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Doctors' Answers to "Frequently Asked Questions" - Xenical, Drug InfoNet, Inc.:"Xenical is a drug designed to lose weight. It does it by inhibiting the enzymes that are produced by the pancreas. This does not allow the fat in your food to be broken up into smaller absorbable pieces. Consequently, the fat cannot be absorbed and passes out your colon. Diarrhea is a common problem. Also, one needs to ensure that the fat absorbable vitamins(A,D,E,K) are not passed with the fat in your stool. To do this take a vitamin at a time when the xenical is not present. The drug is taken thirty minutes before a meal or forty five minutes after to have maximum effect and is not taken if you are not eating. It should be avoided for a very heavy fatty meal since the diarrhea can be uncontrollable at these times. I am not familiar with duromine(nor is it listed in the PDR, can you check the spelling)."
Drug InfoNet, Inc.
5760 Commons Park Drive East Syracuse, NY 13057
Telephone: (315) 671-0801 Fax: (201) 313-3377
http://www.druginfonet.com/faq/new/DRUG_FAQ/Xenical.htm

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Xenical, Most important fact about this drug, Healthsquare.com:"Along with dietary fat, Xenical decreases the absorption of some fat-soluble vitamins and beta-carotene. To compensate, you should take a multivitamin containing vitamins A, E, D, and K once a day, at least 2 hours before or 2 hours after taking Xenical."
HealthSquare.com
Choice Media, Inc.
68 East Main St.
Somerville, NJ 08876
comments@healthsquare.com
http://www.healthsquare.com/newrx/XEN1529.HTM

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Orlistat, Dosing, Medicinenet.com:"The recommended dose for orlistat is one capsule (120 mg) three times daily. Orlistat should be taken one hour after or during a meal containing fat. Meals without fat do not require orlistat. No additional benefit has been shown when orlistat was taken in doses greater than 120mg. Patients should eat a nutritionally balanced, reduced calorie diet that contains approximately 30% of calories from fat. Some dietary vitamins bind to fat (vitamins A, D, E and beta- carotene). When orlistat is taken, these vitamins are not absorbed and are eliminated in the stool in increased amounts along with the fat. Therefore, patients taking orlistat should take a multivitamin containing these "fat-soluble" vitamins to ensure that adequate amounts of the vitamins are available for absorption. To ensure that the vitamins in the multivitamins are not bound to fat like the vitamins in the diet, the multivitamin should be taken at least two hours before or several hours after the orlistat."
MedicineNet, Inc.
903 Calle Amanecer, Suite 300 San Clemente, CA 92673
Telephone: 949.940.6500 Fax: 949.940.1094, smartservice@medicinenet.com
http://www.medicinenet.com/orlistat/article.htm

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Orlistat, What special precautions should I follow? Medlineplus.com:"Before taking orlistat, tell your doctor and pharmacist if you are allergic to orlistat or any other drugs. tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, especially anticoagulants (''blood thinners'') such as warfarin (Coumadin); medications for diabetes, such as glipizide (Glucotrol), glyburide (DiaBeta, Dynase, Micronase), metformin (Glucophage), and insulin; other medications for weight loss; pravastatin (Pravachol); vitamins such as beta-carotene and vitamins A, E, and K; and herbal products. If you are taking cyclosporine (Neoral, Sandimmune), take it 2 hours before or 2 hours after orlistat. tell your doctor if you have or have ever had anorexia nervosa or bulimia, gallstones, thyroid disease, diabetes, kidney problems, or if you consistently have problems absorbing food (malabsorption syndrome). tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding."
clinicaltrials.gov, National Library of Medicine, National Institutes of Health."
Office of Communications and Public Liaison
National Library of Medicine
8600 Rockville Pike Bethesda, Maryland 20894
Phone: (301) 496-6308 Fax: (301) 496-4450 email: publicinfo@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601244.html

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Xenical, Precautions, RXlist.com:"Patients should be counseled to take a multivitamin supplement that contains fat-soluble vitamins to ensure adequate nutrition because XENICAL has been shown to reduce the absorption of some fat-soluble vitamins and beta-carotene. In addition, the levels of vitamin D and beta-carotene may be low in obese patients compared with non-obese subjects. The supplement should be taken once a day at least 2 hours before or after the administration of XENICAL, such as at bedtime."
RxList LLC
500 3rd Street Suite 530
San Francisco, CA 94107
707-747-0985 fax: 708 575 8638, info@rxlist.com http://www.rxlist.com/cgi/generic/orlistat.htm

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Orlistat, How should this medicine be used? Safemedication.com:"Orlistat comes as a capsule to take by mouth. It is usually taken three times a day with each main meal that contains fat. Each time you take orlistat, your meal should contain no more than about 30% of calories from fat. Take orlistat during or up to 1 hour after a meal. If a meal is missed or does not have fat, you may skip your dose. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take orlistat exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor."
American Society of Health-System Pharmacists
7272 Wisconsin Avenue Bethesda, MD 20814
301–657-3000, E-Mail
http://www.safemedication.com/displaydrug.cfm?id=867

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Orlistat, Xenical, What is the most important information I should know about orlistat? WebMD:"Orlistat may decrease your body's absorption of some fat-soluble vitamins. To ensure adequate nutrition, your doctor may recommend taking a multivitamin that contains vitamins D, E, K, and beta-carotene. Take your vitamin supplement once a day, at least 2 hours before or after a dose of orlistat."
WebMD
1175 Peachtree Road, NE, Suite 2400, Atlanta, GA 30361.
service@webmd.net
212-624-3700
http://my.webmd.com/content/drugs/3/4046_2117?bn=Orlistat

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Orlistat, Xenical, Why Prescribed, WholehealthMD.com:"To achieve weight loss and weight maintenance in the maintenance of obesity when used in conjunction with a reduced-calorie diet and appropriate physical activity. Orlistat is indicated for patients with an initial body mass index (BMI) of 30 or greater and in those with a BMI greater than 27 (see Special Concerns for information on BMI calculation) who also have other risk factors such as high blood pressure, high blood cholesterol, and diabetes."
WholeHealthMD LLC
11150 Sunset Hills Road Suite 210 Reston, VA 20190
(262) 367-3200 fax: (262) 367-5934:
http://www.wholehealthmd.com/refshelf/drugs_view/0,1524,850,00.html

See also:

Lipase Inhibitors, Drugdigest.org:"Orlistat (Xenical) inhibits the absorption of fat from the intestine. Instead of fat being absorbed into the body, fat is excreted in the stool. Since fat is excreted rather than absorbed, caloric and fat intake is reduced. Common side effects of orlistat include gas, fecal urgency, fecal incontinence, fatty/oily stools, and increased defecation. These symptoms are greatest when high fat meals are consumed. http://www.drugdigest.org/DD/HC/HCDrugClass/0,4055,550400-550266,00.html

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Clinical trial of lipase inhibitor for the treatment of obesity, Medical Condition News:"Peptimmune, Inc. a privately held biotechnology company, announced that physicians have treated the first participant in a clinical trial to evaluate the safety, tolerability and pharmacokinetics of GT389-255, a lipase inhibitor conjugated to a fat binding polymer for the treatment of obesity. The Phase I single ascending dose (SAD) double blind placebo controlled randomized study will involve 48 healthy male volunteers who will receive the drug in six escalating dose cohorts. Later in 2004, the SAD study will be followed by a multiple ascending dose Phase I study (MAD). If Phase I development is successful, Peptimmune anticipates launching a Phase II trial in patients with obesity in 2005."
http://www.news-medical.net/?id=3926

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