NationMaster - Encyclopedia: Orlistat

Orlistat (marketed under the trade name Xenical by Roche; or over-the-counter as Alli^[1] by GlaxoSmithKline, pronounced [ˈælaɪ], like the English word "ally")—also known as tetrahydrolipstatin—is a drug designed to treat obesity.^[2] Its primary function is preventing the absorption of fats from the human diet, thereby reducing caloric intake. It is intended for use in conjunction with a physician-supervised reduced-calorie diet. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... F. Hoffmannâ€“La Roche, Ltd. ... Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biologicals, and healthcare company. ... This chart shows concisely the most common way in which the International Phonetic Alphabet (IPA) is applied to represent the English language. ... A calorie is a unit of measurement for energy. ...

Orlistat is the saturated derivative of lipstatin—a potent natural inhibitor of pancreatic lipases isolated from the bacterium Streptomyces toxytricini.^[3] However, due to simplicity and stability, orlistat rather than lipstatin was developed into an anti-obesity drug.^[4] Lipstatin is a potent, irreversible inhibitor of pancreatic lipase. ... Secondary metabolites, also known as natural products, are those products (chemical compounds) of metabolism that are not essential for normal growth, development or reproduction of an organism. ... Pancreatic lipase is an enzyme (more specifically, a lipase) secreted from the pancreas that uses hydrolysis to break apart fat molecules. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... Binomial name Preobrazhenskaya & Sveshnikova 1957 Streptomyces toxytricini is a Gram-positive bacterium belonging to the genus Streptomyces. ...

Pharmacology

Orlistat works by inhibiting pancreatic lipase, an enzyme that breaks down triglycerides in the intestine. Without this enzyme, triglycerides from the diet are prevented from being hydrolyzed into absorbable free fatty acids and are excreted undigested. Only trace amounts of orlistat are absorbed systemically; the primary effect is local lipase inhibition within the GI tract after an oral dose. The primary route of elimination is through the feces. Pancreatic lipase is an enzyme (more specifically, a lipase) secreted from the pancreas that uses hydrolysis to break apart fat molecules. ... Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Triglyceride (blue: fatty acid; red: glycerol backbone) Triglycerides are glycerides in which the glycerol is esterified with three fatty acids. ... In anatomy, the intestine is the segment of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine (or colon). ... Hydrolysis is a chemical reaction or process in which a chemical compound reacts with water. ... In chemistry, especially biochemistry, a fatty acid is a carboxylic acid often with a long unbranched aliphatic tail (chain), which is either saturated or unsaturated. ... Upper and Lower gastrointestinal tract The gastrointestinal tract (GI tract), also called the digestive tract, or the alimentary canal, is the system of organs within multicellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. ... Horse feces Feces, faeces, or fÃ¦ces (see spelling differences) is a waste product from an animals digestive tract expelled through the anus (or cloaca) during defecation. ...

At the standard prescription dose of 120 mg three times daily before meals, orlistat prevents approximately 30% of dietary fat from being absorbed,^[5] and about 25% at the standard over-the-counter dose of 60 mg.^[6]^[7] Higher doses do not produce more potent effects.^[8] The milligram (symbol mg) is an SI unit of mass. ...

Efficacy

The amount of weight loss achieved with orlistat varies. In one-year clinical trials, between 35.5% and 54.8% of subjects achieved a 5% or greater decrease in body mass, although not all of this mass was necessarily fat. Between 16.4% and 24.8% achieved at least a 10% decrease in body mass.^[8] After orlistat was stopped, a significant number of subjects regained weight—up to 35% of the weight they had lost.^[8] Despite this relatively small body mass effect, there was a 37% reduction in the incidence of type 2 diabetes,^[9] a significant difference. This study (XENDOS) proved that the side effect profile of orlistat remained the same up to 4 years. Respondents who lost 5% of their initial body weight in the first three months plus 2.5 gm in the first 4 weeks prior to the study, lost 16.4% of their weight at the end of one year. In health care, including medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a process in which a medicine or other medical treatment is tested for its safety and effectiveness, often in comparison to existing treatments. ... In statistics, a result is significant if it is unlikely to have occurred by chance, given that a presumed null hypothesis is true. ... See diabetes mellitus for further general information on diabetes. ...

