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TOPROL-XL is a once-a-day beta-blocker for high blood
pressure, angina pectoris over the long term, and heart failure. In heart failure,
TOPROL-XL is used to treat stable, symptomatic patients with Class II or III
heart failure, as defined by the New York Heart Association classification,
that is caused by high blood pressure, blocked heart arteries, or other heart
muscle disorders. Important Product Information

• TOPROL-XL (metoprolol succinate) extended-release tablets
  is used to treat high blood pressure, angina pectoris over the long term,
  and heart failure. In heart failure, TOPROL-XL is used to treat stable, symptomatic
  patients with Class II or III heart failure, as defined by the New York Heart
  Association classification, that is caused by high blood pressure, blocked
  heart arteries, or other heart muscle disorders. It was studied in patients
  who were already taking other medications for heart failure.
• TOPROL-XL should not be taken by people with the following
• Extreme slowing of the heart rate (known as severe bradycardia)
• A sudden and severe drop in the blood pressure and blood flow through the
  body because the heart is not pumping normally (also known as cardiogenic
  shock)
• Uncontrolled heart failure (known as decompensated heart failure)
• A slowdown of the heart’s electrical signal (also known as heart block)
  as it travels through the heart causing a slower heart rate. There are different
  types or degrees of slowdown. TOPROL-XL should not be taken by patients who
  have second-degree or third-degree (complete) heart block
• Damage to the heart’s natural pacemaker that causes the heart to beat too
  fast or too slow [unless a pacemaker device is in the body] (also known as
  sick sinus syndrome)
• An allergy to TOPROL-XL or any of its ingredients

In some patients, TOPROL-XL should be used with caution: those
with asthma or asthma-like lung disease or those who are taking certain calcium
channel blockers, have diabetes, overactive thyroid disease, hardening or constriction
of the arteries in the arms or legs, or are planning to have surgery.

Talk to your doctor about your health history, and be sure to tell your doctor
if you are taking TOPROL-XL or any other medications.

Until you know how you will react to TOPROL-XL, avoid activities that require
alertness.

In clinical trials of patients with high blood pressure and angina pectoris,
the most commonly reported side effects with immediate release metoprolol tartrate
are: tiredness (10%), dizziness (10%), depression (5%), diarrhea (5%), itching
or rash (5%), shortness of breath (3%), and slow heart rate (3%). If you experience
any of these or other side effects, contact your doctor.

If you’ve been diagnosed with heart failure, high blood pressure (hypertension),
or angina pectoris (chest pain), your doctor may prescribe once-a-day TOPROL-XL
to help you manage your condition. TOPROL-XL is used to treat
high blood pressure, angina pectoris over the long term, and heart failure.
In heart failure, TOPROL-XL is used to treat stable, symptomatic patients with
Class II or III heart failure, as defined by the New York Heart Association
classification, that is caused by high blood pressure, blocked heart arteries,
or other heart muscle disorders. It was studied in patients who were already
taking other medications for heart failure.

Rimonabant: A Miracle Fat-Fighting Drug
Imagine a drug that melts fat, boosts good cholesterol while reducing artery-choking triglycerides, and helps smokers kick the habit. What sounds almost too good to be true could soon be just a prescription away.

Rimonabant is the first drug designed to affect your endocannabinoid system, which influences energy balance, fat storage, cholesterol, and blood-sugar levels. In 2005, U.S. and European researchers reported 2-year results from rimonabant studies that are nothing short of astonishing.

In the American trial, 3,040 volunteers were put on a reduced-calorie diet. Some were given the drug; others, a placebo. After 2 years, the waistlines of volunteers on rimonabant were more than 3 inches smaller (compared with 1.5 inches in the placebo group); 30 percent lost more than a tenth of their body weight (compared with 16 percent with the others). Most surprising, the drug raised HDL, or good, cholesterol by a whopping 25 percent on average. “And there aren’t many other drugs that can do that,” says Christie Ballantyne, MD, director of the Center for Cardiovascular Disease Prevention at Methodist DeBakey Heart Center in Houston. Rimonabant also lowers tri-glycerides and improves insulin sensitivity. For smokers reluctant to quit for fear of gaining weight, the drug may be particularly attractive. In early studies, it improved the odds of kicking the habit and prevented weight gain.

