We take a look at the concerns raised about the marketing of weight-loss drug orlistat contained in the medicine Xenical. Orlistat, sold in Australia as Xenical, is a drug that's promoted as a treatment for those who are overweight and obese. But Xenical isn't the magic-bullet solution to obesity, and we have concerns about its over-the-counter availability at pharmacies. Xenical is taken when you're eating fatty food, so you'll usually take a capsule with each of the three main meals a day unless you know the meal you're eating contains no fat. You must limit the fat that you eat in a day to less than 12g in each meal, and no more than 40g per day. A really fatty meal can result in some unpleasant side effects.

Orlistat blocks some of the fat that you eat, keeping it from being absorbed by your body. This medicine must be used together with a reduced-calorie diet and increased physical activity. Orlistat is for use only in adults that are overweight or obese. The Alli brand is available without a prescription. You should not use this medicine if you have a digestive disorder problems absorbing food. You should not use Xenical if you have gallbladder problems, or if you are pregnant. Do not use Alli if you have had an organ transplant, if you use cyclosporine, or if you are not overweight.

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And belly fat can be a sign of something more: Metabolic syndrome, a group of health problems that include too much fat around the waist, elevated blood pressure, blood sugar, triglycerides, and low good HDL cholesterol -- all boosting your risks of disease. Making matters worse, losing belly fat can sometimes seem daunting. For many people, diet and exercise don't always work. Luckily, we've got options like FDA-approved weight loss medications and even surgery. But belly fat is not particularly tenacious fat to get rid of Frankly, if you reduce calories and exercise more, you will lose weight everywhere -- including your abdomen. While Eisenson considers diet and exercise the most effective weight loss strategies, he acknowledges that there's a role for medical treatments. Keeping the weight off is what's most difficult, he says. If a drug can help people keep off what they've lost, that's meaningful. Both drugs are considered moderately effective in weight loss, with an average of 5 to 22 pounds over a one-year period.

Well-informed patients are more likely to be compliant. It is worth spending time explaining what the medication is, how it is taken and why, how long it is to be used for, what adverse effects to look out for and any alternatives if appropriate. The importance of the drug therapy can be explained and what might happen if the patient did not comply. Aids to help compliance can be suggested, for example packaging of daily doses can be arranged with pharmacists, special containers can be obtained, the help of relatives can be sought, suitable time of day for administration can be chosen and provision of written information can all help. Patient information leaflets must be included in packaging of medicines.

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Obviously, in therapeutic use drugs are taken by many different sectors of the general population least likely to be young, healthy men. Drug trials therefore continue after a drug is on the market through monitoring by the MHRA of the first patients using new drugs and through the yellow card scheme of reporting adverse reactions thereafter. It is possible to predict, and to some extent avoid, likely adverse effects in particular populations using knowledge of factors that affect the four processes price of orlistat reducin in different patient groups. The elderly are known to suffer a higher frequency of adverse effects to medication and the reasons are many and varied. Knowledge of the possible reasons, together with consideration of the problems and changes caused by the ageing process, means that many of the adverse affects could be avoided or at least reduced in intensity. The lower the TR of a drug, the more important these considerations become.

Ganciclovir is similar in mode of action. Adverse reactions can be severe so this drug is reserved for serious viral infections such as cytomegalovirus in immunocompromized patients. Adverse effects include bone marrow suppression, liver and kidney toxicity and central nervous system damage. Some RNA viruses are known as retroviruses. These viruses use an enzyme called reverse transcriptase to copy viral RNA to produce viral DNA. The viral DNA is then incorporated into the host cells DNA where it can lie dormant before being used as a template for the production of more viral RNA.

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Prednisolone is used for most rheumatoid disease. It is not the most potent of the corticosteroids available, but it has the advantage of allowing fine adjustment of doses. To minimize side effects the maintenance dose of prednisolone should be kept as low as possible. In moderate to severe rheumatoid arthritis of less than two years duration, low dose prednisolone may reduce the rate of joint destruction. Nevertheless, it is recommended that maintenance therapy should be for two to four years only and then gradually reduced to avoid possible long-term adverse effects.

Intolerance reactions are often unpredictable with no family history of similar events. Generally, the sick, frail, aged and malnourished are most likely to experience adverse effects in response to usual doses. Allergy to local anaesthetics is possible, although this is not common. It is most likely in people who have regular contact with local anaesthetics such as dentists and anaesthetists. Local anaesthetics used in podiatry are all readily absorbed from their sites of administration into the bloodstream, so potentially they can have systemic side effects. Metabolism is by enzymes in the liver, and to a lesser extent in the kidneys.

Third generation β-blockers also cause peripheral vasodilation and do not adversely affect plasma lipid profiles. An example is celiprolol. Calcium channel blockers are used to treat ischaemic heart disease, arrhythmia and hypertension. This is a diverse group of drugs, which fall into three classes. They all block influx of calcium ions during depolarization of muscle cells. Class I calcium channel blockers work preferentially on calcium ion channels in cardiac muscle cells.

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