Rimonabant
Rimonabant
Ingredients:
Active Ingredient: Rimonabant
Inactive Ingredients: Tablet core: maize starch, lactose monohydrate,
povidone K 30 (E1201), croscarmellose sodium (E468), sodium laurilsulfate
(E487), microcrystalline cellulose (E460), magnesium stearate
Tablet coating: lactose monohydrate, hypromellose 15 mPa.s (E464), titanium
dioxide (E171), macrogol 3000
Tablet polishing: carnauba wax (E903)
What
is Rimonabant?
Rimonabant
pills are the newest drug entrant in the UE pharmaceutical market making
waves for its dual nature of weight loss and smoking cessation property.
As the wonder drug Rimonabant is finally approved for sale through prescription.
This amazing
medicine work by blocking the CB-1 receptors that governs food intake
and tobacco dependency. The receptors are in the brain, but also throughout
the body, notably in fat cells. Among other things, they account for
the sudden surge of appetite felt by people who smoke marijuana.
Doctors
say that this system of receptors is disrupted by tobacco and by chronic
overeating. The medicine restores the balance in the system, reducing
dependence on tobacco and suppressing appetite. Since many smokers are
also overweight, Rimonabant could end up doing double duty.
How
does Rimonabant works?
Rimonabant
Acomplia's novel mode of action targets the same biological "switch"
in the brain that makes people hungry when they smoke cannabis. The
drug binds to and blocks a so-called cannabinoid receptor protein found
on the surface of brain cells.
People
treated for one year with rimonabant 20 mg per day lost 8.6 kg (almost
20 lbs.) vs. a loss of only 2.3 kg (5 lbs.) on placebo (p<0.001).
Waist circumference reduction of 9.1 cm (3.5 inches) in patients treated
for a year (completers) with rimonabant 20 mg (p<0.001 vs. placebo).
Average increase of 23% in HDL-cholesterol in completers (p<0.001
vs. placebo). Average reduction of 15% in triglycerides in completers
(p<0.001 vs. placebo). A positive shift in LDL particle size, with
a reduction (p=0.002 vs. placebo) in the proportion of smaller dense
atherogenic LDL particles, which are associated with cardiovascular
risk, and an increase (p<0.001 vs. placebo) in the proportion of
larger, less atherogenic LDL particles.
Does
Rimonabant slimming pills also aid smoking cessation?
Rimonabant(
Generic Acomplia) has been studied by the french company Sanofi-Aventis
as an aid to smoking cessation based on studies for up to one year in
over 6,500 smokers motivated to quit smoking
How
is Rimonabant used?
Rimonabant
pills should be take as one tablet once a day, before breakfast. The
patients should also follow a reduced calorie diet and increase their
level of physical activity. Rimonabant slimming pills should not be
used in patients who have severe problems with their liver or their
kidneys or on mothers that are breast feeding.
What
is the risk associated with Rimonabant ?
Rimonabant
can lead to several unwanted side effects such as mentioned below: depression,
anxiety, nausea and irritability.
In general, Rimonabant side effects seem to subside once adjustment
to the drug is made. Side effects of Rimonabant slimming pills appear
to be fewer and less severe than those of many other weight loss medications
on the market. This medicine shows more promise as a diet pill as it
has relatively low incidence of side effects as compared to the available
weight loss drugs. Its positive effects on weight loss and to maintain
healthy blood pressure, blood sugar and cholesterol level is going to
prove immensely beneficial for the people who will use this medication..
Weight
Loss Medication Rimonabant May Not Slow Progression Of Heart Disease
According to a recent study published in JAMA, a clinical trial testing
how well the anti-obesity drug rimonabant slowed the development of
coronary artery disease in people with abdominal obesity and pre-existing
coronary disease resulted in mixed conclusions. Called STRADIVARIUS
(the Strategy to Reduce Atherosclerosis Development Involving Administration
of Rimonabant - The Intravascular Ultrasound Study), the trial was conducted
by Steven E. Nissen, M.D. (Cleveland Clinic) and several STRADIVARIUS
investigators.
Nissen
and colleagues write that, "Abdominal obesity, even in the absence
of type 2 diabetes, is associated with a constellation of metabolic
and physiological abnormalities that amplify the risk for atherosclerotic
cardiovascular disease." Some examples of metabolic syndrome are
high triglyceride levels, low HDL (good) cholesterol levels, high blood
pressure, and high blood glucose (blood sugar) levels.
