quality compared to the original
Orsoten, Slovenia	Capsules containing 120 mg of active substance. Packaged in 21, 42, 84 capsules	680-2100	high quality; Availability of all pharmacies
Orsoten slim, Slovenia	Capsules in a dosage of 60 mg. Sold in packs of 42 and 84 capsules	550-1050	affordable price; high quality	unavailable in some pharmacies
Xenalten, Russia	Packages of 21, 42, 84 capsules. Dosages 60 mg, 120 mg	700-2000	low price	difficult to find in pharmacies; lack of clinical studies

OTHER MEDICINES FOR WEIGHT LOSS

Substitutes differ in composition, mechanism of pharmacological action and contraindications for use.

The most popular analogues are the appetite regulators Reduxin, Goldline, Dietressa and the homeopathic drug Cefamadar.

These medications can be used if you are intolerant or have contraindications to taking Orlistat.

Appetite regulators suppress the feeling of hunger, thereby reducing the amount of food consumed. Reducing calorie levels leads to weight loss. The mechanism of their action is to influence the central nervous system.

Name of the drug, country of origin	Active ingredient	Release form	Cost, rub.	Difference from the original
Name of the drug, country of origin	Active ingredient	Release form	Cost, rub.	Advantages	Flaws
Dietressa, Russia	Antibodies to cannabinoid receptor type 1	100 lozenges	580	natural composition; no contraindications, with the exception of pregnancy, breastfeeding, and childhood; good tolerance; no serious side effects; promotes rapid saturation; reduces the amount of food consumed;	long course of treatment (at least 3 months); lack of objective clinical studies; unproven effectiveness; unavailable in most pharmacies
Reduksin, Russia	Complex of sibutramine and microcrystalline cellulose	Packaged in 30, 60, 90 capsules. Available in 2 dosages: 15 and 10 mg sibutramine, cellulose 158.5 and 153.5 mg, respectively	1800-6000	effectiveness is confirmed by numerous positive reviews; widespread; taken once a day, regardless of nutrition	a significant number of contraindications for use (obesity associated with organic lesions of internal organs, for example, hypothyroidism, mental disorders, drug, drug and alcohol addiction, severe damage to the liver, kidneys, etc.); incompatibility with many drugs, especially those affecting the central nervous system; serious side effects from the nervous and cardiovascular systems; high price; dispensed with a doctor's prescription
Goldline, Russia	Sibutramine	Capsules containing 10 or 15 mg of active substance, packaged in	600-2000
Cefamadar, Germany	Homeopathic dilutions	100 tablets	2200	approved for use by children; absence of serious side effects; minimum restrictions on taking medication; dispensed without a doctor's prescription.	lack of clinical studies; high price

To summarize the above

The advantages of the original medicine are clinically proven effectiveness and high quality raw materials.

If someone is not satisfied with the high price of Xenical and wants to buy a cheaper medicine, generics - similar drugs based on orlistat - will come to the rescue. The most affordable and popular among them are Russian-made Listata and Orlistat.

Slovenian Orsoten is a little more expensive, but this manufacturer is famous for its high-quality generics. Therefore, if you have a choice about which orlistat to choose, it is better to buy Orsoten or Xenical.

The most powerful substitutes are drugs based on sibutramine - Goldline, Reduxin. However, they are not only more effective, but also more dangerous due to possible negative health consequences. They are dispensed from the pharmacy only with a doctor's prescription.

Pay attention! You can take appetite regulators based on sibutramine only with a doctor's prescription.

The main factors when choosing a replacement are possible contraindications to taking the drug and its quality.

In any case, taking medications for weight loss should be preceded by consultation with a specialist - only he will be able to select the dosage.

In this article you can read the instructions for use of the drug Xenical. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Xenical in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Xenical in the presence of existing structural analogues. Use for the treatment of obesity and weight loss, in combination with diet in adults, children, as well as during pregnancy and lactation. Composition of the drug.

Xenical- a powerful, specific and reversible inhibitor of gastrointestinal lipases with a long-lasting effect. Its therapeutic effect occurs in the lumen of the stomach and small intestine and consists of the formation of a covalent bond with the active serine site of gastric and pancreatic lipases. The inactivated enzyme then loses the ability to break down food fats, which come in the form of triglycerides, into absorbable free fatty acids and monoglycerides. Since unsplit triglycerides are not absorbed, the resulting decrease in caloric intake into the body leads to a decrease in body weight. Thus, the therapeutic effect of the drug is carried out without absorption into the systemic circulation.

