It is known that in recent decades, an increasing part of the world's population has been suffering from obesity. It's no secret that it's not even about aesthetic flaws, but rather about the potential to get very serious diseases, such as arterial hypertension, coronary heart disease, myocardial infarction, diabetes the second type, infertility and so on.

Everyone who has ever decided to go to the fight against the notorious kilograms knows how difficult it is: exhausting diets, the hardest physical exercise, refusal of favorite food, limiting oneself in almost everything. People are ready to lose weight by any means, just to quickly get rid of fat, which is why many people who want to lose weight are looking for new ways to lose weight. It's about taking medication. Various drugs are used in the treatment of obesity. But reduxin is best known for its combined action.

About the drug

Reduksin (REDUKSIN) - a domestic drug for weight loss, the main active ingredient of which is sibutramine, strongly active substance complex effect on the body.

Its first and main effect is to provide an anorexigenic effect, which is based on blocking the reuptake of neurotransmitters in the synapses of the brain, resulting in a feeling of fullness much earlier than usual.

The second effect is related to the stimulation of metabolism. In this case, the body begins to experience a greater need for energy, the consumption of which begins to increase. All this leads to the fact that the assimilation of food and the use of nutrients contained in food is much more active.

Reviews of doctors

After examining and monitoring patients who took Reduxin, the doctors' reviews can be reduced to the following data:

• 98.5% of patients showed a marked decrease in appetite;
• the portions eaten and the patient's usual daily calorie intake are significantly reduced. On average, 2 - 2.5 times;
• in the process of taking the drug in losing weight, the correct eating behavior is formed;
• this drug for weight loss gives the most stable results, which patients manage to keep for a long time;
• In general, sibutramine is well tolerated by patients and is not addictive.

Thanks to all this, rapid decline weight. The patient is visibly motivated.

Vladimir Larionov, nutritionist

I know from practice that Reduxin is a great help in the treatment of obesity, when folk remedies for weight loss is already unable to bring a good effect. At the same time, after reading only the most general reviews, some women, and often men, begin to drink it on their own. After that, they get serious side effects. I can recommend this drug for the fight against obesity. But only on condition that a doctor is constantly involved in this process.
To achieve a lasting effect, taking the drug should last at least three months, and it is advisable to combine its use with moderate physical activity and a balanced diet. diet food.

Positive effects of taking Reduxin

In general, reduxin has established itself as one of the the best drugs for the treatment of obesity and weight loss, and there is a feeling that mankind has invented universal pills for obesity, taking which, you can permanently get rid of terrible problems.

Reviews of doctors allow us to mark it as the best drug, the intake of which does not depend on food intake. This is very convenient when you can take just 1 tablet a day without adjusting to the need to eat something.

What side effects can reduxin cause?

But like any pharmaceutical drug, reduxin has a number of side effects:

• headache;
• appetite changes;
• constipation;
• heartburn;
• dry mouth;
• weakness;
• backache;
• nervousness;
• difficulty falling asleep or not sleeping soundly;
• runny nose;
• flu symptoms.

Some side effects may be serious. The following symptoms are atypical, but if any of them are present, you should immediately consult a doctor: palpitations, chest pain, difficulty breathing, nausea, intense pain in the stomach, vomiting, euphoria, anxiety, anxiety, depression, dizziness, loss of consciousness , confusion, uncoordinated or abnormal movements, muscle stiffness, uncontrollable hand tremors, seizures, tremors, excessive sweating, fever, sore throat, dilated pupils, vision changes, eye pain, rash, skin redness, itching, difficulty speaking, breathing or swallowing, hoarseness, swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles.

In addition, reduxin is not compatible with most drugs, it gives an increased load on the liver, and can even cause poisoning with conventional flu powders containing paracetamol. Remember that self-administration of strong drugs for weight loss can be hazardous to your health. Therefore, a competent doctor should prescribe reduxin, after carrying out special diagnostic measures.

Catad_pgroup Weight loss products

Reduksin - instructions for use

Registration number:

Tradename: Reduxin™

International non-proprietary name: Sibutramine

chemical name: N- –3-methylbutyl]-N,N-dimethyl-aminohydrochloride monohydrate

Compound:

Active substance: Sibutramine hydrochloride monohydrate 10 mg and 15 mg;
Excipients: microcrystalline cellulose, calcium stearate.
Capsule composition:

• for a dosage of 10 mg: titanium dioxide dye, erythrosin dye, proprietary blue dye, gelatin;
• for a dosage of 15 mg: titanium dioxide dye, patent blue dye, gelatin.

Description

No. 2 capsules are blue for the 10 mg dosage or blue for the 15 mg dosage. The contents of the capsules are white or white with a slightly yellowish tint powder.

Pharmacotherapeutic group: Obesity Treatment

ATX code: A08AA10

pharmachologic effect:

Sibutramine is a prodrug and exerts its effect in vivo through metabolites (primary and secondary amines) that inhibit the reuptake of monoamines (mainly serotonin and norepinephrine). An increase in the content of neurotransmitters in synapses increases the activity of central 5HT-serotonin and adrenergic receptors, which contributes to an increase in satiety and a decrease in the need for food, as well as an increase in thermal production. Indirectly activating beta 3-adrenergic receptors, sibutramine acts on brown adipose tissue.
Weight loss is accompanied by an increase in the concentration of HDL in the blood serum and a decrease in the amount of triglycerides, total cholesterol, LDL and uric acid. Sibutramine and its metabolites do not affect the release of monoamines, do not inhibit MAO; do not have affinity for a large number of neurotransmitter receptors, including serotonin (5-HT 1, 5-HT 1A, 5-HT 1B, 5-HT 2A, 5-HT 2C), adrenergic (beta 1, beta 2, beta 3, alpha 1, alpha 2), dopamine (D l , D 2), muscarinic, histamine (H 1), benzodiazepine and NMDA receptors.

