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Xenical vs Saxenda
Introduction
For individuals struggling with obesity or weight-related health issues, certain medications that interact with the body's metabolism and appetite regulation can provide assistance in managing these problems. Xenical and Saxenda are two such drugs that are prescribed for weight loss. They each impact different mechanisms of the body to induce weight reduction, but both have proven effective in aiding patients' weight loss journeys. Xenical (Orlistat) works by inhibiting pancreatic lipase, an enzyme that breaks down triglycerides in the intestine. By prohibiting this enzyme from working, Xenical prevents fat absorption thus reducing caloric intake leading to weight loss. On the other hand, Saxenda mimics a hormone that targets areas of the brain which regulate appetite and food intake - it makes you feel fuller sooner which helps control your calorie consumption better.
Xenical vs Saxenda Side By Side
| Attribute | Xenical | Saxenda |
|---|---|---|
| Brand Name | Xenical | Saxenda |
| Contraindications | Chronic malabsorption syndrome, cholestasis | Personal or family history of thyroid cancer, Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) |
| Cost | $615 for a 30-day supply | $1300 for a 30-day supply |
| Generic Name | Orlistat | Liraglutide |
| Most Serious Side Effect | Serious liver problems, including jaundice and severe stomach or abdominal pain | Pancreatitis, gallbladder problems, kidney problems, rapid heart rate |
| Severe Drug Interactions | Cyclosporine | Not specifically mentioned, but caution advised due to potential for serious mood changes and suicidal thoughts |
| Typical Dose | 120 mg orally three times a day | Start with 0.6 mg per day, increasing by 0.6 mg each week to a recommended dose of 3.0 mg per day |
What is Xenical?
Orlistat (the generic name for Xenical) was one of the first drugs in the lipase inhibitor class of weight-loss medications. Orlistat, first approved by the FDA in 1999, works by inhibiting gastrointestinal lipases enzymes that break down fats. By preventing this breakdown and absorption, it effectively helps promote weight loss. It is prescribed to aid individuals trying to lose weight or prevent gaining back any lost weight.
On the other hand, Liraglutide (marketed as Saxenda), which was approved later by FDA in 2014, belongs to a different class of medication known as GLP-1 receptor agonists used primarily for diabetes but found effective for weight management as well. Unlike Xenical which acts on digestive enzymes, Saxenda mimics an intestinal hormone that helps regulate blood sugar levels while also slowing digestion and reducing appetite.
While both medications have been proven effective for aiding with weight loss when coupled with diet and exercise changes, they work differently within your body systems and have different side effect profiles.
What conditions is Xenical approved to treat?
Xenical and Saxenda are both drugs approved for the management of obesity:
- Xenical is indicated for long-term weight loss in overweight or obese adults, including those with risk factors such as hypertension, diabetes, or dyslipidemia.
- Saxenda, on the other hand, is not only approved to assist with weight loss in situations similar to Xenical but also has an additional indication: use alongside a reduced-calorie meal plan and increased physical activity in adults with at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus or high cholesterol.
How does Xenical help with these illnesses?
Xenical aids in weight management by reducing the amount of fat absorbed from your diet. It achieves this by inhibiting lipase, an enzyme that breaks down fats in the gut, thereby preventing these fats from being metabolically available and causing them to be excreted instead. Lipids are a type of nutrient that serve as one of our body's main sources of energy, but excessive intake can lead to obesity and associated health risks.
On the other hand, Saxenda works differently; it mimics a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain which regulate appetite and food intake. The increased GLP-1 levels make you feel less hungry and more satisfied after eating, leading to reduced calorie intake.
Therefore both Xenical and Saxenda can help patients manage their weight effectively but through different mechanisms - Xenical reduces fat absorption while Saxenda suppresses appetite.
What is Saxenda?
Saxenda is the brand name for liraglutide, a medication that mimics an intestinal hormone (GLP-1) which induces feelings of satiety and slows gastric emptying. It was approved by the FDA in 2014 as a treatment for obesity, alongside diet and exercise.