Judging by the results of fat content in stool, the effect of orlistat (the active ingredient of the drug Xenical) begins 24-48 hours after administration. After discontinuation of the drug, the fat content in stool usually returns to pre-therapy levels within 48-72 hours.

Efficiency

Obese patients

Patients with obesity and type 2 diabetes mellitus

In clinical studies of 6 months to 1 year, overweight or obese patients with type 2 diabetes treated with orlistat experienced greater weight loss compared with patients treated with diet therapy alone. Body weight loss occurred mainly due to a decrease in the amount of fat in the body. It should be noted that before the start of the study, despite taking hypoglycemic agents, patients often had insufficient glycemic control. However, with orlistat therapy, a statistically and clinically significant improvement in glycemic control was observed. In addition, during orlistat therapy, a decrease in doses of hypoglycemic agents, insulin concentrations, and a decrease in insulin resistance were observed.

Reducing the risk of developing type 2 diabetes in obese patients

Pubertal obesity

In a clinical study lasting 1 year in obese adolescents, when taking Xenical, a decrease in body mass index was observed compared with the placebo group, where there was even an increase in body mass index. In addition, patients in the orlistat group showed a decrease in fat mass and waist and hip circumference compared to the placebo group. Also, patients receiving orlistat therapy experienced a significant reduction in diastolic blood pressure compared to the placebo group.

Preclinical safety data

Composition of the drug

Orlistat + excipients + gelatin capsule shell.

Pharmacokinetics

In volunteers with normal body weight and obesity, systemic exposure to the drug is minimal. Based on animal data, orlistat is metabolized primarily in the intestinal wall. Studies in normal and overweight individuals have shown that the main route of elimination is excretion of unabsorbed drug in the feces. About 97% of the administered dose of the drug was excreted in feces, with 83% as unchanged orlistat. The cumulative renal excretion of all substances structurally related to orlistat is less than 2% of the administered dose. The time until the drug is completely eliminated from the body (with feces and urine) is 3-5 days. The ratio of orlistat elimination routes in volunteers with normal and overweight was the same.

Indications

long-term therapy for obese or overweight patients, incl. having risk factors associated with obesity, in combination with a moderately hypocaloric diet;
in combination with hypoglycemic drugs (metformin, sulfonylurea derivatives and/or insulin) or a moderately hypocaloric diet in patients with type 2 diabetes mellitus who are overweight or obese.

Release forms

Capsules 120 mg.

The drug in the form of tablets or solution does not currently exist; perhaps Xenical in this form is a fake.

Instructions for use and method of use

Long-term therapy of obese or overweight patients, including those with risk factors associated with obesity, in combination with a moderately hypocaloric diet in adults and children over 12 years of age, the recommended dose of orlistat is one 120 mg capsule with each main meal (during during meals or no later than an hour after meals).

In combination with hypoglycemic drugs (metformin, sulfonylureas and/or insulin) or a moderately hypocaloric diet in patients with type 2 diabetes mellitus who are overweight or obese: in adults, the recommended dose of orlistat is one 120 mg capsule with each main meal (during meal or no later than an hour after eating).

If meals are skipped or if the food does not contain fat, then Xenical can also be skipped.

The effectiveness and safety of Xenical in patients with impaired liver and/or kidney function, as well as in elderly and pediatric patients (under 12 years of age) have not been studied, so taking the drug is not recommended for these categories of people.

Side effect

oily discharge from the rectum;
release of gases with some discharge;
imperative urge to defecate;
steatorrhea;
increased frequency of bowel movements;
loose stools;
flatulence;
pain or discomfort in the abdomen.

As a rule, these adverse reactions are mild and transient. They occurred in the early stages of treatment (in the first 3 months), and most patients had no more than one episode of such reactions.

When treated with Xenical, the following adverse events also occur:

"soft" stool;
pain or discomfort in the rectum;
fecal incontinence;
bloating;
tooth damage;
gum damage;
headaches;
upper respiratory tract infections;
lower respiratory tract infections;
urinary tract infections;
dysmenorrhea;
anxiety;
weakness;
hypoglycemic conditions;
rash;
hives;
angioedema;
bronchospasm;
anaphylaxis;
rectal bleeding;
diverticulitis;
pancreatitis.

