Q. I read about a new drug called ribotanan, I think, but I may have spelled it wrong. The drug affects the body’s cannabinoid receptors. It is supposed to curb appetite, lower cholesterol and block glucose.
Are you familiar with this drug? My doctor and I steer clear of typical diet drugs although I am overweight, (6’3″ and 285 lbs) because they raise blood pressure and I am pre-hypertensive.
A. Rimonabant (Acomplia) is a novel weight loss drug awaiting approval from the FDA. The manufacturer, Sanofi-Aventis, hopes that it will get the green light to market this prescription medicine sometime in 2006.
Acomplia works by blocking receptors in the brain that are important for appetite. These cannabinoid-1 receptors are the same ones that respond to marijuana by causing the munchies. Inhibiting them appears to deter appetite.
In a year-long study, people taking Acomplia lost 14 pounds more than those on placebo. The drug also appears to raise good HDL cholesterol, lower triglycerides and improve blood sugar and blood pressure control. Side effects may include depression, anxiety, and nausea.
Q. In a recent column you mentioned an interaction between cranberries and Coumadin, based on a British report.
At the time I had been drinking a lot of cranberry juice. I take Coumadin and the doctors did not understand why my blood was so thin. I was having frequent nosebleeds.
I stopped the cranberry juice, and my nosebleeds went away. My latest blood test was in the proper range (INR=2.2). Thanks.
A. Although the FDA has not issued a formal warning about this interaction, we think that people on Coumadin (warfarin) should be wary if they drink cranberry juice or eat a lot of cranberries. Your story reinforces our concern.
Q. My cholesterol has ranged between 240 and 260 for years. My doctor prescribed Lipitor so I could get it below 200. It brought the cholesterol down but I had joint and muscle pains that were so bad I could hardly walk. Pravachol and Zocor were almost as bad.
My doctor is skeptical about these side effects because my blood tests are normal. Now he wants me to try lovastatin. He says it’s “weaker and shouldn’t give me any trouble.
I refuse to take medicine that prevents me from exercising. Isn’t there any other type of cholesterol-lowering drug that doesn’t affect muscles or joints?
A. The drugs your doctor has been prescribing are all “statins. Muscle pain and weakness are not uncommon with such medicine, even when blood tests are normal.
There are many other ways to get cholesterol down, including prescription drugs like WelChol or Tricor. Generic compounds like cholestyramine, gemfibrozil and niacin offer cost-effective cholesterol control. The nutrient Coenzyme Q10 sometimes helps reduce muscle pain from statin drugs.
We are sending you our Guides to Heart Health and Cholesterol-Lowering Drugs for more information on these other options. Anyone who would like copies, please send $3 in check or money order with a long (no. 10) stamped (63 cents), self-addressed envelope: Graedons’ The People’s Pharmacy®, No. CL-75, P. O. Box 52027, Durham, NC 27717-2027.
Q. What can you tell me about salsalate? My doctor says it’s safer than aspirin.
A. Salsalate is a kissing cousin to aspirin. It is disalicylic instead of acetylsalicylic acid. Since it is absorbed from the small intestine, salsalate may be a little less likely to irritate the stomach.