“We’re hopeful that in combination with diet and exercise, rimonabant will offer an entirely new way to fight the epidemic of obesity and diabetes,” Ballantyne says.

Whole grains: packaging helps you eat better
New dietary guidelines, released last year, made it official: We should all shoot for three or more 1-ounce whole-grain servings a day. Luckily, food manufacturers are making it easier. In September, foods from breakfast cereals and breads to energy bars began to bear the stamp of the nonprofit Whole Grains Council, which guarantees that a serving has at least 16 grams of whole grains. Not all manufacturers choose to use the stamp. But you can be sure that packaged foods marked “excellent” have one full serving; those marked “good” contain half a serving, or at least 8 grams. Results from the Nurses’ Health Study show why grains are so important: The more that women in the study consumed, the lower their risk of heart disease. A 2005 Tufts University study showed that whole-grain foods slowed the accumulation of arterial plaque.

Longevity: Good news for the pleasantly plump
Rarely has a single scientific study sparked such joy—and such outrage. Published in The Journal of the American Medical Association last April, a U.S. Centers for Disease Control and Prevention (CDC) analysis of nationwide data found that people who are overweight actually live longer than normal-weight people. Compared with underweight people, the plump have even more of a longevity advantage.

Previous studies suggested that more than 400,000 people die each year from being obese. The new analysis, led by epidemiologist Katherine Flegal, showed only 112,000 excess deaths and found that being underweight was linked in the study to some 33,000 deaths a year. The people with the lowest death rates were moderately overweight—with a body-mass index between 25 and 29.9.

Rimonabant, a selective CB1 endocannabinoid receptor antagonist, may have potential in the prevention of type 2 diabetes, according to a study presented here at the 41st annual meeting of the European Association for the Study of Diabetes.Julio Rosenstock, MD, from the Dallas Diabetes Center in Texas, presented one-year data from the rimonabant prediabetes subgroup of patients who were enrolled in the RIO-Lipids, RIO-Europe, and RIO-North America phase 3 studies. These studies were multicenter, randomized, double-blind, placebo-controlled trials that asssessed 5 or 20 mg of rimonabant in overweight/obese patients. The primary end point of these pivotal studies was weight loss, and secondary end points included waist circumference, glycemic control, and lipid parameters.

For the prediabetes subgroup analysis of 1,290 subjects, prediabetes was defined as impaired fasting glucose (100-125 mg/dL).

Improvements among prediabetes subjects for multiple cardiometabolic risk factors, including high-density lipoprotein (HDL) cholesterol and triglyceride levels, insulin resistance, waist circumference, and body weight were highly consistent with the published data on rimonabant.

Significant weight loss was seen in subjects with prediabetes taking rimonabant 5 mg (–3.2 kg, P = .002) and 10 mg (–6.9 kg; P < .001) compared with –1.7 kg for placebo. HDL cholesterol and triglyceride levels improved significantly in subjects taking 20 mg of rimonabant.

There was a clear but not statistically significant trend for subjects with prediabetes taking riomonabant 20 mg to revert from impaired fasting glucose to normal glucose tolerance (46.5% for patients in the rimonabant group vs 39.2% for those in the placebo group).

“This is a useful indicator of what could be expected from a larger, long-term prospective study with rimonabant in subjects with prediabetes,” Paul Z. Zimmet, from the International Diabetes Institute in Caulfield, Victoria, Australia, told Medscape.

