The Lowdown on Xenical and Reductil
Xenical and Reductil Information

Dietitian, Juliette Kellow summarises the key characteristics of slimming pills Xenical (orlistat) and Reductil (sibutramine), how they work and what the side effects are...

The Lowdown on Xenical and Reductil

By Dietitian, Juliette Kellow BSc RD


Reductil has been taken off the market because it has been linked to an increased risk of heart attacks and strokes. A trial involving 10,000 patients revealed that Reductil could lead to heart problems.

This is made even more worrying by the fact that the weight-loss pill was only available to those who are obese and already at a greater risk of developing heart problems.

Those responsible for regulating medicines and healthcare products said: ‘Evidence suggests that there is an increased risk of non-fatal heart attacks and strokes with this medicine that outweigh the benefits of weight loss, which is modest and may not be sustained in the long-term after stopping treatment.’

Since Reductil was introduced in 2001 there have been 2094 suspected adverse reactions and 17 deaths linked to the drug. Six of the deaths were caused by heart problems and stroke.

People who are currently taking the drug are advised to make a routine appointment with their doctor to discuss Reductil and that there are no health risks in stopping treatment before seeing their doctor

These drugs should be prescribed by your doctor, although unfortunately you can buy them over the internet. It’s not something we’d recommend. Orlistat is now available in an over the counter version called Alli. Read dietitian, Juliette Kellow's Alli Diet Pill Review.


  Xenical (Orlistat) Reductil (Sibutramine)

What is it?

Xenical is a lipase inhibitor. Its active ingredient is lipostatin. Reductil is a satiety enhancer. Its active ingredient is sibutramine hydrochloride.
How does it work? Xenical blocks the action of the fat-digesting lipase enzymes in the intestine. This stops around 30 percent of the fat you’ve eaten from being absorbed. It simply passes through your digestive system and you lose weight as a result. Reductil blocks the nerve cells that release and reabsorb serotonin. This means serotonin levels increase. These act in the brain and enhance feelings of fullness so that you eat less and consequently lose weight.
Who is it suitable for? Your doctor will decide whether Xenical is suitable for you. It will only be prescribed if your Body Mass Index (BMI) is 30 or more or your BMI is 28 or more and you have other health problems such as heart disease or type 2 diabetes. You’ll also only be prescribed Xenical if dieting and exercise alone have produced a weight loss of at least 2.5kg over four weeks. In contrast, it’ll be discontinued if you haven’t lost at least five percent of your body weight after 12 weeks. Alternatively see your pharmacist about the new Alli Diet Pill. Your doctor will decide whether Reductil is suitable for you. It will only be prescribed if your Body Mass Index (BMI) is 30 or more or your BMI is 27 or more and you have other weight-related health problems.
Do I still need to diet and exercise? Yes! To avoid unpleasant side effects, you should follow a reduced-calorie diet where no more than 30 percent of calories come from fat. Taking more exercise is also recommended. Yes! Reductil should be used in conjunction with a reduced-calorie diet. Taking more exercise is also recommended.
Is there any proof that it works? Xenical has been extensively studied. In clinical trials, almost twice as many patients who received Xenical, achieved an average weight loss of 10 percent or more of their body weight in one year, compared to those on diet alone. Reductil has also been studied. When used in combination with a reduced-calorie diet and appropriate physical activity, 77 percent of patients achieved weight loss that benefited their health.
What support do patients get? Patients have access to the Medical Action Plan (MAP). This 12-month plan provides information to help patients follow a reduced-calorie diet providing less than 30 percent of daily calories from fat. It also includes advice on how to increase activity levels. Patients have access to the Change for Life programme. This 12-month package provides motivational support and advice on healthy eating and physical activity to encourage permanent behavioural and lifestyle changes.
Are there any side effects? Unabsorbed fat can cause loose stools and flatulence. Xenical also interferes with the absorption of the fat-soluble vitamins A, D, E, and K, so you might need to take supplements. The most common side effects include insomnia, constipation, a dry mouth and small increases in blood pressure.


References and Sources:

New England Journal of Medicine - Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects

European Medicines Agency - European Medicines Agency recommends suspension of marketing authorisation for Sibutramine

JAMA - Weight control and risk factor reduction in obese subjects treated for 2 years with Orlistat

Medicines and Healthcare Regulatory Agency UK - Public Assesment Report - Orlistat

International Journal of Obesity Related Metabolic Disorders - Sibutramine: A novel anti obesity drug


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