Pharmacokinetics.
After oral administration, it is rapidly absorbed from the gastrointestinal tract by at least 77%. During the “first pass” through the liver, it undergoes biotransformation under the influence of the cytochrome P450 3A4 isoenzyme with the formation of two active metabolites (mono- and didesmethylsibutramine). After taking a single dose of 15 mg, the maximum blood concentration (Cmax) of monodesmethylsibutramine is 4 ng / ml (3.2-4.8 ng / ml), didesmethylsibutramine - 6.4 ng / ml (5.6-7.2 ng / ml). ml). Cmax is achieved after 1.2 hours (sibutramine), 3-4 hours (active metabolites). Simultaneous food intake lowers the Cmax of metabolites by 30% and increases the time to reach it by 3 hours without changing the AUC. It is quickly distributed on fabrics. Protein binding is 97% (sibutramine) and 94% (mono- and didesmethylsibutramine). The equilibrium concentration of active metabolites in the blood is reached within 4 days after the start of treatment and is approximately 2 times higher than the plasma level after taking a single dose. The half-life of sibutramine is 1.1 hours, monodesmethylsibutramine is 14 hours, didesmethylsibutramine is 16 hours. Active metabolites undergo hydroxylation and conjugation to form inactive metabolites, which are excreted mainly by the kidneys.

Indications for use.

Reduxin is indicated for weight loss in the following conditions:

• alimentary obesity with a body mass index (BMI) of 30 kg/m 2 or more;
• alimentary obesity with a BMI of 27 kg / m 2 or more, if there are other risk factors due to overweight, such as type 2 diabetes mellitus or dyslipoproteinemia (impaired lipid metabolism).

Contraindications:

• established hypersensitivity to sibutramine or to other components of the drug;
• the presence of organic causes of obesity (for example, hypothyroidism);
• serious eating disorders - anorexia nervosa or bulimia nervosa;
• mental illness;
• Gilles de la Tourette syndrome (generalized tics);
• concomitant use of MAO inhibitors (for example, phentermine, fenfluramine, dexfenfluramine, ethylamphetamine, ephedrine) or their use within 2 weeks before the appointment of the drug Reduxin; the use of other drugs acting on the central nervous system (for example, antidepressants, antipsychotics); drugs prescribed for sleep disorders containing tryptophan, as well as other centrally acting drugs for weight loss;
• ischemic heart disease, decompensated chronic heart failure, birth defects hearts, occlusive diseases of peripheral arteries, tachycardia, arrhythmia, cerebrovascular diseases (stroke, transient disorders of cerebral circulation);
• uncontrolled arterial hypertension (blood pressure (BP) above 145/90 mmHg) (See also the section “Special Instructions”);
• thyrotoxicosis;
• severe violations of the liver and / or kidneys;
• benign prostatic hyperplasia;
• pheochromocytoma;
• angle-closure glaucoma;
• established pharmacological, drug or alcohol dependence;
• pregnancy and lactation period;
• age up to 18 years and over 65 years.

Carefully the drug should be prescribed under the following conditions:
arrhythmia in history, chronic circulatory failure, coronary artery disease (including history), cholelithiasis, arterial hypertension (controlled and history), neurological disorders, including mental retardation and convulsions (including history) , impaired liver and / or kidney function of mild to moderate severity, motor and verbal tics in history.

Use during pregnancy and lactation

Since there is still not a sufficiently convincing number of studies regarding the safety of sibutramine exposure to the fetus, this drug should not be used during pregnancy.
Women of childbearing age should use contraceptives while taking Reduxin.
Reduxin should not be taken while breastfeeding.

Dosage and administration

Reduxin is administered orally 1 time per day. The dose is set individually, depending on tolerability and clinical efficacy. An initial dose of 10 mg is recommended, with poor tolerance, 5 mg may be taken. Capsules should be taken in the morning without chewing and with a sufficient amount of liquid (a glass of water). The drug can be taken on an empty stomach or combined with food intake. If a weight loss of 5% or more is not achieved within 4 weeks from the start of treatment, then the dose is increased to 15 mg / day.
Treatment with Reduxin should not be continued for more than 3 months in patients who do not respond well enough to therapy, i.e. who, within 3 months of treatment, fail to achieve a 5% level of weight loss from the initial level. Treatment should not be continued if, during further therapy, after the achieved weight loss, the patient again gains 3 kg or more in body weight. The duration of treatment should not exceed 2 years, since there are no data on efficacy and safety for a longer period of taking sibutramine.
Treatment with Reduxin should be carried out in combination with diet and exercise under the supervision of a physician with practical experience in the treatment of obesity.

Side effect

Most often, side effects occur at the beginning of treatment (in the first 4 weeks). Their severity and frequency weaken over time. Side effects are generally mild and reversible. Side effects, depending on the effect on organs and organ systems, are presented in the following order (often> 10%, sometimes 1-10%, rarely Sweating is sometimes noted on the part of the skin.
In isolated cases, the following clinically significant adverse events have been described during treatment with sibutramine: dysmenorrhea, edema, flu-like syndrome, skin itching, back pain, abdominal pain, paradoxical increase in appetite, thirst, rhinitis, depression, drowsiness, emotional lability, anxiety, irritability, nervousness, acute interstitial nephritis, bleeding, Shenlein-Genoch purpura (bleeding into the skin), convulsions, thrombocytopenia, transient increase in the activity of "liver" enzymes in the blood.
One patient with schizoaffective disorder, which was presumed to have existed prior to treatment, developed acute psychosis after treatment.
Withdrawal reactions such as headache or increased appetite are rare. There is no evidence that after treatment there is an abstinence syndrome, withdrawal syndrome or mood disorders.
Changes in the cardiovascular system
There is a moderate rise in blood pressure at rest by 1-3 mm Hg. and a moderate increase in heart rate of 3-7 beats per minute.
In some cases, more pronounced increases in blood pressure and heart rate are not excluded. Clinically significant changes in the level of blood pressure and pulse are recorded mainly at the beginning of treatment (in the first 4-8 weeks).
The use of Reduxin in patients with elevated blood pressure: see the section "Contraindications" and "Special Instructions".

Overdose

There are extremely limited data on overdose of sibutramine. Specific signs of overdose are unknown, however, the possibility of a more pronounced manifestation of side effects should be considered. You should notify your doctor in case of suspected overdose.
Medical measures for overdose: there is no special treatment and specific antidotes. It is necessary to perform general measures: ensure free breathing, monitor the state of the cardiovascular system, and, if necessary, carry out supportive symptomatic therapy. Timely use of activated charcoal can reduce the intake of sibutramine in the body. Gastric lavage may also useful action. Patients with high blood pressure and tachycardia can be prescribed beta-blockers. The effectiveness of forced diuresis or hemodialysis has not been established.

Overdose

Symptoms: increased severity of side effects.
Treatment: taking activated charcoal, gastric lavage, symptomatic therapy, with an increase in blood pressure and tachycardia - the appointment of beta-blockers.

