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Orlistat

Diet and exercise are an integral part of a weight loss program. It is recommended to begin a dietary program and exercise before starting therapy with Orlistat.

While taking Orlistat, you must adhere to a fractional, balanced, moderately hypocaloric diet, with a fat content of no more than 30% of the daily calorie intake (for example, with a diet of 2000 kcal/day, fat intake should be no more than 66 g/day). You should adhere to the recommendations received regarding diet and physical activity, both during and after stopping the drug.

The use of the drug Orlistat leads to an increase in fat content in stool already 24-48 hours after the start of administration. After discontinuation of Orlistat, stool fat content usually returns to baseline levels within 48 to 72 hours.

Following a low-fat diet reduces the likelihood of adverse reactions from the gastrointestinal tract.

Taking orlistat may potentially impair the absorption of fat-soluble vitamins (A, D, E, K and beta-carotene). The vast majority of patients receiving orlistat during the four-year clinical studies had vitamin A, D, E, K and beta-carotene concentrations within normal limits. For preventive purposes, it is recommended to take multivitamins at night.

Since weight loss is usually accompanied by an improvement in carbohydrate metabolism, patients with type 2 diabetes mellitus should consult a doctor before starting therapy with Orlistat and, if necessary, adjust the dose of hypoglycemic drugs.

A decrease in body weight during treatment may be accompanied by a decrease in blood pressure and the concentration of TC in the blood plasma. Patients taking antihypertensive or lipid-lowering drugs should consult a doctor and, if necessary, adjust the dose of these drugs.

In clinical studies, no interaction was observed between oral contraceptives and orlistat. However, orlistat may indirectly reduce the bioavailability of oral contraceptives, which may lead to the development of unwanted pregnancy. It is recommended to use additional methods of contraception in case of acute diarrhea.

Patients with kidney disease should consult a doctor, as hyperoxaluria and nephropathy may develop.

Patients taking amiodarone, warfarin or other oral anticoagulants should also consult a physician before starting orlistat therapy as changes in the INR may occur.

Patients should stop taking Orlistat and consult a doctor if symptoms occur: icteric discoloration of the sclera or skin, itching, dark urine and loss of appetite.

Cases of rectal bleeding have been observed with the use of orlistat. If this phenomenon occurs, the patient should consult a doctor.

When orlistat and levothyroxine sodium are used together, hypothyroidism and/or decreased control of hypothyroidism may develop. Patients taking levothyroxine sodium should consult their doctor before starting treatment with orlistat, because It may be necessary to take orlistat and levothyroxine sodium at different times, and the dose of levothyroxine sodium may need to be adjusted.

Patients taking antiepileptic drugs should consult their doctor before starting treatment with orlistat, because they should be monitored for possible changes in the frequency and severity of seizures. In these cases, the possibility of taking orlistat and antiepileptic drugs at different times should be considered.

Patients should consult their physician before using orlistat concomitantly with antiretroviral drugs used to treat HIV infection. Orlistat may reduce the absorption of antiretroviral drugs and negatively affect their effectiveness.

Orlistat-Akrikhin capsules 120 mg 42 pcs. in Moscow

With the simultaneous use of orlistat and cyclosporine, a decrease in the concentration of cyclosporine in the blood plasma is possible, which can lead to a decrease in the immunosuppressive effectiveness of cyclosporine. Therefore, concomitant use of orlistat and cyclosporine is not recommended.

However, if such concomitant use is necessary, more frequent monitoring of cyclosporine plasma concentrations is recommended, both when used simultaneously with orlistat and after discontinuation of orlistat. The concentration of cyclosporine in the blood plasma should be monitored until it stabilizes.

When using orlistat concomitantly with amiodarone, clinical observation and ECG monitoring are recommended, as a decrease in the concentration of amiodarone in the blood plasma is possible.

When taking orlistat and warfarin or other anticoagulants simultaneously, a decrease in prothrombin concentration and an increase in INR may be observed, which leads to changes in hemostatic parameters. It is necessary to monitor INR values during concomitant therapy with warfarin or other oral anticoagulants.