Unlike Xenical, Saxenda doesn’t inhibit pancreatic lipases to prevent dietary fat absorption but instead works centrally to help control appetite. Its unique mechanism of action means that its side effect profile differs from other weight loss medications like Xenical. Although it may cause nausea initially, this tends to subside with continued use; it does not commonly lead to undesirable GI effects such as oily stools or fecal urgency often associated with Xenical.
Due to its different mode of action on inducing satiety rather than blocking fat absorption, Saxenda can be helpful particularly in individuals who struggle with overeating or have difficulty controlling portion sizes.
What conditions is Saxenda approved to treat?
Saxenda has received approval from the FDA for use in the following circumstances:
- Chronic weight management, alongside a reduced-calorie meal plan and increased physical activity, in adults with an initial BMI of 30 or more (obese), or 27 or more (overweight) if other health issues such as hypertension, type 2 diabetes mellitus, or dyslipidemia are also present.
- Long-term weight control in patients aged 12 years and older with a body weight above 60 kg and an initial BMI equivalent to an adult's of over 30 (obese), or over 27 if associated with certain comorbidities.
How does Saxenda help with these illnesses?
Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist that plays several roles in the body, including delaying gastric emptying, increasing feelings of fullness and satisfaction after eating, and regulating insulin secretion. These effects work together to help control hunger and manage blood sugar levels which can support weight loss efforts. Saxenda works by mimicking the function of naturally occurring GLP-1 to increase these sensations of satiety. Its influence on blood glucose regulation also makes it a potential choice for overweight or obese patients with type 2 diabetes. In contrast to Xenical, which primarily works by preventing dietary fat absorption in the intestines, Saxenda's multi-target approach may provide an effective alternative when traditional diet drugs are not suitable or have failed to achieve desired results.
How effective are both Xenical and Saxenda?
Both orlistat (Xenical) and liraglutide (Saxenda) have been approved by the FDA for long-term weight management. Although they act via different mechanisms, both medications can be prescribed to aid in weight loss efforts alongside a reduced-calorie diet and regular physical activity. Orlistat works by inhibiting pancreatic lipase, an enzyme that breaks down fats for absorption in the intestine; thus reducing fat absorption by about 30%. Liraglutide mimics a naturally occurring hormone called GLP-1 that regulates appetite.
The effectiveness of orlistat and liraglutide was evaluated in several double-blind clinical trials. Studies show comparable efficacy between these two drugs when used as part of a comprehensive weight loss program, with similar safety profiles observed.
A 2004 meta-analysis review on orlistat demonstrated its effectiveness at promoting significant weight loss compared to placebo from the first month of treatment onward. It also showed favorable side effect profiles compared to other anti-obesity drugs at large doses, indicating it's well-tolerated even among special populations like adolescents and individuals with type 2 diabetes.
In contrast, a 2015 study indicated that liraglutide seems more effective than placebo in sustaining long-term weight maintenance. However, due to its unique mechanism of action affecting satiety regulation directly via central nervous system pathways - unlike most anti-obesity medicines - Saxenda is often considered only after traditional options have failed or are not tolerated due to unwanted side effects such as gastrointestinal upset caused by Xenical's mode of action.
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At what dose is Xenical typically prescribed?
Dosages of Xenical typically begin at 120 mg orally three times a day during or up to 1 hour after each main meal. If a meal is missed or contains no fat, the dose can be omitted. For Saxenda, the initial dosage is 0.6 mg per day for one week; this should be increased by 0.6 mg each week until reaching the recommended dose of 3.0 mg per day as tolerability allows over time (usually about five weeks). Both medications should not exceed their respective maximum dosages and are intended to work in conjunction with a reduced-calorie diet and increased physical activity.
At what dose is Saxenda typically prescribed?