Interaction with other drugs

Inhibitors of microsomal oxidation, incl. P450 3A4 inhibitors (ketoconazole, erythromycin, cyclosporine, etc.) increase plasma concentrations of sibutramine metabolites with an increase in heart rate and a clinically insignificant increase in the QT interval. Rifampicin, macrolide antibiotics, phenytoin, carbamazepine, phenobarbital and dexamethasone can accelerate the metabolism of sibutramine. The simultaneous use of several drugs that increase the content of serotonin in the blood can lead to the development of a serious interaction. The so-called serotonin syndrome can develop in rare cases with the simultaneous use of Reduxin with selective serotonin reuptake inhibitors (drugs for the treatment of depression), with certain drugs for the treatment of migraine (sumatriptan, dihydroergotamine), with potent analgesics (pentazocine, pethidine, fentanyl), or antitussive drugs (dextromethorphan).
Sibutramine does not affect the effect of oral contraceptives.
With the simultaneous administration of sibutramine and alcohol, there was no increase in the negative effects of alcohol. However, alcohol is absolutely incompatible with the dietary measures recommended when taking sibutramine.

special instructions

Reduxin should be used only in cases where all non-drug measures to reduce body weight are ineffective - if the weight loss for 3 months was less than 5 kg.
Reduxin treatment should be carried out as part of a complex therapy for weight loss under the supervision of a physician with practical experience in the treatment of obesity. Comprehensive therapy includes both diet and lifestyle changes and increased physical activity. An important component of therapy is the creation of prerequisites for a stable change in dietary habits and lifestyle, which are necessary to maintain the achieved weight loss even after discontinuation of drug therapy. As part of Reduxin therapy, patients need to change their lifestyle and habits in such a way that, after completion of treatment, the achieved reduction in body weight is maintained. Patients should clearly understand that failure to comply with these requirements will lead to a repeated increase in body weight and repeated visits to the attending physician.
In patients taking Reduxin, it is necessary to measure the level of blood pressure and heart rate. In the first 2 months of treatment, these parameters should be monitored every 2 weeks, and then monthly. In patients with arterial hypertension, whose blood pressure level is higher than 145/90 mm Hg during antihypertensive therapy, this control should be carried out especially carefully and, if necessary, at shorter intervals. In patients whose blood pressure twice exceeded the level of 145/90 mmHg during repeated measurement, treatment with Reduxin should be suspended (See the section “Side effects. Changes in the cardiovascular system”).
Particular attention should be paid to the simultaneous administration of drugs that increase the QT interval. These drugs include H1-histamine blockers (astemizole, terfenadine); antiarrhythmic drugs that increase the QT interval (amiodorone, quinidine, flecainide, mexiletine, propafenone, sotalol); motility stimulator gastrointestinal tract cisapride; pimozide, sertindole and tricyclic antidepressants. This also applies to conditions that can lead to an increase in the QT interval, such as hypokalemia and hypomagnesemia. (See also the section “Interaction with other drugs”).
The interval between taking MAO inhibitors (including furazolidone, procarbazine, selegiline) and Reduxin should be at least 2 weeks.
Although the relationship between the use of Reduxin and the development of primary pulmonary hypertension has not been established, however, given the well-known risk of drugs in this group, with regular medical monitoring, special attention should be paid to symptoms such as progressive dyspnea (breathing disorder), chest pain and swelling in the legs .
If you miss a dose of the drug Reduxin, you should not take a double dose of the drug in the next dose, it is recommended to continue further taking the drug according to the prescribed scheme.
Duration of reception Reduksin should not exceed 2 years.

Reduxin (Sibutramine + Microcrystalline Cellulose) is a drug for getting rid of excess body fat, realizing its therapeutic potential due to the combined action of its components. Sibutramine becomes a true drug only after metabolic transformations in the biological environment of the body. Active metabolites of the drug - primary and secondary amines - inhibit the reuptake of neurotransmitters serotonin and norepinephrine. An increase in the concentration of the latter in the synapses of nerve endings activates serotonin 5-hydroxytryptamine receptors and adrenoreceptors, which, in turn, contributes to the development of a feeling of satiety, a decrease in the psychological need for food, and an increase in heat production. By stimulating beta-3-adrenergic receptors, sibutramine acts on adipose tissue (the so-called "brown fat"). A decrease in the proportion of adipose tissue in the body composition is accompanied by an increase in the level of high density lipoproteins (the so-called “good cholesterol”) in the blood, while a decrease in the concentration of triglycerides, low density lipoproteins (“bad cholesterol”), total cholesterol and uric acid.

Being a pronounced enterosorbent, microcrystalline cellulose has a good absorption capacity and detoxification properties. Absorbs and provides elimination from the body of various pathogens, exogenous and endogenous toxins, allergens, as well as potentially toxic metabolites.

After oral administration, Reduxin is rapidly and in a significant (about 80%) volume absorbed in the digestive tract.

It undergoes the effect of the first passage through the liver (it is at this stage that the active metabolites of the drug are formed). The half-life of sibutramine is about 1 hour, its active metabolites are 14-16 hours. The drug is excreted mainly by the kidneys. Multiplicity of reception of Reduksin - 1 time per day. The dose in each case is determined by the doctor, observing the individual reaction of the patient's body in the initial phase of the therapeutic course. As such a trial dose, 10 mg is used, with observed adverse reactions to the drug, the dose is halved, and if individual intolerance is confirmed, it is canceled. Optimal time reception - in the morning, after waking up, but if necessary, Reduxin can be taken with food at a later time. If in the first month of drug therapy body weight decreased by less than 5%, then the dose is increased by 1.5 times (up to 15 mg). The duration of the therapeutic course in the absence of positive results should not exceed 90 days. If, according to its results, a decrease in body weight by more than 5% was not achieved, the treatment is considered unsuccessful. The same conclusion follows in the event that the patient, after the initial weight loss, begins to gain weight again (3 or more kg). The total duration of taking Reduxin should not exceed two years, since this drug is relatively young, and so far there has not been enough information about its efficacy and safety. Taking Reduxin, you must adhere to a balanced diet and devote enough time to physical exercise.