Side effects

The primary side effects of the drug are gastrointestinal-related. Side effects are most severe when beginning therapy, and decrease in frequency with time; in clinical trials, nearly half of side effects lasted less than a week, but some may persist for over six months.^[10] Because orlistat's main effect is to prevent dietary fat from being absorbed, the fat is excreted unchanged in the feces and so the stool may become oily or loose (steatorrhea). Increased flatulence is also common. Bowel movements may become frequent or urgent, and rare occurrences of fecal incontinence have been seen in clinical trials; the manufacturer website of alli recommends to users "[...] Until you have a sense of any treatment effects, it's probably a smart idea to wear dark pants, and bring a change of clothes with you to work".^[11]^[12] To minimize these effects, foods with high fat content should be avoided; the manufacturer advises consumers to follow a low-fat, reduced-calorie diet. Oily stools and flatulence can be controlled by reducing the dietary fat content to somewhere in the region of 15 grams per meal,^[13] and it has been suggested that the decrease in side effects over time may be associated to long-term compliance with a low-fat diet.^[14] An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of medications. ... Steatorrhoea is the formation of bulky, grey or pale faeces. ... Flatulence (expelled through the anus in a process commonly known as farting or emitting gas) is the presence of a mixture of gases known as flatus in the digestive tract of mammals. ...

Absorption of fat-soluble vitamins and other fat-soluble nutrients is inhibited by the use of orlistat. A multivitamin tablet containing vitamins A, D, E, K, and beta-carotene should be taken once a day, at least 2 hours before or after taking the drug.^[10] It has been suggested that this article or section be merged with Vitamin. ... Retinol (Vitamin A) For the record label, see Vitamin Records A vitamin is an organic compound required in tiny amounts for essential metabolic reactions in a living organism. ... Vitamin A is an essential human nutrient. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... Tocopherol, or Vitamin E, is a fat-soluble vitamin in eight forms that is an important antioxidant. ... Vitamin K1 (phylloquinone). ... Carotene is a terpene, an orange photosynthetic pigment, important for photosynthesis. ...

Despite claims that orlistat increases the risk of breast cancer amongst clinical trial participants, there is evidence to suggest that the introduction of specific varied preparations containing orlistat, namely the concurrent administration of orlistat and the monoclonal antibody trastuzumab, can actually induce cell death in tumor cells and block their growth.^[15] Monoclonal antibodies (mAb) are antibodies that are identical because they were produced by one type of immune cell, all clones of a single parent cell. ... Trastuzumab (more commonly known under the trade name Herceptin) is a humanized monoclonal antibody that acts on the HER2/neu (erbB2) receptor. ... Programmed cell death (PCD) is the deliberate suicide of an unwanted cell in a multicellular organism. ...

A 2006 animal study linked orlistat with aberrant crypt foci (ACF), lesions found in the colon which are believed to be one of the earliest precursors of colon cancer.^[16]^[17] It has been suggested that this article or section be merged with Large intestine. ...

Interactions

Orlistat may reduce plasma levels of ciclosporin (also known as "cyclosporin" or "cyclosporine", trade names Sandimmune, Gengraf, Neoral, etc.), an immunosuppressive drug frequently used to prevent transplant rejection; the two drugs should therefore not be administered concomitantly.^[10] Ciclosporin (INN), cyclosporine or cyclosporin (former BAN), is an immunosuppressant drug. ... For a list of immunosuppressive drugs, see the transplant rejection page. ... Transplant rejection occurs when the immune system of the recipient of a transplant attacks the transplanted organ or tissue. ...

Contraindications

Orlistat is contraindicated in:^[10] In medicine, a contraindication is a condition or factor that increases the risk involved in using a particular drug, carrying out a medical procedure or engaging in a particular activity. ...

Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that stores about 50 ml of bile (or gall) until the body needs it for digestion. ... Laparoscopic Cholecystectomy as seen through laparoscope X-Ray during Laparoscopic Cholecystectomy Cholecystectomy (, plural: cholecystectomies,) is the surgical removal of the gallbladder. ... A pregnant woman near the end of her term Pregnancy is the carrying of one or more offspring in an embryonal or fetal stage of development by female mammals, including humans, inside their bodies, between the stages of conception and birth. ... Breastfeeding an infant Symbol for breastfeeding (Matt Daigle, Mothering magazine contest winner 2006) Breastfeeding is the feeding of an infant or young child with milk from a womans breasts. ...