Orlistat may reduce the absorption of fat-soluble vitamins A, D, E, K and beta-carotene.

If multivitamins are indicated, they should be taken no earlier than 2 hours after taking orlistat or before bedtime.

Orlistat may reduce the absorption of antiepileptic drugs, which may lead to seizures.

There have been several case reports of decreased efficacy of HIV antiretroviral drugs, antidepressants, antipsychotics (including lithium) and benzodiazepines that coincided with the initiation of orlistat treatment in patients with previously adequately controlled conditions. In such patients, treatment with orlistat should be initiated after a careful benefit/risk assessment.

Given the lack of pharmacokinetic interaction studies, coadministration of orlistat and acarbose should be avoided.

Orlistat can indirectly reduce the effectiveness of oral contraceptives, which in some cases can lead to unplanned pregnancy. It is recommended to use an additional method of contraception also in case of severe diarrhea.

When taken simultaneously with levothyroxine sodium, due to decreased absorption of inorganic iodine and/or levothyroxine sodium, hypothyroidism and/or decreased control of hypothyroidism may develop.

No drug interactions were detected with amitriptyline, atorvastatin, biguanides, digoxin, fibrates, fluoxetine, losartan, phenytoin, phentermine, pravastatin, nifedipine, sibutramine and ethanol.

Orlistat-Akrikhin caps 120 mg N84 (Akrikhin)

Orlistat is a specific, long-acting inhibitor of gastrointestinal lipases. It acts in the lumen of the stomach and small intestine, forming a covalent bond with the active serine site of gastric and pancreatic lipases. An inactivated enzyme is unable to break down food fats, which come in the form of triglycerides, into absorbable free fatty acids and monoglycerides. Unsplit triglycerides are not absorbed, and therefore the intake of calories into the body decreases, which leads to a decrease in body weight. The therapeutic effect of the drug is carried out without absorption into the systemic circulation. Increases the concentration of fat in feces 24-48 hours after administration. Provides effective control of body weight, reduction of fat storage. Efficacy Obese patients In clinical studies, patients taking orlistat experienced greater weight loss compared to patients on diet therapy. Weight loss began within the first 2 weeks after the start of treatment and lasted from 6 to 12 months, even in patients with a negative response to diet therapy. Over the course of 2 years, there was a statistically significant improvement in the profile of metabolic risk factors associated with obesity. In addition, compared to placebo, there was a significant reduction in body fat. Orlistat is effective in preventing weight gain. Re-gain of body weight, no more than 25% of what was lost, was observed in approximately half of the patients, and in half of these patients, no re-gain of body weight was observed or even a further decrease was observed. Obese patients with type 2 diabetes mellitus In clinical studies lasting 6 months to 1 year, overweight or obese patients with type 2 diabetes mellitus receiving orlistat experienced greater weight loss compared to patients treated with diet therapy alone. Body weight loss occurred mainly due to a decrease in the amount of fat in the body. It should be noted that before the start of the study, despite taking hypoglycemic agents, patients often had insufficient glycemic control. However, with orlistat therapy, a statistically and clinically significant improvement in glycemic control was observed. In addition, during orlistat therapy, a decrease in doses of hypoglycemic agents, insulin concentrations, and a decrease in insulin resistance were observed. Reducing the risk of developing type 2 diabetes in obese patients In a 4-year clinical trial, orlistat was shown to significantly reduce the risk of developing type 2 diabetes (by approximately 37% compared to placebo). The degree of risk reduction was even greater in patients with baseline impaired glucose tolerance (approximately 45%). There was greater weight loss in the orlistat treatment group compared to the placebo group. Maintaining body weight at a new level was observed throughout the entire study period. Moreover, compared with placebo, patients treated with orlistat showed a significant improvement in their metabolic risk factor profile. Pubertal Obesity In a 1-year clinical study in obese adolescents, orlistat was associated with a decrease in body mass index compared with placebo, which even increased body mass index. In addition, patients in the orlistat group showed a decrease in fat mass, as well as waist and hip circumferences compared to the placebo group. Also, patients receiving orlistat therapy experienced a significant reduction in diastolic blood pressure compared to the placebo group.