Pharmacology

Combined drug for the treatment of obesity, the action of which is due to its constituent components. Sibutramine is a prodrug and exerts its effect in vivo through metabolites (primary and secondary amines) that inhibit the reuptake of monoamines (mainly serotonin and norepinephrine). An increase in the content of neurotransmitters in the synapses increases the activity of central serotonin 5-HT receptors and adrenoreceptors, which contributes to an increase in satiety and a decrease in the need for food, as well as an increase in thermal production. Indirectly activating β 3 -adrenergic receptors, sibutramine acts on brown adipose tissue. Weight loss is accompanied by an increase in the concentration of HDL in the blood serum and a decrease in the amount of triglycerides, total cholesterol, LDL, and uric acid.

Sibutramine and its metabolites do not affect the release of monoamines, do not inhibit MAO; do not have affinity for a large number of neurotransmitter receptors, including serotonin (5-HT 1 , 5-HT 1A , 5-HT 1B , 5-HT 2A , 5-HT 2C), adrenoreceptors (β 1 , β 2 , β 3 , α 1, α 2), dopamine (D 1 , D 2), muscarinic, histamine (H 1), benzodiazepine and NMDA receptors.

Microcrystalline cellulose is an enterosorbent, has sorption properties and a nonspecific detoxification effect. It binds and removes from the body various microorganisms, their metabolic products, toxins of exogenous and endogenous nature, allergens, xenobiotics, as well as an excess of some metabolic products and metabolites responsible for the development of endogenous toxicosis.

Pharmacokinetics

Absorption, distribution, metabolism

After taking the drug inside, sibutramine is rapidly absorbed from the gastrointestinal tract, not less than 77%. It undergoes a "first pass" effect through the liver and is biotransformed with the participation of cytochrome P450 isoenzyme 3A4 to form two active metabolites (mono- and didesmethylsibutramine). After taking a single dose of 15 mg C max monodesmethylsibutramine is 4 ng / ml (3.2-4.8 ng / ml), didesmethylsibutramine - 6.4 ng / ml (5.6-7.2 ng / ml). C max sibutramine is reached after 1.2 hours, active metabolites - after 3-4 hours. Taking it simultaneously with food reduces C max of metabolites by 30% and increases the time it is reached by 3 hours without changing AUC. Rapidly distributed into tissues. The binding of sibutramine to plasma proteins is 97%, and mono- and didesmethylsibutramine is 94%. C ss of active metabolites in the blood is achieved within 4 days after the start of treatment and is approximately 2 times higher than the plasma level after taking a single dose.

breeding

T 1/2 sibutramine - 1.1 h, monodesmethylsibutramine - 14 h, didesmethylsibutramine - 16 h. Active metabolites undergo hydroxylation and conjugation to form inactive metabolites, which are excreted mainly by the kidneys.

Release form

Capsules No. 2 blue; the contents of the capsules are white or white with a slightly yellowish tint powder.

Excipients: calcium stearate.

The composition of the capsule shell: titanium dioxide dye, azorubine dye, patent blue dye, gelatin.

10 pieces. - blister packs (aluminum/PVC) (3) - cardboard packs.
10 pieces. - cellular contour packings (aluminum/PVC) (6) - packs of cardboard.

Dosage

Reduksin ® is prescribed orally 1 time / day. The dose is set individually, depending on tolerability and clinical efficacy. The recommended initial dose is 10 mg, with poor tolerance, a dose of 5 mg can be taken. Capsules should be taken in the morning without chewing and drinking plenty of liquid. The drug can be taken on an empty stomach or combined with food intake.

If a weight loss of 5% or more is not achieved within 4 weeks from the start of treatment, then the dose is increased to 15 mg / day. The duration of therapy with Reduxin should not exceed 3 months in patients who do not respond well enough to therapy (i.e., who fail to reduce weight by 5% of the initial body weight within 3 months of treatment). Treatment should not be continued if, with further therapy (after achieved weight loss), the patient again gains 3 kg or more in body weight.

The total duration of therapy should not exceed 2 years, since there are no data on efficacy and safety for a longer period of taking sibutramine.

Therapy with Reduxin should be carried out by a doctor with practical experience in the treatment of obesity. The drug should be combined with diet and exercise.

Overdose

There are extremely limited data on overdose of sibutramine. In case of overdose, the patient should consult a doctor.

Symptoms: may increase the severity of side effects. Specific signs of overdose are unknown.

Treatment: taking activated charcoal, gastric lavage, symptomatic therapy, with an increase in blood pressure and tachycardia - the appointment of beta-blockers. There is no specific treatment or specific antidotes. It is necessary to perform general measures: ensure free breathing, monitor the state of the cardiovascular system, and, if necessary, carry out supportive symptomatic therapy. The effectiveness of forced diuresis or hemodialysis has not been established.

Interaction

Inhibitors of microsomal oxidation, incl. inhibitors of cytochrome P450 isoenzyme 3A4 (including ketoconazole, erythromycin, cyclosporine) increase plasma concentrations of sibutramine metabolites with an increase in heart rate and a clinically insignificant increase in the QT interval. Rifampicin, macrolide antibiotics, phenytoin, carbamazepine, phenobarbital and dexamethasone can accelerate the metabolism of sibutramine. The simultaneous use of several drugs that increase the content of serotonin in the blood can lead to the development of a serious interaction. The so-called serotonin syndrome can develop in rare cases with the simultaneous use of Reduxin with selective serotonin reuptake inhibitors (drugs for the treatment of depression), with some drugs for the treatment of migraine (sumatriptan, dihydroergotamine), with potent analgesics (pentazocine, pethidine, fentanyl) or antitussives. drugs (dextromethorphan). Sibutramine does not affect the effect of oral contraceptives.

With the simultaneous administration of sibutramine and ethanol, there was no increase in the negative effect of ethanol. However, the use of alcohol is absolutely not combined with the dietary measures recommended when taking sibutramine.

Side effects

Side effects, depending on the impact on organs and organ systems, are presented in the following order (often -> 10%, sometimes - 1-10%, rarely -< 1%).

From the CNS and peripheral nervous system: often - dry mouth, insomnia; sometimes - headache, dizziness, anxiety, paresthesia, and changes in taste; in isolated cases - back pain, depression, drowsiness, emotional lability, anxiety, irritability, nervousness, convulsions.

One patient with schizoaffective disorder thought to have existed prior to treatment developed acute psychosis after treatment.

Since the cardiovascular system: sometimes - tachycardia, palpitations, increased blood pressure, vasodilation. There is a moderate rise in blood pressure at rest by 1-3 mm Hg. and a moderate increase in heart rate of 3-7 beats per minute. In some cases, more pronounced increases in blood pressure and heart rate are not excluded. Clinically significant changes in the level of blood pressure and pulse are recorded mainly at the beginning of treatment (in the first 4-8 weeks).