Availability

In most areas, such as the United Kingdom, France, and Canada, orlistat is available by prescription only. In Australia and the United States, certain formulations of orlistat have been approved for sale without a prescription. Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ...

Australia

In Australia, orlistat is currently available over-the-counter in 120 mg size (84 capsules to the pack). Initially available only with a prescription, it was reclassified as a "Pharmacist Only Medicine" in October 2003. In late 2006, the Australian Consumers' Association complained that Roche was inappropriately advertising the drug to teenagers, and Roche was forced to withdraw its ads.^[18] The Association filed further complaints^[18] with the Therapeutic Goods Administration—TGA, Australia's regulatory authority for healthcare products—and the TGA's Scheduling Committee agreed to convene on February 20, 2007, to discuss possible revoking of orlistat's over-the-counter status.^[19] The Committee ultimately decided to keep orlistat as a Schedule 3 drug, but withdrew its authorization of direct-to-consumer Xenical advertising, stating this "increased pressure on pharmacists to provide orlistat to consumers...this in turn had the potential to result in inappropriate patterns of use".^[20] Xenical has recently began being advertised direct-to-customers again. 2007 is a common year starting on Monday of the Gregorian calendar. ... Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ... The Standard for the Uniform Scheduling of Drugs and Poisons, abbreviated SUSDP, is a document used in the regulation of drugs and poisons in Australia. ... The Australian Consumers Association (the ACA), which was known as the Australasian Consumers Association between 1959 and 1963), is a non-profit organization founded in 1959 to research and advocate on behalf of Australian consumers, similar to the Consumers Union in the United States, which it considers a sister organisation... The Therapeutic Goods Administration or TGA is the regulatory body for drugs and therapeutic goods in Australia. ... is the 51st day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ...

United States

On January 23, 2006, a U.S. Food and Drug Administration advisory panel voted 11 to 3 to recommend the approval of an OTC formulation of orlistat, to be marketed under the name alli by GlaxoSmithKline.^[21] Approval was granted on February 7, 2007,^[22] and alli became the first weight loss drug officially sanctioned by the U.S. government for over-the-counter use.^[23] Consumer advocacy organization Public Citizen, through its Health Research Group, opposed over-the-counter approval for orlistat, calling it "the height of recklessness" and "a dangerous mistake" due to questionable benefits and possible adverse effects.^[24] is the 23rd day of the year in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... hi â€œFDAâ€ redirects here. ... GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biologicals, and healthcare company. ... is the 38th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Public Citizen is a U.S. non-governmental organization, founded by Ralph Nader in 1971 and based in Washington, DC. Its activities span across a diverse range of issues, including energy policy, trade policy, campaign finance reform and accountability, consumer protection, medical malpractice, and public health. ...

Alli became available in the U.S. in June of 2007. It is sold as 60 mg capsules—half the dosage of prescription orlistat.^[23]^[24]

Generic formulations

As of 2007, no generic formulations of orlistat are legally available in the United States. U.S. patent protection for Xenical, originally to end on June 18, 2004, was extended by five years (until 2009) by the U.S. Patent and Trademark Office. The extension was granted on July 20, 2002.^[25] 2007 is a common year starting on Monday of the Gregorian calendar. ... A generic drug (pl. ... is the 169th day of the year (170th in leap years) in the Gregorian calendar. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... PTO headquarters in Alexandria The United States Patent and Trademark Office (PTO or USPTO) is an agency in the United States Department of Commerce that provides patent and trademark protection to inventors and businesses for their inventions and corporate and product identification. ... is the 201st day of the year (202nd in leap years) in the Gregorian calendar. ... Also see: 2002 (number). ...