Atherosclerotic
disease is more commonly known as "hardening" of the arteries,
and it occurs when the inner walls of the arteries accumulate plaque
deposits. Abdominal obesity is a fundamental cause of atherosclerotic
disease, but currently there are few treatment options available for
the condition. The drug rimonabant, a selective cannabinoid type 1 receptor
antagonist, is one possible treatment option. Lacking the approval of
the U.S. Food and Drug Administration, the drug is only available in
other countries.
To compare
rimonabant against placebo, the researchers designed a randomized, double-blinded
clinical trial that included 839 patients at 112 centers in North America,
Europe, and Australia selected from December 2006 to December 2007.
For 18 to 20 months after random assignment, participants received either
20 mg daily of rimonabant pills or a matching placebo. Part of the selection
process maintained that patients were eligible only if they needed coronary
angiography for medical reasons. After randomization, participants scheduled
clinic visits at 3, 6, 12, and 18 months. The STRADIVARIUS researchers
were chiefly concerned with the change in the percent atheroma volume
(PAV) and secondarily concerned with the change in normalized total
atheroma volume (TAV). Both PAV and TAV indicate how much plaque has
built-up on the inner lining of an artery. These markers of atherosclerotic
progression were measured by ultrasonographic coronary imaging.
"In
the rimonabant slimming pills vs. placebo groups, PAV increased 0.25
percent vs. 0.51 percent, respectively, and TAV decreased -2.2mm³
vs. an increase of 0.88mm³," write the researchers. "Rimonabant-treated
patients had a larger reduction in body weight (-4.3kg [-9.5 lbs.] vs.
-0.5 kg [-1.1 lbs.]) and greater decrease in waist circumference (-4.5
cm [-1.77 inches] vs. -1.0 cm [- 0.39 inches]). In the rimonabant vs.
placebo groups, high-density lipoprotein cholesterol levels increased
5.8mg/dL (22.4 percent) vs. 1.8mg/dL (6.9 percent) and median (midpoint)
triglyceride levels decreased -24.8 mg/dL (20.5 percent) vs. -8.9 mg/dL
(6.2 percent)."
The investigators
also found, however, that changes in the level of "bad" cholesterol
(LDL-C) and changes in blood pressure were not significantly different
between groups. "Psychiatric adverse effects were more common in
the rimonabant group (43.4 percent vs. 28.4 percent)," with anxiety
and depression being the most commonly reported adverse side effects.
In the
authors' words: "Administration of rimonabant slimming pills, 20mg,
daily for 18 months did not significantly reduce the rate of progression
of coronary disease for the primary IVUS (intravascular ultrasound)
end point, the change in PAV." Although, "The secondary endpoint,
change in TAV, showed a statistically significant treatment effect favoring
rimonabant."
"Because
the current study failed to achieve a statistically significant effect
for the primary efficacy measure, additional studies will be required
to further define the role of rimonabant in the treatment of abdominally
obese patients with coronary disease and metabolic risk factors,"
the authors conclude.
An accompanying
editorial by John S. Rumsfeld, M.D., Ph.D. (Denver Veterans Affairs
Medical Center and the Department of Medicine at the University of Colorado)
and Brahmajee K. Nallamothu, M.D., M.P.H. (Ann Arbor Veterans Affairs
Medical Center and the Department of Medicine, University of Michigan)
notes that the STRADIVARIUS trial is critical to understanding the effectiveness
and safety of rimonabant.
"This
drug is clearly efficacious for weight loss, underscoring its promise
as a therapeutic option for obesity. However, despite improvements in
metabolic parameters, STRADIVARIUS demonstrated no efficacy of rimonabant
for coronary artery disease progression while it simultaneously heightened
concern about its safety profile," write Rumsfeld and Nallamothu.
They conclude:
"The hopes for this amazing drug wich is rimonabant ultimately
may be realized if the medication is shown to have a favorable effect
on mortality and cardiovascular events. In that case, doctors will be
grateful for a new weapon in the fight against the obesity epidemic
but will have to remain vigilant for trade-offs in quality of life,
an outcome of equal importance to survival and certainly more important
than any surrogate measure."
