Cobese
Cobese Uses, Dosage, Side Effects, Food Interaction and all others data.
Cobese is a reversible inhibitor of gastrointestinal lipase. It exerts its therapeutic activity in the lumen of the stomach and small intestine by forming a covalent bond with the active serine residue site of gastric and pancreatic lipase. The inactivated enzymes are thus unavailable to hydrolyze dietary fat in the form of triglycerides into absorbable free fatty acids and monoglycerides. As undigested triglycerides are not absorbed, the resulting caloric deficit may have a positive effect on weight control.
Cobese helps with weight reduction and maintenance by inhibiting the absorption of dietary fats via the inhibition of lipase enzymes.
| Trade Name | Cobese |
| Availability | Rx and/or OTC |
| Generic | Orlistat |
| Orlistat Other Names | Orlipastat, Orlipastatum, Orlistat, Tetrahydrolipstatin |
| Related Drugs | phentermine, semaglutide, Wegovy, Saxenda, liraglutide, Alli |
| Type | Capsule |
| Formula | C29H53NO5 |
| Weight | Average: 495.7348 Monoisotopic: 495.392373811 |
| Protein binding | Orlistat is >99% bound to plasma proteins (mainly lipoproteins and albumin). |
| Groups | Approved, Investigational |
| Therapeutic Class | Appetite suppressant drugs/Anti-obesity drugs |
| Manufacturer | Ranbaxy Laboratories (sun Pharma) |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Cobese is used for obesity management including weight loss and weight maintenance when used in conjunction with a reduced-calorie diet. Cobese is also used for the reduction of the risk of weight regain after prior weight loss. Cobese 120 mg is used for obese patients with an initial body mass index (BMI) ≥30 kg/m2 or ≥27 kg/m2 in the presence of other risk factors (eg, hypertension, diabetes, dyslipidemia) and Cobese 60 mg is used for overweight & obese patients with an initial body mass index (BMI) ≥25 kg/m2.
Cobese is also used to associated treatment for these conditions: Weight Gain, Weight Reduction
How Cobese works
Cobese is a potent and selective inhibitor of various lipase enzymes responsible for the metabolism of fat. It acts in the gastrointestinal (GI) tract via covalent binding to the serine residues located on the active site of both gastric and pancreatic lipase. When orlistat is taken with food containing fat, it partially inhibits the hydrolysis of triglycerides. This decreases absorption of monoaclglycerides and free fatty acids, contributing to weight maintenance and weight loss.
Dosage
Cobese dosage
The recommended dose of Cobese is one 60 mg or 120 mg capsule three times a day with each main meal containing fat (during or up to 1 hour after the meal). The patient should be on a nutritionally balanced, reduced-calorie diet that contains approximately 30% of calories from fat. The daily intake of fat, carbohydrate, and protein should be distributed over three main meals. If a meal is occasionally missed or contains no fat, the dose of Cobese can be omitted.
Because Cobese has been shown to reduce the absorption of some fat-soluble vitamins and beta-carotene, patients should be counseled to take a multivitamin containing fat-soluble vitamin to ensure adequate nutrition. The vitamin supplement should be taken at least 2 hours before or after the administration of Cobese, such as at bedtime.
Side Effects
Commonly-observed adverse events associated with the use of Cobese include oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, fecal incontinence.
Toxicity
The oral LD50 of orlistat is >5000 mg/kg in rats. Single orlistat doses of 800 mg and multiple doses of up to 400 mg three times a day for 15 days have been administered to healthy weight and obese subjects without clinically significant adverse findings. In addition, doses of 240 mg three times a day have been given to obese patients for 6 months without a significant adverse effects. Post-marketing reports of overdoses cases indicate no adverse events or adverse events that are similar to those reported with the recommended dose. If a significant overdose with orlistat occurs, the patient should be observed for at least 24 hours. Based on the results of clinical studies, systemic effects caused by orlistat are likely to be rapidly reversible.
Precaution
Patients should be advised to adhere to dietary guidelines. gastrointestinal events may increase when orlistat is taken with a diet high in fat (>30% of calories from fat). The daily intake of fat should be distributed over three main meals. If a meal is missed, the dose of orlistat may be omitted.