“Since two key drivers behind the development of type 2 diabetes are abdominal obesity and insulin resistance, and rimonabant improves both of these, this investigational drug could have an important role in therapy for the prevention of both type 2 diabetes and indeed cardiovascular disease,” Dr. Zimmet concluded.

Acomplia without prescription

NEW YORK: Do fat pills work? Are they safe?

Dr. CELESTE ROBB-NICHOLSON : Scientists are studying factors that influence how full we feel and how fast we burn calories. Prescription weight-loss drugs–which include phentermine (sold as Adipex-P and other brand names), sibutramine (Meridia) and orlistat (Xenical)–can temporarily manipulate some of these factors. Another new drug, acomplia without prescription, which blocks an appetite receptor in the brain, is awaiting approval from the Food and Drug Administration. (And Xenical may be available over the counter later this year.) The National Institutes of Health recommends that weight-loss drugs be given only to people with a body-mass index (BMI) over 29–or 27, if the patient has weight-related problems like type 2 diabetes, high blood pressure or arthritis. They should be taken in conjunction with lifestyle changes and they do have side effects, so check with your doctor. Those who lose weight and keep it off generally …

As the number of overweight Americans grows, so does the number of frustrated dieters. For some, turning to drugs or surgery might actually be a better answer than calorie counting and yo-yoing up and down on the scales.Nearly one in three Americans fits the definition of obesity–a body mass index (BMI) of 30 or higher (see page 6 to calculate). About 5% of Americans are “morbidly obese,” with a BMI of 40 or higher, or about 100 pounds overweight.

Even if you’re lucky enough not to fall into either category, it’s likely you know someone who does. And although controversy abounds about the health implications for people who are slightly overweight (see EN, June 2005), there is no equivocation about people who are severely overweight. Obesity clearly increases your risk of health problems, especially high blood pressure, diabetes, heart attack and stroke, and increases the risk of death. acomplia without prescriptionFor people who have struggled to lose weight with diet and exercise, prescription medications are one choice. But for those who are severely overweight and suffering from medical conditions exacerbated by extra pounds, surgery may be an even better option. Note: It’s important to understand that drugs and surgery do not take the place of diet and exercise, which are still essential.acomplia without prescription

How to know who might benefit the most from either option? EN reviews the latest drugs for weight loss, as well as the criteria for weight-loss surgery.

Rx Choices. As a rule, prescription weight-loss medications are for people with a BMI of at least 30, or a BMI of 27 if they also suffer weight-related health conditions, such as high blood pressure, high blood cholesterol or type 2 diabetes.With diet drugs, most weight loss occurs within six months of starting treatment, after which body weight tends to level off or even increase. And as with all medications, weight-loss drugs can have side effects that may ultimately determine which drug is right for you. We’ve categorized them into three groups.

Rimonabant for sale, an investigational drug that is a cannabinoid-1 receptor blocker, promoted modest but sustained decreases in weight and waist circumference when combined with a low-calorie diet, reported Dr. F. Xavier Pi-Sunyer of the Obesity Research Center at St. Luke’s-Roosevelt Hospital, New York, and associates.

The drug also improved cardiometabolic risk factors in the multicenter Rimonabant for sale in Obesity-North America (RIO-NA) trial, the researchers said.

Central cannabinoid-1 receptor activation stimulates appetite. Rimonabant reduces overactivation of these receptors …

We may at last have the long-awaited anti-fat wonder drug. Sanofi-Aventis’s Acomplia (rimonabant) helps people to lose weight, stop smoking and, unexpectedly, increase their good cholesterol levels.

Despite a history of failures in the field, investors expect the drug to shine simply because of the huge market for a safe, effective drug to tackle obesity. The world’s obese population has ballooned to about 400m, and the US …

To people who have struggled for a lifetime to lose weight, the new drug called rimonabant sounds like a dream come true.