References

^ Always rendered with a lowercase a, i.e. as alli.
^ Bodkin J, Humphries E, McLeod M (2003). "The total synthesis of (−)-tetrahydrolipstatin". Australian Journal of Chemistry 56 (8): 795–803. DOI:10.1071/CH03121.
^ Barbier P, Schneider F (1987). "Syntheses of tetrahydrolipstatin and absolute configuration of tetrahydrolipstatin and lipstatin". Helvetica Chimica Acta 70 (1): 196–202. DOI:10.1002/hlca.19870700124.
^ Pommier A, Pons M, Kocienski P (1995). "The first total synthesis of (-)-lipstatin". Journal of Organic Chemistry 60 (22): 7334–7339. DOI:10.1021/jo00127a045.
^ (2006) 2006 Physicians' Desk Reference (PDR). Thomson PDR. ISBN 1-56363-527-5.
^ myalli.com – frequently asked questions. GlaxoSmithKline (2007). Retrieved on 2007-08-18.
^ Parker-Pope, Tara. "Weighing the Pros and Cons Of New Fat-Blocking Drug Alli", The Wall Street Journal, June 19, 2007, pp. D1. Retrieved on 2007-08-18.
^ ^a ^b ^c Xenical Pharmacology, Pharmacokinetics, Studies, Metabolism. RxList.com (2007). Retrieved on 2007-03-16.
^ Torgerson J, Hauptman J, Boldrin M, Sjöström L (2004). "XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients.". Diabetes Care 27 (1): 155–61. PMID 14693982.
^ ^a ^b ^c ^d Roche Pharmaceuticals (January 5, 2007). Xenical® Product Label (PDF, 300 KiB). U.S. Food and Drug Administration. Retrieved on 2007-02-19.
^ myalli.com – what are treatment effects?. Retrieved on 2007-06-24.
^ Hall, Carla. "New diet drug touches off a feeding frenzy", Los Angeles Times, June 15, 2007. Retrieved on 2007-06-20.
^ PRNewswire (February 7, 2007). FDA Approves alli™ (orlistat 60 mg capsules) Over-The-Counter (PDF, 21 KiB). Press release. Retrieved on 2007-04-08.
^ Mancini MC, Halpern A (2006). "Pharmacological treatment of obesity". Arq Bras Endocrinol Metab 50 (2): 377–89. DOI:/S0004-27302006000200024. PMID 16767304. Free full text with registration
^ J. A. Menendez, L. Vellon and R. Lupu (2005). "Antitumoral actions of the anti-obesity drug orlistat (XenicalTM) in breast cancer cells: blockade of cell cycle progression, promotion of apoptotic cell death and PEA3-mediated transcriptional repression of Her2/neu (erbB-2) oncogene". Annals of Oncology 16 (8): 1253–1267. PMID 15870086.
^ Garcia S, da Costa Barros L, Turatti A, Martinello F, Modiano P, Ribeiro-Silva A, de Oliveira Vespúcio M, Uyemura S (2006). "The anti-obesity agent Orlistat is associated to increase in colonic preneoplastic markers in rats treated with a chemical carcinogen.". Cancer Lett 240 (2): 221–4. PMID 16377080.
^ Takayama T, Katsuki S, Takahashi Y, Ohi M, Nojiri S, Sakamaki S, Kato J, Kogawa K, Miyake H, Niitsu Y (1998). "Aberrant crypt foci of the colon as precursors of adenoma and cancer". N Engl J Med 339 (18): 1277–84. PMID 9791143. Free full text with registration.
^ ^a ^b Drug advertising: Xenical. CHOICE (February 2007). Retrieved on 2007-02-16.
^ Bissett, Kelvin. "Weight drugs danger revealed", The Daily Telegraph, February 5, 2007. Retrieved on 2007-02-16.
^ Australian Therapeutic Goods Administration (February 22, 2007). Scheduling of orlistat. Press release. Retrieved on 2007-03-03.
^ "Panel Supports Offering Diet Pill Orlistat Over the Counter", The Washington Post, January 24, 2006, pp. A02. Retrieved on 2006-08-10.
^ U.S. Food and Drug Administration (February 7, 2007). FDA Approves Orlistat for Over-the-Counter Use. Press release. Retrieved on 2007-02-07.
^ ^a ^b Saul, Stephanie. "Weight-Loss Drug to Be Sold Over the Counter", The New York Times, February 7, 2007. Retrieved on 2007-02-10.
^ ^a ^b Schmid, Randolph E. "FDA OKs First Nonprescription Diet Pill", The Washington Post, February 8, 2007. Retrieved on 2007-02-10.
^ Rogan, James E. (July 30, 2002). Certificate Extending Patent Term Under 35 U.S.C. § 156 (PDF, 32 KiB). United States Patent and Trademark Office. Retrieved on 2007-04-08.