Saxenda therapy is typically initiated at a dose of 0.6 mg per day for one week. The dosage can then be increased by increments of 0.6 mg per week until the recommended daily dose of 3.0 mg is reached, usually within five weeks. This incremental increase helps to minimize gastrointestinal side effects, which are more common at the start of treatment and tend to lessen over time with continued use at the same dosage level. If patients do not experience sufficient weight loss or have difficulty tolerating the maximum dose, it may need to be reduced to a lower tolerated dose or discontinued altogether after consultation with your healthcare provider.
What are the most common side effects for Xenical?
Common side effects of Xenical include:
- Oily spotting from the rectum
- Gas with discharge, oily or fatty stools
- Increased number of bowel movements
- Poor bowel control (loose stools)
- Stomach pain, nausea and vomiting
- Jaundice (yellowing skin or eyes)
- Signs of kidney stones such as back pain, pelvic pain, bloody urine
On the other hand, Saxenda may cause:
- Nausea which is usually mild to moderate and decreases over time
- Hypoglycemia in patients with type 2 diabetes mellitus who are also using medicines for treating diabetes.
- Constipation
- Diarrhea -Vomiting
In case these common side effects persist or worsen gradually while taking either Xenical or Saxenda , it's important to seek medical help.
Are there any potential serious side effects for Xenical?
While Xenical and Saxenda are both FDA-approved medications for weight loss, they have different potential side effects. Here's what you need to know:
- For Xenical: This medication can sometimes cause serious liver problems, including jaundice (yellowing of the skin or eyes), dark urine, persistent nausea or vomiting, severe stomach or abdominal pain.
- For Saxenda: It may increase your risk of certain mental health disorders such as suicidal thoughts. If you notice sudden mood changes like depression or thoughts about self-harm while using Saxenda, it's important to seek immediate medical attention.
Both drugs can also trigger allergic reactions in some people. Symptoms might include hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Xenical may sometimes lead to kidney problems - symptoms include little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired.
Saxenda has been reported to occasionally cause a rapid heart rate. You should contact your healthcare provider if you experience palpitations or feel like your heart is pounding/racing during treatment with this drug.
It’s crucial that these medications only be used under the supervision of a healthcare professional who can monitor for potential adverse effects and adjust dosages as necessary.
What are the most common side effects for Saxenda?
Saxenda, another popular weight loss medication, may cause the following side effects:
- Nausea, vomiting, stomach pain or upset
- Decreased appetite which can lead to weight loss
- Constipation
- Dizziness and fatigue
- Dry mouth
- Insomnia or sleep disturbances
- Increased heart rate and palpitations
- Anxiety or restlessness -Cold symptoms like stuffy nose and sore throat.
Remember that it's essential to discuss these potential side effects with your doctor when considering Saxenda for weight management. The choice between medications should always be made based on an individual’s specific medical history and needs.
Are there any potential serious side effects for Saxenda?
Saxenda is generally considered safe, but like any drug, it can come with potential side effects. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Serious mood changes and/or thoughts about suicide
- Pancreas inflammation - severe upper stomach pain (usually on the left side) spreading to your back with nausea and vomiting
- Rapid heart rate
- Gallbladder problems: severe abdominal pain that might spread to the shoulder blades along with fever and yellowing skin or eyes
- Kidney problems: little or no urination, painful or difficult urination, rapid weight gain
If you notice these symptoms while taking Saxenda, stop usage immediately and seek medical attention promptly.
Contraindications for Xenical and Saxenda?
Both Xenical and Saxenda, along with most other weight loss medications, may cause gastrointestinal side effects in some people. If you experience severe abdominal pain or discomfort, persistent nausea or vomiting, please seek immediate medical attention.
Neither Xenical nor Saxenda should be used if you are taking, or have been taking cyclosporine (a medication that suppresses the immune system), as this can lead to decreased absorption of the drug and hence reduced effectiveness. Always inform your physician about the medications you are currently using; for those on cyclosporine therapy who wish to start either Xenical or Saxenda will require a period of 2 hours before or 4 hours after administration to prevent unfavorable interactions.