It will make a person uninterested in fattening foods, they have heard from news reports and word of mouth. Weight will just melt away, and fat accumulating around the waist and abdomen will be the first to go. And by the way, those who take it will end up with higher levels of HDL, the good cholesterol. If they smoke, they will find it easier to quit. If they are heavy drinkers, they will no longer crave alcohol.

“Holy cow, does it also grow hair?” asked Dr. Catherine D. DeAngelis, editor of The Journal of the American Medical Association.

At obesity treatment centers, nearly every patient asks for rimonabant sale– or Acomplia, as it will be called if its maker, Sanofi- Aventis, gets approval to market it in the United States.

But many medical researchers say not so fast. While Rimonabant for sale may be intriguing, these experts say, the mythology in the making is hardly justified by what is known so far.

There are no published studies from clinical trials to justify any of the claims for what some patients are already calling a miracle drug. The data that the company has presented indicate that rimonabant is about as effective for weight loss in obese people as two other drugs already on the market.

Rimonabant has not been approved for sale in the United States or anywhere else. Sanofi-Aventis has not yet submitted its application for marketing to the Food and Drug Administration. The company says it plans to apply early next year.

MADRID — rimonabant canada, the novel cannabinoid type 1 receptor-blocking drug that has been gaining considerable attention for its ability to induce weight loss, improve glucose metabolism, raise HDL cholesterol and lower triglycerides, also appears to lead to small but meaningful reductions in blood pressure in hypertensive obese patients.

SAN DIEGO — The investigational drug rimonabant canada produces highly significant cardiovascular and metabolic benefit in patients with type 2 diabetes, Andre Scheen, M.D., reported at the annual scientific sessions of the American Diabetes Association.

Millions of Americans take popular drugs to lose weight, but the long-term risks and benefits of these medications aren’t known, two Canadian researchers contend. Drs. Raj Padwal and Sumit Majumdar, of the University of Alberta, said long-term studies are needed to determine whether losing weight on drugs such as sibutramine (Meridia), orlistat (Xenical) and rimonabant canada (Acomplia) actually reduces the risks of heart attack, stroke and diabetes associated with being overweight or obese.

By Rebecca Jenkins LANCET Overweight and obese patients with inadequately controlled type 2 diabetes benefit by adding a weight-loss drug that blocks pleasure centres in the brain, a study suggests. canada Rimonabant (Acomplia), a selective cannabinoid-1 receptor blocker, significantly reduced weight and HbA1c levels in overweight and obese patients with type 2 diabetes, inadequately controlled with metformin or sulphonylureas.

Americans’ poor diets and inactivity are making diabetes the drug industry’s next sales bonanza. Jack S. Friedman developed diabetes when he was only 32 years old. Twenty-two years later the computer engineer weighs 265 pounds and takes insulin and nine other drugs to treat his diabetes, obesity and cholesterol.

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• A few days after the latest clinical results with rimonabant were published in the Feb. 15 issue of the Journal of the American Medical Association, the Food and Drug Administration declined to approve this widely anticipated new drug, according to the February 18 issue of the Wall Street Journal. Rimonabant (Sanofi-Aventis) has been causing excitement among physicians and patients alike during the past several years. Over that time, randomized clinical trials have shown that the drug can help with both sustainable weight loss and with smoking cessation.

• According to company spokesmen, the FDA last week issued an “approvable” lettter for the weight loss indication, but a “non-approvable” letter for smoking cessation.

• Early trials with rimonabant were very promising, and while many have cautioned that it’s way too early to get very excited about this drug, such cautions have been largely ignored. People have been chomping at the bit to get at rimonabant.

• Rimonabant is the first of a class of drugs, called CB1 blockers, that act on the endocannabinoid system (the EC system), a natural system that modulates the body’s energy balance and nicotine dependence. An over-stimulated EC system is thought to play a role both in obesity and in tobacco dependence, and CB1 blockers are supposed to reduce this overstimulation.