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The Wall Street Journal (WSJ) is an international daily newspaper published by Dow Jones & Company in New York City, New York, USA, with Asian and European editions, and a worldwide daily circulation of more than 2 million as of 2006, with 931,000 paying online subscribers. ... is the 170th day of the year (171st in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 230th day of the year (231st in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... March 16 is the 75th day of the year (76th in leap years) in the Gregorian calendar. ... F. Hoffmannâ€“La Roche, Ltd. ... January 5 is the 5th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... PDF is an abbreviation with several meanings: Portable Document Format Post-doctoral fellowship Probability density function There also is an electronic design automation company named PDF Solutions. ... A kibibyte (a contraction of kilo binary byte) is a unit of information or computer storage, commonly abbreviated KiB (never kiB). 1 kibibyte = 210 bytes = 1,024 bytes The kibibyte is closely related to the kilobyte, which can be used either as a synonym for kibibyte or to refer to... hi â€œFDAâ€ redirects here. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 50th day of the year in the Gregorian calendar. ... 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A press release (sometimes known as a news release or press statement) is a written or recorded communication directed at members of the news media for the purpose of announcing something claimed as having news value. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... April 8 is the 98th day of the year (99th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... The New England Journal of Medicine (New Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... February 16 is the 47th day of the year in the Gregorian calendar. ... The Daily Telegraph is a tabloid newspaper published in Sydney, New South Wales, by Nationwide News, part of News Corporation. ... is the 36th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... February 16 is the 47th day of the year in the Gregorian calendar. ... The Therapeutic Goods Administration or TGA is the regulatory body for drugs and therapeutic goods in Australia. ... is the 53rd day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... A press release (sometimes known as a news release or press statement) is a written or recorded communication directed at members of the news media for the purpose of announcing something claimed as having news value. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 62nd day of the year (63rd in leap years) in the Gregorian calendar. ... The Washington Post is the largest newspaper in Washington, D.C.. It is also one of the citys oldest papers, having been founded in 1877. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 222nd day of the year (223rd in leap years) in the Gregorian calendar. ... hi â€œFDAâ€ redirects here. ... is the 38th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... A press release (sometimes known as a news release or press statement) is a written or recorded communication directed at members of the news media for the purpose of announcing something claimed as having news value. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 38th day of the year in the Gregorian calendar. ... The New York Times is a daily newspaper published in New York City by Arthur Ochs Sulzberger Jr. ... is the 38th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 41st day of the year in the Gregorian calendar. ... The Washington Post is the largest newspaper in Washington, D.C.. 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PTO headquarters in Alexandria The United States Patent and Trademark Office (PTO or USPTO) is an agency in the United States Department of Commerce that provides patent and trademark protection to inventors and businesses for their inventions and corporate and product identification. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... April 8 is the 98th day of the year (99th in leap years) in the Gregorian calendar. ...

External links

Categories: Antiobesity drugs | Lactones A division of the Anatomical Therapeutic Chemical Classification System A Alimentary tract and metabolism A08A Antiobesity preparations, excluding diet products A08AA Centrally acting antiobesity products A08AA01 Phentermine A08AA02 Fenfluramine A08AA03 Amfepramone A08AA04 Dexfenfluramine A08AA05 Mazindol A08AA06 Etilamfetamine A08AA07 Cathine A08AA08 Clobenzorex A08AA09 Mefenorex A08AA10 Sibutramine A08AA56 Ephedrine, combinations A08AB Peripherally... Phentermine is an appetite suppressant of the amphetamine and phenethylamine class. ... Fenfluramine is a drug that was part of the Fen-Phen anti-obesity (the other drug being phentermine). ... Diethylcathinone, more commonly called Diethylpropion in the medical field (TenuateÂ®) is a sympathomimetic stimulant drug marketed as an appetite suppressant. ... Dexfenfluramine, also marketed under the name Redux, is a appetite-suppresant drug. ... Mazindol is a central nervous system simulant. ... Cathine (β-hydroxyamphetamine) is a monoamine alkaloid found in the shrub Catha edulis (khat). ... Clobenzorex (also known under the brand names Asenlix, Finedal, or Rexigen; or the US slang greenies) is a stimulant drug used as an anorectic (that is, a medication that suppresses appetite). ... Sibutramine (MeridiaÂ® in the USA, ReductilÂ® in Europe), usually as sibutramide hydrochloride monohydrate, is an orally administered agent for the treatment of obesity. ... Rimonabant (SR141716) is an anorectic anti-obesity drug. ...

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