Contraindications

chronic malabsorption syndrome;
cholestasis;
hypersensitivity to the drug or any other components contained in the capsule.

Use during pregnancy and breastfeeding

In animal reproductive toxicity studies, no teratogenic or embryotoxic effects of the drug were observed. In the absence of a teratogenic effect in animals, a similar effect in humans should not be expected. However, due to the lack of clinical data, Xenical should not be prescribed to pregnant women.

The excretion of Xenical in breast milk has not been studied, so it should not be taken during breastfeeding.

Special instructions

When used in combination with hypoglycemic drugs such as metformin, sulfonylureas and/or insulin in patients with type 2 diabetes mellitus who are overweight (body mass index (BMI) ≥28 kg/m2) or obese (BMI ≥30 kg/m2 ), Xenical in combination with a moderately hypocaloric diet provides an additional improvement in the compensation of carbohydrate metabolism.

Drug interactions

The simultaneous use of Xenical and acarbose should be avoided due to the lack of data from pharmacokinetic studies.

Analogues of the drug Xenical

Structural analogues of the active substance:

Alli;
Xenalten;
Orlimax;
Orlistat;
Orsoten;
Orsoten slim.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Effective and affordable substitutes for Xenical capsules

In medical practice, Xenical is used to overcome obesity, in conjunction with a prescribed diet. People who are preparing to lose weight want to purchase this pharmaceutical product, because the pills will help to lose weight without significant harm to health. However, the price of the medicine will not satisfy many who want to buy it. But you can save a little on the cost by choosing cheaper similar products.

Pharmaceutical effect

Xenical is a powerful inhibitor. The active ingredient is Orlistat. It has a beneficial effect on gastrointestinal lipases. The process of breaking down fats stops and they are not absorbed into the body. This leads to an inevitable decrease in the patient's weight.

Studies of stool fat content have established that the drug in question begins to act after 1-2 days after use. Stopping treatment returns the previous fat content in stool after 2-3 days.

What does the drug help with?

Indications for use:

Long-term treatment of obesity, including overweight people and people prone to obesity;
Concurrent use of various hypoglycemic medications in the fight against diabetes.

Who should refuse treatment?

Contraindications:

Patients with individual intolerance to the active and other components;
In case of impaired absorption of carbohydrates, proteins and fats by the digestive tract;
With a decrease or complete cessation of bile formation.

Can it be used by women during pregnancy and lactation?

Due to the fact that there is no verified information from clinical studies about the harm of the drug to the female body who is preparing to give birth to a baby and who is breastfeeding. Accordingly, the medical product is not prescribed.

Negative side effects

In the form of unfavorable processes during therapy, problems with the digestive system may occur. The frequency of bowel movements increases, and stool may become liquid with a high fat content. Less common is a feeling of discomfort in the abdomen and bloating. Patients who are hypersensitive to the drug have allergies of various forms - from a harmless allergic reaction to life-threatening anaphylactic shock.

Treatment rules

How to use Xenical:

It is important to distribute food intake, namely by composition - fats, proteins and carbohydrates, across all three meals per day.

The same dosage is used in patients who combine treatment with other medications - metformin, insulin, and a diet based on a calorie deficit.

If the patient for some reason missed a meal, or the meal does not contain fat, then Xenical should not be used.

The body's reaction to an overdose

Studies have established that frequent use of the drug at a dose of 400 mg three times a day for half a month did not cause severe symptoms in patients.

In the event of an accidental or intentional increase in the dose, undesirable manifestations do not differ from taking the recommended dose. However, in case of overdose, it is necessary to exercise medical supervision throughout the day.

Do I need medical advice before my appointment?

Many people who do not like their physique due to some excess weight want to find different ways to lose weight quickly. Sometimes the right solution for obese people is Xenical tablets. However, it is strictly forbidden to drink them without a doctor’s recommendation. This is due to the fact that existing diseases may worsen while taking the pills. Any diseases associated with impaired functioning of the renal and cardiovascular systems will not ensure favorable weight loss.

Finding ways to buy medicine and jeopardizing your health is not worth it. Only a doctor should determine whether the drug is appropriate.

