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Doctors' Answers to "Frequently Asked Questions" - Xenical

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An indi vidual patient is always advised to consult their own physician.

[posted 09/30/2000]
Question: HI
i know someone that would like to ask
can you tell me about two kinds of drugs? :-

What are they for?
What is in the drugs?
What are the dangers?
Also what could happon if taken?


Answer: 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).

[posted 07/10/2000]
Question: Ive been taking wellbutrin for 9 months and had been on
zoloft for 3yrs and gained 50 lbs. My doctor
prescribed xenical, I lost 20lbs in 5 months and hit a plateau.
He then prescribed meridia and I have lost another 15 lbs in 2 months.
My question is wellbutrin and meridia a okay combo since they both deal with the seretonin
levels of the brain. I do experience migrain headaches and hair loss/thinning. Im 30 yrs old
and still need to loose 30 lbs. I needed a anti depressant because I was so depressed from the weight gainand starting a new business, etc
Newly married and huge was a horrible experience.Thank you for any info

Answer: Okay as long as you take the wellbutrin at a different time from the xenical so the xenical does not block the absorption of the wellbutrin.

[posted 04/6/2000]

Answer: Yes, but not simultaneously. There may be interference with absorption of the lipitor.

[posted 02/15/2000]
Question: I took two weight loss drugs during the first month of my pregnancy.
They were Xenical and Metab-O-LITE (a Ma Huang/ephedra concentrate)
What are the effects of these on the fetus? Should I be worried?

Answer: Xenical is a Class B drug in pregnancy. Studies done in animals in high dosage have demonstrated no appreciable fetal damage/malformation. Studies have not been done on the drug in humans due to ethical considerations. I have no information 0n the Metab-O-Lite, check with the company.

[posted 01/31/2000]
Question: Is it safe to take both Meridia (to help me control food cravings and learn better eating habits) and Xenical (to help me lose weight more quickly, which is highly motivating)? I currently take thyroid medication, asthma medication (Azmacort, Ventolin, & Singulaire), a multivitamin, gingko biloba, and L-lysine. I am in good health except for exercise-induced asthma, which has gotten worse with my weight gain.

Answer: I wouldn't. Try one at a time and ensure you take your other medications separate from the xenical if that is your option.

[posted 11/4/1999]
Question: Recently, I have seen several commercials for a new perscription drug that supposedly blocks fat. I can't remember the name of it -- do you know what it is, or have any information about it?

Answer: The prescription one is called Xenical. After your food leaves the stomach, it enters the small intestine. At this point, the pancreas produces different enzymes to cut up the big molecules and allow them to be absorbed. One of these is an enzyme that cuts/reduces fat molecules. Xenical blocks the ability of this enzyme to work. Consequently, you cannot absorb most of the fat and it passes through the stool and out the other end. It needs to be taken 30 minutes before or 45 minutes after eating. It can produce Vitamin A,D,E,K malabsorption since these are fat soluble vitamins, consequently you'll need to take a multivitamin some time away from the Xenical. It only works if you eat, so if you have a small meal, a very low fat meal or don't eat it does not help to take it. Taking it with a very high fat meal(prime rib with sour cream for example) can result in uncontrolled diarrhea-even to loss of bowel control. So, most patients learn to reduce the fat in their meals to avoid this and not take it with the really fat excessive meals. It's not cheap but works without many systemic side effects since it only works in the small intestine. There is concern about blood vitamin levels with this drug and this needs to be watched closely. It is relatively new and we may find problems that we don't suspect due to it's relative newness.

[posted 11/10/1999]
Question: I am 35 yrs old and pregnant with twins. I have a 10 month old daugther and had been taking the pill after her birth. I had no intention of having any more children and in addition to the pill had been taking xenical and adipex. I am worried about any problems this could do to the babies. I can get an amno test at the very end of this month. Do you know if any studies have been done on pregnancys and these drugs? I really appreciate any advice you could give me. thanks


Answer: There are no direct studies of the fetal problems with these drugs. Xenical is not supposed to be absorbed, but does affect fat soluble vitamin absorption. Any vitamin deficiency can affect a child, but unlikely if you have been on supplements. Adipex is in unknown territory.

[posted 08/6/1999]
Question: Hi, I am taking phentermine for weight loss and it works well but doctors don't usually like to prescribe it for more than a month or two. Why does that scare them so much? Also, is Meridia as effective? What about the drug Xenical? Also, I am taking Prozac, too but had to double the dose after a month of Phentermine...do these types of drugs commonly cause depression or personality changes? Thanks.

Answer: You'd have to ask your md about their prescription practices, most mds wouldn't have this problem. Merida works but is slow and expensive. It achieves about 2 pounds a month at a cost of 60-70$. Xenical works better but tends to cause some diarrhea-especially with high fat meals. There is some concern about vitamin metabolism with xenical-especially A,D,E,K. I've had better luck with xenical and don't use meridia much.

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