Rimonabant : New Novel anti-obesity agent.

(Endocannabinoid System- A Novel target for Cardiometabolic Risk, Review Article, Shashank Joshi, JAPI Vol 55 June 2007 , Page 439)

Q. What is Rimonabant and how does it act ?

Rimonabant is a new anti-obesity agent. It acts on the Endocannabinoid system. It is a CB1 Endocannabinoid system Antagonist. It was invented by Sanofi.

Q. What is the Endocannabinoid system and what is its role in Obesity ?

• Endocannaboid system comes from the research on action of Cannabis on human body.
• Cannabis and its effects are known since ancient times and it is consumed in various forms likeGanja etc.
• The Cannabinoid system increases Sexual drive, increase appetite, and modulates addiction to various substances like tobacco.

Since it has a role in increasing Appetite and inducing the desire to eat, the drug Rimonabant breaks this drive by acting on the CB1 receptor.

Q. Are there any other drugs which act on this system ?

• DRONABINOL is an antiemetic that is a Endocannabinoid receptor agonist.
• NABILONE is a CB1 stimulant used as an appetite stimulant
• CB1 agnosit also used in muscle spasticity in Multiple Sclerosis

Q. What are the Endocannabinoid receptor ?

There are two types of Endocannabinoid receptors.

1. CB1 Receptor on which ligand ANANDAMIDE acts (derived from the Sanskrit word 'Anand' meaning pleasure ) on which RIMONABANT Acts.

2. CB2 receptor which is found in the immune system and ligand 2-AG acts on it.

Q. In which group of patients should Rimonabant be given with caution ?

Obesity is often associated with Depression. It is prefreble to avoid this drug in patients with Depression because data of safety are currently not avaiable and there have been reports of worseing iof depression with this agent.

Q. Is there any other use of Rimonabant ?

Rimonabant has potential to be used in Tobacco deaddiction. STRATUS trial is currently on for finding out the same.

Q. What is the dose of Rimonanbant ?

Rimonabant is given in dose of 20mg Once daily before breakfast. It causes an average wieght loss of 4 Kg in one year of use. Studies for use more than 2 years is not avaiable.