From the digestive system: often - loss of appetite, constipation; sometimes - nausea, exacerbation of hemorrhoids. With a tendency to constipation in the early days, it is necessary to control the evacuation function of the intestine. If constipation occurs, stop taking and take a laxative. In isolated cases, abdominal pain, a paradoxical increase in appetite, a transient increase in liver enzymes.

Dermatological reactions: sometimes - sweating; in isolated cases - skin itching, Shenlein-Genoch purpura (hemorrhages in the skin).

On the part of the body as a whole: in isolated cases, the following clinically significant adverse events are described: dysmenorrhea, edema, flu-like syndrome, thirst, rhinitis, acute interstitial nephritis, bleeding, thrombocytopenia.

Withdrawal reactions such as headache or increased appetite are rare. There is no evidence that after treatment there is an abstinence syndrome, withdrawal syndrome or mood disorders.

Most often, side effects occur at the beginning of treatment (in the first 4 weeks). Their severity and frequency weaken over time. Side effects are generally mild and reversible.

Indications

For weight loss in the following conditions:

• alimentary obesity with a body mass index (BMI) of 30 kg/m 2 or more;
• alimentary obesity with a BMI of 27 kg / m 2 or more in combination with other risk factors due to overweight (type 2 diabetes mellitus / non-insulin-dependent / or dyslipoproteinemia).

Contraindications

• the presence of organic causes of obesity (for example, hypothyroidism);
• severe eating disorders (anorexia nervosa or bulimia nervosa);
• mental illness;
• Gilles de la Tourette syndrome (generalized tics);
• simultaneous reception of MAO inhibitors (for example, phentermine, fenfluramine, dexfenfluramine, ethylamphetamine, ephedrine) or their use within 2 weeks before the appointment of the drug Reduxin ® ; the use of other drugs acting on the central nervous system (for example, antidepressants, antipsychotics); drugs prescribed for sleep disorders containing tryptophan, as well as other centrally acting drugs for weight loss;
• IHD, decompensated chronic heart failure, congenital heart defects, occlusive diseases of peripheral arteries, tachycardia, arrhythmias, cerebrovascular diseases (stroke, transient cerebrovascular accidents);
• uncontrolled arterial hypertension (BP above 145/90 mm Hg);
• thyrotoxicosis;
• severe liver dysfunction;
• severe renal dysfunction;
• benign prostatic hyperplasia;
• pheochromocytoma;
• angle-closure glaucoma;
• established drug, drug or alcohol addiction;
• pregnancy;
• lactation (breastfeeding);
• children and adolescents up to 18 years of age;
• old age over 65;
• established hypersensitivity to sibutramine or to other components of the drug.

The drug should be prescribed with caution in the following conditions: arrhythmias in history, chronic circulatory failure, coronary artery disease (including history), cholelithiasis, arterial hypertension (controlled and in history), neurological disorders, including mental retardation and convulsions (including in history), impaired liver and / or kidney function of mild to moderate severity, motor and verbal tics in history.

Application features

Use during pregnancy and lactation

The drug should not be used during pregnancy due to the lack of a sufficiently convincing number of studies on the safety of the effects of sibutramine on the fetus.

Women of childbearing age should use contraceptives while taking Reduxin.

Reduksin ® should not be used during the period breastfeeding.

Application for violations of liver function

It is contraindicated in severe hepatic impairment. With caution, the drug should be prescribed for impaired liver function of mild to moderate severity.

Application for violations of kidney function

Contraindicated in severe renal impairment. With caution, the drug should be prescribed for impaired renal function of mild to moderate severity.

Use in children

Contraindicated in children and adolescence up to 18 years old.

special instructions

Reduksin ® should be used only in cases where all non-drug measures to reduce body weight are ineffective - if the weight loss within 3 months was less than 5 kg.

Treatment with Reduxin should be carried out as part of complex therapy for weight loss under the supervision of a physician with practical experience in the treatment of obesity.

Comprehensive therapy for obesity includes both diet and lifestyle changes and increased physical activity. An important component of therapy is the creation of prerequisites for a stable change in dietary habits and lifestyle, which are necessary to maintain the achieved weight loss even after discontinuation of drug therapy. Patients need to change their lifestyle and habits as part of Reduxin ® therapy in such a way that, after completion of treatment, the achieved weight loss is maintained. Patients should clearly understand that failure to comply with these requirements will lead to a repeated increase in body weight and repeated visits to the attending physician.

In patients taking Reduxin ® , it is necessary to measure blood pressure and heart rate. In the first 2 months of treatment, these parameters should be monitored every 2 weeks, and then monthly. In patients with arterial hypertension (who have blood pressure levels above 145/90 mm Hg during antihypertensive therapy), this control should be carried out especially carefully and, if necessary, at shorter intervals. In patients in whom blood pressure twice exceeded the level of 145/90 mm Hg during repeated measurement. treatment with Reduxin ® should be suspended.

Particular attention should be paid to the simultaneous administration of drugs that increase the QT interval. These drugs include blockers of histamine H 1 receptors (astemizole, terfenadine); antiarrhythmic drugs that increase the QT interval (amiodarone, quinidine, flecainide, mexiletine, propafenone, sotalol); Gastrointestinal motility stimulants (cisapride, pimozide, sertindole and tricyclic antidepressants). Caution should be observed when using the drug against the background of conditions that are risk factors for an increase in the QT interval (hypokalemia, hypomagnesemia).

The interval between taking MAO inhibitors and Reduxin should be at least 2 weeks.

The relationship between taking Reduxin and the development of primary pulmonary hypertension has not been established, however, given the well-known risk of drugs in this group, with regular medical monitoring, special attention should be paid to symptoms such as progressive dyspnea (breathing disorder), chest pain and swelling in the legs.

Influence on the ability to drive vehicles and control mechanisms

Taking the drug Reduxin ® may limit the patient's ability to drive vehicles and control mechanisms.

Every girl, without exception, dreams of having a slender or toned body and makes attempts to combat excess weight. Often, weight loss is required medical indications, and then, in addition to diets, special medications may also be required, one of which is Reduxin. Contraindications and harms of this medicine are actively discussed by doctors and patients, and it, like any other medicine, should not be taken without consulting a specialist.