• The latest published clinical trial with rimonabant Fda, the RIO-North America study, showed that in 3040 patients treated for two years, 20 mg of rimonabant produced a significant reduction in weight, waist circumference, triglycerides, and in the percentage of patients with metabolic syndrome, as well as a significant increase in HDL levels, compared to placebo. Disturbingly, however, 50% of patients in both the rimonabant and placebo groups (and patients did not know which group they were in) dropped out before the study was finished. Furthermore, to maintain the favorable results, chronic therapy with rimonabant online- which will be a very expensive drug - appears necessary. In addition, while the weight loss and reduction in waist circumference were statistically significant as compared to placebo, they were not of impressive magnitude. The average weight loss over 2 years was about 15 pounds, and the average reduction in waist size was 2 - 4 inches. And finally, about 6% of patients on rimonabant reported anxiety, and 5% reported feeling depressed.

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Acomplia (rimonabant) has been licensed in the UK only for obesity treatment and not for smoking cessation. Although during clinical studies the drug clearly demonstrated a reduced craving for nicotine in patients the drug has only at the moment been approved treatment of obesity. As this is a prescription medication we strongly advise consulting your doctor or a certified physician. Our service is not/should not be considered as an alternative to the treatment advice your doctor can provide.

Acomplia purchase, the obesity panacea pill for weight control has been released for sale on prescription in the UK on 21st June 2006. Available in 20mg tablets, it has to be taken daily on prescription of a certified doctor from 121doc.com.

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Acomplia works directly on the urge or craving to eat more. This is accomplished by working on the endocannabinoid system, a system affecting energy balance, glucose and lipid metabolism and body weight. Blocking certain receptors in the brain will result in the patient experiencing the feeling of being full thus wanting to eat less than normal. Along with using in conjunction with a calorie reduced diet and exercise it significantly helps obese patients achieve a weight loss.

How much weight can be lost on Acomplia

More than 6800 patients have undergone placebo-controlled studies using Acomplia with substantial results. In the subsequent phase 3 trials a dietician prescribed a diet for patients and they were asked to increase physical activity/exercise.

On the completion of a year and taking an Acomplia 20mg pill daily a mean weight loss of 6.5 kg was observed as compared as 1.6kg with a placebo. The first 9 months were the most crucial in which significant weight loss was achieved.

It was also observed that the risk of regaining weight was quite lower using Acomplia.

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Rimonabant accepted for filing by the FDA

Sanofi-aventis announced today that the United States Food and Drug Administration (FDA) has accepted for filing the company’s New Drug Application (NDA) for rimonabant, the first agent in a new therapeutic class known as selective cannabinoid type 1 (CB1) blockers.

Rimonabant, discovered and developed by sanofi-aventis, is thought to represent a new approach for the comprehensive management of cardiovascular risk factors. The compound has been studied to date in over 6,500 overweight and obese adults for up to 2 years.

Despite therapeutic advances in recent decades, cardiovascular disease remains the leading cause of mortality worldwide. Current treatments generally target risk factors individually, rather than providing a comprehensive management approach to such cardiovascular risks as dyslipidemia, abdominal obesity and insulin resistance, which comprise the metabolic syndrome.

As the first selective CB1 blocker, the effects of rimonabant on lipid and glucose metabolism, insulin resistance and reduced intra-abdominal adiposity, evidenced by a reduction in waist circumference, have been studied. Abdominal obesity is recognized as a significant risk factor in the development of cardiovascular disease.

Rimonabant also has been studied by 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.

A Marketing Authorization Application to the European Medicines Agency (EMEA) for rimonabant has also been submitted.

About sanofi-aventis
Sanofi-aventis is the world’s third-largest pharmaceutical company, ranking number one in Europe. Backed by a world-class R&D organization, sanofi-aventis is developing leading positions in seven major therapeutic areas: cardiovascular, thrombosis, oncology, metabolic diseases, central nervous system, internal medicine, and vaccines. The sanofi-aventis Group is listed in Paris (EURONEXT: SAN) and in New York