Interaction
May reduce the absorption of iodine salts and/or levothyroxine, fat-soluble vit (A, D, E, K) and beta carotene. May decrease plasma levels of ciclosporin and amiodarone. May decrease the efficacy of antiepileptic drugs (e.g. valproate, lamotrigine), antiretrovirals, antidepressants, antipsychotics (including lithium). Additive effect on glycaemic control with antidiabetics. May cause hormonal contraceptive failure. May enhance the anticoagulant effect of warfarin.
Food Interaction
- Take with food. Take with meals or up to 1 hour after a meal. Doses may be skipped for missed meals or fat-free meals.
Cobese multivitamins interaction
[Minor] Cobese decreases the absorption of fat-soluble vitamins.
Studies have shown a 30% reduction in beta-carotene absorption and a 60% reduction in tocopherol acetate absorption when coadministered with orlistat.
Vitamin supplements should be taken at least two hours before or after orlistat administration.
Cobese Drug Interaction
Moderate: lamotrigine, levothyroxineMinor: cholecalciferolUnknown: amphetamine / dextroamphetamine, zolpidem, aspirin, lorazepam, celecoxib, duloxetine, omega-3 polyunsaturated fatty acids, fluticasone nasal, clonazepam, atorvastatin, pregabalin, acetaminophen, cyanocobalamin, ascorbic acid, alprazolam, sertraline, cetirizine
Cobese Disease Interaction
Major: malabsorptionModerate: diabetics, (fat soluble) vitamin deficiency, nephrolithiasis
Volume of Distribution
Volume of distribution cannot be obtained because the absorption of orlistat is minimal. Cobese is minimally distributed to erythrocytes and is primarily bound to proteins.
Elimination Route
The systemic absorption and exposure of orlistat is low, however, systemic absorption of the drug is not required for orlistat activity. After an oral dose with 360 mg of radiolabeled orlistat, plasma radioactivity achieved a peak at about 8 hours. Plasma concentrations of unchanged parent drug were close to the lower end of detection limits (15
Half Life
The half-life of orlistat of the small amount of absorbed orlistat ranges between 1-2 hours.
Elimination Route
After single oral dose of radiolabled orlistat in both normal weight and obese volunteers fecal excretion of the unabsorbed drug was found to be the major route of elimination with 11,20 Fecal elimination of orlistat is estimated between 95-97%. Complete excretion by both routes occurs within in 3 to 5 days.
Pregnancy & Breastfeeding use
Pregnancy Category X. Cobese is contraindicated during pregnancy, because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm.
It is not known whether Cobese is present in human milk or not. Caution should be exercised when Cobese is administered to a nursing woman.
Contraindication
Cobese is contraindicated in Pregnancy, Patients with chronic malabsorption syndrome, Patients with cholestasis, Patients with known hypersensitivity to Cobese or to any component of this product.
Special Warning
Pediatric use: Safety and effectiveness in pediatric patients below the age of 12 have not been established.
Acute Overdose
Single doses of 800 mg and multiple doses of up to 400 mg three times a day for 15 days have been studied in normal weight and obese subjects without significant adverse findings. If a significant overdose of orlistat occur, it is recommended that the patient be observed for 24 hours. Based on human and animal studies, any systemic effects attributable to the lipase inhibiting properties of orlistat should be rapidly reversible
Storage Condition
Store below 25°C; excursions permitted to 15° to 30°C. Keep the medicine out of reach of children.
Innovators Monograph
You find simplified version here Cobese
Cobese contains Orlistat see full prescribing information from innovator Cobese Monograph, Cobese MSDS, Cobese FDA label
FAQ
What is Cobese used for?
Cobese is used with an individualized low-calorie, low-fat diet and exercise program to help people lose weight. Prescription Cobese is used in overweight people who may also have high blood pressure, diabetes, high cholesterol, or heart disease.
How safe is Cobese?
The Food and Drug Administration published a safety review of orlistat in 2010 because of rare reports of serious liver injury in people using it. The FDA found no evidence to confirm that Cobese was the cause of the reported liver injuries.
How does Cobese work?