Description

The drug "Reduxin" is a drug for the treatment of obesity, the main active ingredient of which is sibutrabine hydrochloride.

While taking the drug, metabolism increases and energy consumption increases. The medicine suppresses the feeling of hunger and appetite, thanks to which, any, even the most strict diets are tolerated with ease.

"Reduxin" is a popular and common weight loss drug in the domestic market and is available in the form of capsules, which contain a white-yellow powder inside.

Worth knowing! The drug is produced with various dosages active substance, most often 10 and 15 mg.

In addition to suppressing the feeling of hunger and a significant decrease in appetite, the drug also affects adipose tissue, contributing to a more fast weight loss. The drug affects the central nervous system and the brain, so taking it, especially when the recommended dosages are exceeded, can cause various side effects.

Important! In some cases, for weight loss and the treatment of obesity, "Reduxin" is categorically contraindicated, in addition, it is not compatible with many drugs, especially antipsychotics and sedatives.

Before taking the drug, you should undergo a complete medical examination and consult with a nutritionist and your doctor.

Release form

The drug "Reduxin" is available in various forms that differ in composition and action. In pharmacies you can find the following options for the drug:

Composition and action

The main active ingredients of the drug "Reduxin" are:

1. Sibutamine hydrochloride at a dosage of 10 or 15 mg;
2. Microcrystalline cellulose - 158.5 mg.

In addition to the active ingredients, the capsules also contain:

• gelatin;
• calcium stearate;
• titanium dioxide;
• azarubine;
• patented blue dye.

The work of the central nervous system is based on the creation and transmission of electrical impulses between neurons through special processes of various lengths and branching - dendrites and axons. This transmission is provided by special substances, neurotransmitters, which affect the speed of signal transmission. These substances accumulate in nerve cells and are released only when a signal passes through a specific area of ​​the nervous system, preserving the path along which the signal traveled so that the response from the cerebral cortex is received in the same place from which the request came.

Worth knowing! The signal pathway of the nervous system created by neurotransmitters is called a synapse.

Neurotransmitters include many hormones, including norepinephrine and serotonin, which can not only create a synapse from a nerve cell, but also undergo reuptake, that is, return back to the cell from which they were previously released.

Sibutramine is a reuptake inhibitor and prevents the absorption of neurotransmitters into the processes of nerve cells, thereby dramatically increasing the amount of norepinephrine and serotonin in the intercellular space and blood flow.

Thus, sibutramine provides:

• dulling hunger;
• acceleration of saturation;
• stimulation of metabolism (acceleration of metabolism);
• activity of the cardiovascular system;
• increase in thermal production;
• decrease in the level of triglycerides, total cholesterol and uric acid in the blood serum;
• destruction of brown adipose tissue.

Microcrystalline cellulose is an active enterosorbent with a detoxifying effect. This element of the drug "Reduxin" is able to bind and remove toxic substances, pathogenic microorganisms and their metabolic products from the body:

• xenobiotics;
• allergens;
• toxins of endogenous and exogenous nature;
• excess metabolic products;
• metabolites.

Indications

Given that "Reduxin" is a potent prescription drug, it should be taken if there are special indications.

The drug is prescribed to reduce body weight in such conditions as:

1. Alimentary obesity with a body mass index of 30 kg/m² or more.
2. Alimentary obesity with a body mass index of 27 kg / m² and above in the presence of risk factors caused by excessive body weight (lipid metabolism disorders, type 2 diabetes mellitus, etc.).

Worth knowing! The body mass index is a special indicator developed by the Belgian sociologist and statistician Adolphe Quetelet in 1869 and used in official dietetics and medicine. To calculate BMI, the formula is used: weight / double height in meters.

Often the drug is used by patients with a BMI lower than indicated by the manufacturer in order to obtain the desired weight and figure, but in any case, its administration should be agreed with a specialist.

Important! Doctors prescribe "Reduxin" only when other weight loss methods have not provided desired result, and overweight threatens the health of the patient.

Contraindications

Given the active effect of the drug "Reduxin" on the central nervous system, there are a number of contraindications in which the use of the drug is strictly prohibited:

1. Increased individual sensitivity to any of the ingredients of the drug.
2. The presence of organic causes of overweight (eg, hormonal disorders, hypothyroidism, etc.);
3. Eating disorders - anorexia or bulimia that arose against the background of nervous disorders.
4. Mental illnesses and disorders.
5. Generalized tics (Gilles de la Tourette's syndrome).
6. Taking certain medications.
7. Diseases of the cardiovascular system, including chronic heart failure, congenital heart defects, ischemic disease, arrhythmia and tachycardia. Peripheral arterial disease, cerebrovascular disease.
8. Arterial hypertension (pressure over 145/90 mm Hg).
9. thyrotoxicosis.
10. Pheochromocytoma.
11. Severe liver or kidney dysfunction.
12. Angle-closure glaucoma;
13. Benign prostatic hyperplasia.
14. Any addiction (medication, alcohol, drugs).
15. Children and the elderly (the drug is prohibited for use by persons under 18 and over 65 years of age).

In some situations, the drug "Reduxin" is used with extreme caution:

• the presence of arrhythmia in history;
• diseases of the coronary arteries, including those transferred earlier;
• neurological disorders and disorders (mental retardation, convulsions, etc., including those suffered earlier);
• mild and moderate disorders of the liver and kidneys;
• verbal and motor tics in history;
• cholelithiasis;
• controlled arterial hypertension.

Important! Taking the drug "Reduxin" is categorically contraindicated during pregnancy and breastfeeding, as there are no studies on the safety of its effects on the body of the mother and fetus during this period. Contraception should be used while taking the drug.

Side effects

According to the results of studies, including post-marketing, taking Reduxin may be accompanied by some side effects. Undesirable manifestations associated with taking slimming capsules are most pronounced at the initial stage of therapy and become weaker over time. In most cases, these effects are reversible and not particularly severe.