Furthermore, individuals with chronic malabsorption syndrome (an inability to absorb food nutrients) and cholestasis (a condition where bile cannot flow from liver cells to duodenum) should avoid using Xenical. Similarly, those suffering from any type of thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not use Saxenda.
How much do Xenical and Saxenda cost?
For the brand name versions of these drugs:
- The price for a 30-day supply of Xenical (120 mg) averages around $615, which works out to approximately $20.50/day.
- The cost for Saxenda (3mg/mL), on the other hand, can reach up to about $1300 per month, or roughly $43.33/day.
Thus, if you are considering one of these medications for weight management, it's important to note that Xenical is significantly less expensive than Saxenda on a daily basis. However, cost should not be your primary consideration in determining which drug is right for you.
There currently aren't generic options available in the United States for these prescription medications. Therefore unlike with most medicines where generics offer significant savings over their branded counterparts, this isn’t applicable here when comparing Xenical and Saxenda. It's also worth noting that prices may vary based on location and pharmacy/drugstore used.
Popularity of Xenical and Saxenda
Orlistat, commonly known by the brand name Xenical, was prescribed to nearly 2.8 million people in the USA in 2020. Orlistat accounts for a significant share of prescriptions for weight loss medications and is classified as a lipase inhibitor, which means it works by reducing fat absorption from your diet.
Liraglutide, marketed under names such as Saxenda among others, has seen an increase in prescriptions since its approval by the FDA for chronic weight management in December 2014. In 2020 alone, approximately half a million prescriptions were filled out across America. Liraglutide belongs to a class of drugs called GLP-1 receptor agonists and works differently than orlistat; instead of blocking fat absorption, it helps control your appetite so that you eat less.
While both these drugs are designed to assist with weight loss when paired with lifestyle changes like dieting and exercising regularly, they work through different mechanisms and have distinct side effect profiles.
Conclusion
Both Xenical (orlistat) and Saxenda (liraglutide) have been shown to be effective in aiding weight loss, supported by numerous clinical studies. They are sometimes used together under careful supervision of a healthcare provider as they may interact with each other. Their mechanisms of action differ significantly: Xenical acts locally in the stomach and small intestine by preventing the absorption of dietary fats, while Saxenda works centrally on the brain to suppress appetite.
Xenical is often considered a first-line treatment option for obesity due to its safety profile and efficacy, whereas Saxenda is usually prescribed for individuals who did not respond well to initial treatments or need additional help managing their body weight.
While both medications can lead to significant cost outlay - particularly if patients are paying out-of-pocket - generic versions of orlistat do provide some potential savings.
The effectiveness of both Xenical and Saxenda isn't immediate; it takes time for them to work properly within one's system.
In terms of side effects, both drugs generally cause mild gastrointestinal issues but with differing profiles: Xenical can lead to fat-soluble vitamin deficiencies because it blocks fat absorption, while Saxenda might bring about nausea and decreased appetite due its central mechanism. It's crucial that patients monitor their health closely when starting these treatments and seek medical advice immediately should any adverse symptoms arise.
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Refrences
- Ballinger, A. (2000, May). Orlistat in the treatment of obesity. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.1.4.841
- Henness, S., & Perry, C. M. (2006). Orlistat. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200666120-00012
- Hauptman, J. (2000). Orlistat: Selective Inhibition of Caloric Absorption Can Affect Long-Term Body Weight. Endocrine. Springer Science and Business Media LLC.http://doi.org/10.1385/endo:13:2:201
- Gorgojo‐Martínez, J. J., Basagoiti‐Carreño, B., Sanz‐Velasco, A., Serrano‐Moreno, C., & Almodóvar‐Ruiz, F. (2019, August 19). Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real‐world setting: The XENSOR Study. International Journal of Clinical Practice. Hindawi Limited.http://doi.org/10.1111/ijcp.13399