Cobese works by blocking the receptors in the brain that dopamine acts on. This prevents the excessive activity of dopamine and helps to control psychotic illness.
What are the common side effects of Cobese?
Common side effects of Cobese are include:
- Abdominal or stomach pain or discomfort
- back pain
- difficulty with moving
- gas with leaky bowel movements
- inability to hold bowel movement
- increases in bowel movements
- loss of bowel control
- oily bowel movements
- oily spotting of underclothes
Is Cobese safe during pregnancy?
Cobese should not be used during pregnancy as it may harm your unborn baby. Weight loss offers no potential benefit to a pregnant woman and may result in fetal harm.
Is Cobese safe during breastfeeding?
It is unlikely that Cobese will be absorbed by the infant in amounts that would adversely affect the breastfed infant.
Can I drink alcohol with Cobese?
Cobese does not interact with alcohol, so it is safe to drink alcohol while taking Cobese.
Can I drive after taking Cobese ?
You may feel less alert, drowsy or sleepy and have blurred vision while taking this medicine. If this happens, do not drive or use any tools or machines.
When should be taken of Cobese?
You should take it with liquids during the meal or up to 1 hour after eating. If you occasionally miss a meal or eat a meal that contains no fat, you should skip the dose of Cobese.
Can I take Cobese on empty stomach?
Cobese only works when there are fats in what you eat, so if you miss a meal or if you eat a meal which is fat-free then do not take a dose of Cobese.
How long does Cobese take to work?
You can expect to see results in 1-3 months; aiming to lose 5% of your starting body weight in 3 months.
What is the half life of Cobese?
The half-life of the absorbed orlistat is in the range of 1 to 2 hours.
How long does Cobese take to work?
You should not take Cobese for more than six months over the counter.
What happen if I forget to take Cobese?
If you forget to take a dose at the right time, take it as soon as you remember, then go on as before. However, do not take a double dose to make up for a forgotten tablet.
What happen If I stop taking Cobese?
Keep taking Cobese until your doctor tells you to stop. Do not stop taking your medicine just because you feel better as your illness may get worse or come back. Unless your doctor tells you otherwise, Cobese should not be stopped suddenly as this may cause withdrawal effects such as muscle stiffness or unusual body movements.
Can I overdose on Cobese ?
Yes, you can overdose on Cobese. Although the symptoms of such an overdose are not known, they are probably the same as the side effects. This includes: nausea, vomiting, diarrhea, gas, abdominal distress, oily feces and incontinence of feces.
Does Cobese effect fertility?
In Cobese group, significant improvement was observed in lipid profile at the end of 3 months. Conception rates were 40% and 16.7% and 3.3% in Cobese, metformin group and control group respectively.
Can Cobese affects my heart ?
Treatment with Cobese in conjunction with diet promotes significantly greater weight loss and cardiovascular risk factor reduction than diet alone amongst obese patients at high risk of future coronary events.
Can Cobese affect my kidneys?
Cobese use has been limited by troublesome but benign gastrointestinal side effects, it has more recently been associated with acute kidney injury (AKI).
Can Cobese affects my liver?
The liver injury that occurs during Cobese therapy ranges in severity from minor serum aminotransferase elevations to acute symptomatic hepatitis to severe acute liver failure that can be fatal or require emergency liver transplantation. There is no known therapy for orlistat induced liver injury.
Is Cobese good for weight loss?
Cobese promotes weight loss by decreasing the amount of dietary fat absorbed in your intestines.
Is Cobese harmful?
More specifically, the use of Cobese has been associated with several mild-to-moderate gastrointestinal adverse effects, such as oily stools, diarrhoea, abdominal pain and faecal spotting.
Can Cobese affect periods?
Women may also notice irregularities in the menstrual cycle while taking Cobese. Side effects are most common in the first few weeks after beginning the drug.
Does Cobese cause depression?
Evidence suggested one in 10 people taking the Cobese, whose Cobese name is Acomplia, may develop mental side-effects including low mood and depression, anxiety, irritability, nervousness and sleep disorders.
Can Cobese cause weight gain?
Cobese can cause weight gain also with other side effects.