Side effects of the drug may be manifested by the following symptoms:

1. From the side of the central nervous system:
   • dry mouth;
   • insomnia;
   • headache;
   • dizziness;
   • anxiety;
   • change in taste sensations;
   • paresthesia;
   • convulsions;
   • short-term memory impairment.
2. From the side of the cardiovascular system:
   • tachycardia;
   • feeling of heartbeat;
   • increased blood pressure;
   • flickering arrhythmia.
3. From the gastrointestinal tract and digestive system:
   • loss of appetite;
   • constipation;
   • nausea;
   • exacerbation of hemorrhoids;
   • diarrhea;
   • vomit;
   • urinary retention.
4. From the side of the skin:
   • increased sweating;
   • dysmenorrhea;
   • puffiness;
   • purpura (bleeding into the skin);
   • alopecia (hair loss).
5. From the immune system:
   • allergic reactions;
   • hives;
   • rashes;
   • anaphylactic shock.
6. From the side of the psyche:
   • suicidal thoughts;
   • psychosis;
   • manic tendencies.
7. From the visual organs:
   • blurred vision;
8. From the reproductive system:
   • ejaculation disorder;
   • lack of orgasm;
   • impotence;
   • violations of the female cycle;
   • uterine bleeding.

In addition to the side effects described during Reduxin therapy, the following are also possible:

• flu-like syndrome;
• pain in the back and abdomen;
• paradoxical increase in appetite;
• increased thirst;
• rhinitis;
• drowsiness;
• depression;
• nervousness and irritability;
• increased liver enzymes in the blood;
• bleeding;
• acute nephritis.

Benefit and harm

The drug "Reduxin" has a number of useful properties:

Worth knowing! Receiving capsules "Reduxin" provides a slow and gradual weight loss up to 1 kg per week, and therefore does not create stress for the body caused by sudden jumps in body weight.

Taking the drug is accompanied by a change in eating habits, patients begin to eat less and the need for food gradually decreases, therefore, even after the end of Reduxin therapy, the results of losing weight persist for a long time.

Among the advantages of the drug, one can also note the convenience of its use (one capsule per day) and the absence of addiction.

Despite the large number of advantages, the drug "Reduxin" is made on the basis of a potent chemical and can cause some harm to the body, especially with uncontrolled intake, excess dosage and treatment without consulting a doctor and prior medical examination.

According to the observations of doctors and patients, Reduxin therapy is accompanied by:

1. Negative changes in the composition of the blood.
2. An increased risk of strokes and heart attacks, especially in patients with a tendency to cardiovascular disease.
3. Lots of side effects.
4. Deterioration of general condition and well-being.
5. Irritability and nervous disorders.

Worth knowing! During studies conducted over two years on animals, it was found that in male rats on which the drug was used, the incidence of benign tumors increased significantly, and the offspring of rabbits were born with noticeable anomalies.

Sibutramine, on the basis of which the drug "Reduxin" was created, is a potent psychotropic substance that has a tonic effect on the central nervous system, similar to narcotic substance. As a result, the use of the drug does not stimulate weight loss, but creates psychological condition, in which energy appears and appetite decreases.

Important! In 2010, Reduxin was withdrawn from the American pharmaceutical market due to minimal effectiveness and a high risk of consequences that are dangerous to health in general and the cardiovascular system in particular.

Instructions for use

Capsules "Reduxin" are intended for oral administration. They should be swallowed whole, without chewing or opening, with a large amount of water.

Take 1 capsule per day, at the dosage prescribed by your doctor, starting with a minimum dose of 10 mg.

Worth knowing! If, after a month of taking the drug, the results of therapy are unsatisfactory and body weight has decreased by less than 5%, the dosage is increased to 15 mg.

The total duration of treatment with significant obesity should not exceed two years, since there are no data on the safety of taking the drug for a longer time.

If within three months the total body weight could not be reduced by 5% of the initial weight. treatment with "Reduxin" is canceled and another is selected medicine.

Important! Therapy of obesity and weight loss with the use of the drug "Reduxin" should be carried out as directed and under the supervision of an experienced physician. Treatment is combined with dietary nutrition and physical activity.

The instructions for the drug indicate that it can be taken on an empty stomach, or immediately before a meal. According to reviews, the greatest effectiveness of "Reduxin" is observed when taking the capsule in the middle of the day, since only in this case the feeling of hunger is suppressed until the evening.

special instructions

The drug "Reduxin" is used as part of the complex therapy of obesity, along with a special diet and recommended by a specialist physical exercises.

There are special instructions that should be considered while taking the drug:

1. During treatment, blood pressure and heart rate should be measured. In the first months of treatment every two weeks. Further monthly. If the pressure level exceeds 145/90, the drug should be discontinued.
2. Reception of the drug "Reduxin" is forbidden to be combined with therapy with MAO inhibitors (ephedrine, ethylamphetamine, fenfluramine, etc.), as well as other drugs that affect the central nervous system, including antipsychotics and antidepressants, drugs for sleep disorders and any other drugs for weight loss with a central effect. You can start therapy with "Reduxin" no earlier than two weeks after taking such drugs.
3. With the simultaneous use of antiarrhythmic drugs, stimulants of gastrointestinal motility, hypokalemia and hypomagnesemia, Reduxin is used with extreme caution.
4. During therapy, attention should be paid to the occurrence of such undesirable symptoms as dyspnea (breathing disorders), chest pain, swelling of the legs, however, the relationship between the occurrence of such manifestations and the use of Reduxin has not been proven.
5. If you miss the next dose of the drug, you should not take a double dosage in the next dose. Treatment continues according to the scheme prescribed by the doctor.
6. Drive transport and mechanisms, as well as engage in other activities related to the need to concentrate during therapy with Reduxin, should be done with extreme caution.

If you are interested in how to take Reduxin 15 mg to lose weight, then you should know and remember that experts recommend drinking pills only for people who are obese - then the effect of the drug will not adversely affect health, and the created feeling of satiety will allow the body to lose weight. Familiarize yourself with the composition of the drug, find out what contraindications this fat-burning medicine has.

What is Reduxin 15 mg

Reduxin 15 mg is a combined drug that not only promotes weight loss, but also simultaneously increases the amount of HDL in the blood, due to which the level of uric acid and cholesterol in the body decreases and the number of triglycerides is significantly reduced. The main components of Reduxin are sibutramine and microcrystalline cellulose.

According to the manufacturer of this medicine (and this is also confirmed by the reviews of those who lose weight and lose weight), this medication helps well for weight correction: it helps to reduce a person's need for food, while it quickly increases the feeling of satiety and thermal production. When buying Reduxin capsules for weight loss, it is important not to forget that treatment with their help should occur only with the participation of a dietitian.