Features of the treatment process

By increasing the recommended, established dosage, it is impossible to achieve a positive effect;
No studies have been conducted on the adverse effects on patients under twelve years of age, as well as those diagnosed with serious pathologies of the liver and kidneys;
While taking the medication, the patient must eat a balanced diet. Food should be low in calories. The fat content of the product should not exceed 30%. Otherwise, there may be a risk of increased adverse reactions;
In diabetics, the metabolic process can be improved, which will reduce the dosage of drugs against impaired glucose absorption;
An enhanced effect can be achieved by taking multivitamins in parallel. They should be drunk before going to bed or two hours after consuming Xenical;
Drinking alcoholic beverages during treatment is not permitted.

Absorption with other medications

Medicinal substances with which interactions have not been established:

Atorvastatin;
Amitriptyline;
Digoxin;
Buguanidam;
Fluoxetine;
Losartan;
Various oral contraceptives;
Warfarin;
Nifedipine;
Pravastatin.

When vitamins D, E and beta-carotene are taken together, their absorption is reduced. Multivitamins should be taken no earlier than two hours after taking Xenical or before falling asleep.

Simultaneous use of the medication in question with various drugs intended for epilepsy can cause seizures.

Concurrent use of the immunosuppressant Cyclosporine and the antiarrhythmic drug Amiodarone reduces their effectiveness.

Simultaneous treatment with Xenical and Acarbose is not permitted, since the necessary pharmacological studies have not been carried out.

How much does Xenical cost: price at the pharmacy

Sales in pharmaceutical shops - according to doctor's prescription. The cost (on the website apteka.ru, Moscow) is extremely high - for the drug you will have to pay from 1087 (21 capsules per package) to 1791 rubles (42 capsules). In the regions, prices for pharmaceutical products differ insignificantly from those in the capital.

List of inexpensive generics of imported and Russian production

The table shows a list of inexpensive generics of the drug under study:

Listal – (Russian alternative)

Used to combat obesity and excessive body weight. At the same time, you need to follow a calorie deficit diet.

You should not take Listal tablets if you have cholestasis, malabsorption, or problems with normal tolerance of their essential elements. Not recommended for pregnant women and those who are breastfeeding. This is due to the lack of proven evidence of safe treatment.

Taking this pharmaceutical product simultaneously causes some harmful reactions in the body. First of all, the digestive organs are affected, causing diarrhea, abdominal pain, and flatulence. In addition, headaches, respiratory infections, and a general state of weakness are common.

Orlistat – (Poland)

Another similar medication. Helps against obesity, namely for people with a high body mass index or those who are overweight.

Orlistat capsules are not prescribed to children under twelve years of age who have hypersensitivity to their composition, a chronic form of malabsorption, problems with bile excretion, as well as women expecting a child and breastfeeding.

The most common parallel harmful phenomena are unstable functioning of the gastrointestinal tract, since the absorption of dietary fats is blocked during therapy. They manifest themselves in diarrhea and epigastric pain. There may be a decrease in immunity, which predisposes the body to various infectious diseases - influenza, upper respiratory tract, urinary system. Anxious feelings, migraines, as well as local reactions - rashes on the skin of the body are allowed. Women may experience disruptions to their menstrual cycle.

Orsoten – (Russia/Slovenia)

The cheapest complete analogue of Xenical. Prescribed for long-term treatment of serious weight problems, namely painful obesity and increased body weight.

It is not allowed to be used by patients with allergies to the active substances of Orsoten, diseases of the biliary system, or by women preparing for childbirth or during breastfeeding. It is not issued to minors.

It has many associated reactions of a harmful nature, although mild. They are due to the fact that the drug actively removes fat obtained from food, which leads to dysfunction of the stomach and intestines - severe softening of stools, abdominal pain, increased frequency of bowel movements. A long period of treatment practically prevents these phenomena.

Conclusion on accessible and inexpensive synonyms

The medicine studied in this analytical material stands out for its effectiveness, but at the same time its price is relatively high. On the Russian pharmaceutical market, similar medicines can be purchased cheaper without problems, since they are presented quite well. Domestic and imported pharmaceutical companies produce a number of generics, famous for their high-quality breakdown and blocking the absorption of carbohydrates and fats. An important point in preparing for treatment of weight problems is visiting a qualified nutritionist. His competence includes determining the body mass index, selecting a medication and establishing the recommended dose.