Word: redux
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Americans looking for another quick weight-loss fix may soon be tempted by orlistat, a new diet drug that's nearing approval by the Food and Drug Administration. Hopes previously pinned on Redux and the drug combination Fen-Phen were dashed by revelations that they can cause heart valve damage. But a study published Wednesday in the Journal of the American Medical Association says that orlistat has no such life-threatening side effects. Where Redux and Fen-Phen worked in the brain to suppress appetite, orlistat, made by Hoffman-La Roche, blocks the absorption of some fat in the intestines...
Just how relieved you feel, however, depends on how carefully you read the reports. Taken together, the studies do, after all, confirm that taking Redux or fenfluramine (whether alone or in combination with phentermine as part of the wildly popular fen/phen regimen) can trigger an abnormal thickening of the heart valves, which may cause a backward flow and pooling of blood. Cardiologists pay special attention to such "leaky valves" because they are particularly vulnerable to infection, may predispose you to congestive heart failure or may signal the need for surgery...
Under the best circumstances--in which patients took Redux at the recommended dose for the shortest period of time, 11 weeks--changes in heart valves appeared to be not too serious. The longer that patients took the diet pills or the higher the dose, however, the greater the problems. (In the case of Redux, that meant taking more than 30 mg a day; for fenfluramine, more than 60 mg a day.) One study found that the risk of developing a heart-valve problem jumped 10- to 20-fold...
...meantime, if you took Redux or fenfluramine, be sure to tell your doctor. If he or she detects a murmur or if you develop significant shortness of breath, you will have to have an ultrasound examination of the heart called an echocardiogram to determine whether you need further medical attention. If there is a valve problem, you may have to take antibiotics before undergoing certain procedures, such as teeth cleaning, that increase the risk that bacteria could enter your bloodstream...
...good thing that has come out of all this is that doctors and patients seem more realistic about another diet pill, Meridia, which was approved after Redux was recalled. Most see it as part of a diet-and-exercise program instead of a one-pill panacea. And physicians are more likely to restrict its use to the truly obese...