Composition of Reduksin

According to the reviews of losing weight, when taking the drug, they feel high activity, slight euphoria and at the same time do not feel hunger at all. All this is explained by the fact that Reduxin contains the following components:

1. Sibutramine- the main active ingredient. Sibutramine is ideal for weight loss, because its action is aimed at reducing appetite, reducing hunger, in general, so that a person prone to overeating consumes fewer calories. In addition to affecting the satiety center in the brain, the substance differs in its effect on adrenoreceptors, due to which the breakdown of fat cells occurs. Further fatty acid are converted into energy, and the resulting water and glycerin are excreted from the body.
2. Microcrystalline cellulose- a substance that, when it enters the stomach, swells strongly, due to which a person eats up a smaller portion. Swelling, cellulose absorbs a huge amount of water and additionally "grabs" harmful substances, however, this causes not only a lack of appetite, but also a strong thirst.

Indications for the use of Reduxin

The domestic drug is becoming increasingly popular among nutritionists who help their patients in the fight against excess weight. According to the manufacturer, indications for the use of Reduxin are as follows:

• with alimentary obesity, if the body mass index exceeds 30 kilograms per 1 sq. m.;
• with alimentary obesity, in the case when the body mass index is 27 kg / sq. m., but dyslipidemia or diabetes mellitus is still observed.

Application instruction of Reduksin of 15 mg

Regarding the dosage of the drug, the patient must follow the recommendations of his doctor, who, before prescribing a dosage, must necessarily conduct appropriate studies and send him for testing. Another important factor for determining the norm is the degree of obesity of a person who needs to take Reduxin. The instructions for the use of Reduxin 15 mg say that the capsule should be drunk once a day in the morning, and it does not matter whether it is with meals or on an empty stomach - the effectiveness of the drug will not decrease. You can drink a Reduxin tablet with water.

Patients who started taking Reduxin tablets to lose weight are first given a small dose, then, depending on the effectiveness and individual tolerance, it can be changed. For example, it is recommended to switch to a dosage of Reduxin 15 mg after passing the first stage of treatment - a month of taking 10 mg tablets, if the course did not give the desired result in losing weight.

How to take Reduxin 15 mg to lose weight

15 mg is a safe dosage for weight loss. However, for the active burning of fat cells, it is recommended to make a change in lifestyle and diet: include sports every day, give up fried and fatty foods, sweets. Your diet should include more low-fat vegetables fermented milk products, fruits, fish, berries. It is advisable to start taking the medicine with 10 mg tablets. If in a month you did not manage to lose more than 2 kg, then the dosage increases to 15 mg. Check out the simple rules on how to properly take Reduxin 15 mg to lose weight:

• drink the capsule in the morning on an empty stomach with 200 ml of plain water;
• the minimum course of treatment is 3 months, but if during the time of taking the pills the weight began to increase, then the treatment should be interrupted immediately.

Course duration

The drug should be taken, taking into account the initial weight and general health. Often, the duration of the course of taking Reduxin at a dosage of 15 mg does not exceed 3 months. As women (and men) who are losing weight from a lot of weight say, the course can last longer - up to 6 months, but you need to take the medication under the supervision of a doctor. It is worth noting that you need to drink pills to lose weight only when nothing else helps. This also applies to analogues of Reduksin.

Reduxin's contraindications

The manufacturer warns that the use of this medicine is prohibited if you are hypersensitive to the active ingredient sibutramine or other components, during pregnancy, during the period of feeding a baby, if you are under 18 or over 65 years old. In addition, Reduxin's contraindications include:

• thyrotoxicosis;
• bulimia, anorexia;
• hypothyroidism (obesity of organic type);
• pheochromocytoma;
• mental illness;
• severe disorders of the kidneys, liver;
• angle-closure glaucoma;
• vascular disease, heart disease.

Reduxin is highly discouraged from being combined with any drugs that belong to MAO inhibitors, with hypnotic drugs containing tryptophan, with neuroleptics and other drugs that affect human central nervous system receptors. The number of drugs incompatible with Reduxin also includes those that are used to treat obesity and those with which the patient struggles with mental pathologies.

Side effects of Reduxin

After reviewing the instructions on how to take Reduxin 15 mg to lose weight, it is also important to know how taking pills threatens the body, because such a high dosage can be dangerous for the body and disrupt metabolic processes. After self-administration of the drug, in addition to such unpleasant symptoms as dry mouth and a strong feeling of thirst, other side effects of Reduxin can be observed:

• unmotivated outbursts of aggression;
• psychosis or a state with suicidal thoughts (in such a situation, the doctor should immediately prohibit the use of the medicine);
• insomnia;
• impotence, problems with orgasm, ejaculation;
• complete loss of appetite;
• uterine bleeding, violation of the cycle of menstruation;
• lack of coordination;
• diarrhea and vomiting;
• from the nervous system: short-term memory impairment, convulsions.

As for the sensations of a patient who has exceeded the recommended dose of Reduxin 15 mg, he may experience severe headaches, increased blood pressure, malaise, dizziness or tachycardia. In case of an overdose, a person can experience any of the above side effects, and to a pronounced degree. If any of the symptoms appear, stop taking the medicine and rush to the doctor.

Reduksin's analogs

For weight loss, not only Reduxin can be used, but also similar means - dietary supplements, the main thing is to choose an additive that is suitable in content. The price of Reduxin analogues can be both more expensive and cheaper than the original - the manufacturer already decides here, for example, dietary supplements from the manufacturer Globul have a low cost. Another difference in price depends on the number of pills in the package. The analogues of Reduxin include funds with the following names:

• Goldline;
• Reductil;
• Meridia;
• Slimia;
• Lindax.

As for Reduxin Light, this is a medication that is the exact opposite of its predecessor. It is recommended to take it with an active lifestyle or physical training. The drug contains linoleic acid, vitamin E and other elements. Active substances normalize metabolism, promote the breakdown of fats. The price for Reduxin Light is less than for regular Reduxin, because each of them has a different effect on the body.

The price of Reduxin 15 mg

The sale of the drug should be carried out only in pharmacies. Even if the price of Reduxin 15 mg in some dubious online store of Chinese goods is too cheap, you should refuse this purchase, because for such a promotion you can “undermine” your health. How much does Reduxin cost in a pharmacy? Its cost is quite affordable: a plate for 30 capsules costs about 2,700 rubles on average. It is worth noting that the drug is dispensed only by prescription, so if you decide that only pills will help you lose weight, be sure to visit a doctor.

You can also order Reduxin online: in Moscow and St. Petersburg, delivery is carried out quickly and at a minimal cost. Here are the approximate prices of the original medicine and Reduxin Light in different cities.