Are you are one of few last patients who still get Celevac prescribed? Unfortunately, Celevac was discontinued, and now it is impossible to get it on prescription or purchase from the pharmacy. In this post, I will briefly review the use of Celevac,:what it is and talk about alternative options (prescription and over the counter products) which have similar use to Celevac.
What is Celevac?
Celevac is a brand of tablets containing methylcellulose. Each Celevac tablet contained 500mg of methylcellulose. Celevac tablets were licensed as general sale list medicines (GSL), which means they could be sold in any retail outlet, including pharmacies, over the counter without a prescription.
Celevac tablets were discontinued by the manufacturer, which means they cannot be purchased over the counter or supplied on prescription. Generally speaking, Celevac tablets were rarely prescribed on NHS, and in recent months prescribing of Celevac in NHS has diminished due to obvious reasons.
Today, methylcellulose can be purchased in the UK. Read more in the section about alternative products.
What are Celevac tablets used for?
Licensed use of Celevac tablets:
- To control appetite and the treatment of obesity
- To help with diarrhoea
- To control colostomy and ileostomy
What is methylcellulose?
Methylcellulose is a compound produced from cellulose, the main component of the walls found in plant cells. Methylcellulose is composed of insoluble fiber. Fiber is a term used to describe plant components, which are not broken down (digested) in human body.
Methylcellulose has applications in a variety of industries. In pharmacy, methylcellulose is mainly used in the treatment of constipation. In relation to the treatment of constipation, methylcellulose is classified as a bulk-forming laxative.
Can you use methylcellulose for weight loss?
The body does not digest methylcellulose. In the presence of water, methylcellulose swells and soften the faeces. Increased bulk from methylcellulose promotes peristalsis (movement of the muscles in the intestine). The proposed mechanism of weight loss is by reducing energy intake, caused by creating fullness due to the increased mass of fibre which comes from methylcellulose.
Celevac alternative options
Although Celevac tablets are now discontinued, there are few alternative options to consider. The selection of the best alternative products depends on the intended use. Most products that contain similar fibres are used as bulk-forming laxatives rather than as appetite suppressants (see: best over the counter laxatives).
Nevertheless, I broadly divided Celevac’s alternatives into two groups:
- appetite control alternatives
- bulk-forming laxatives
Appetite control alternatives:
1. Boots Appetite Control capsules
Previously known as Boots Appetite Control tablets, Boots Appetite Control capsules are sold to help to lose weight gain by promoting a feeling of fullness. Boots Appetite Control tablets used to be produced by the manufacturer of Celevac tablets.
Today,Boots Appetite Control capsules contain a glucomannan, a dietary fibre, which, similarly to methylcellulose, is found in the cell walls of some plants. Read next section on the effectiveness of glucomannan in weight reduction.
Boots Appetite Control capsules can be used by adults over 18 years of age. Boots Appetite Control capsules can be purchased from Boots website or from instore pharmacies.
2. Glucomannan Complex
Glucomannan is another popular water-soluble dietary fibre. Similarly to methylcellulose and cellulose, glucomannan absorbs water and expands. The ability of glucomannan to absorb (take in) water is one of the best out of all dietary fibres (Keithley et al., 2013). In term of weight loss, glucomannan acts as a bulking agent, which creates a feeling of fullness.
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Is glucomannan effective in weight loss?
All glucomannan products, including the one listed below, have average ratings on Amazon.co.uk. Small studies investigated the use of glucomannan as a weight loss product. For example, one study was investigating glucomannan as a weight loss supplement in 53 overweight individuals, of whom 23 received glucomannan and 24 placebo product. This study confirmed the lack of the effectiveness of glucomannan in weight loss.
Weight loss was measured at week two and week eight of the study. In conclusion, glucomannan supplements were well tolerated; however, they did not cause weight loss (ibid).
Zalewski et al., reviewed the effect of glucomannan on body weight in overweight or obese children and adults by looking at all eligible trials involving taking glucomannan for weight loss. In total, six clinical trials were included in this review. It was concluded that glucomannan may help to reduce body weight in healthy obese or overweight adults (Zalewski et al., 2015).
3. Psyllium Husk Fiber supplements
Many psyllium supplements, like the one listed below, are promoted as products that can help with constipation, digestion and weight loss. These advertised properties are similar to Celeva’s licensed use. Psyllium husk is composed of both soluble and insoluble fiber, which means it can be used to treat constipation and to control appetite.
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Is psyllium effective in weight loss?
Many studies investigated the impact of psyllium supplement on weight loss and other parameters such as BMI and changes in cholesterol. All studies have a low number of participants, which limits the evidence.
For example, in one study (Pal et al., 2011), individuals were randomly divided into the following groups:
- Usual diet and placebo (a dummy) supplement: group 1
- Usual diet and fibre supplement (psyllium): group 2
- A healthy diet and placebo (dummy) supplement: group 3
- A healthy diet and fibre supplement HLT-FIB: group4
This study concluded that adding a fibre supplement (psyllium) to the usual diet (group 2) resulted in improved total cholesterol, body weight, BMI and % of body fat. Groups 2-4 have shown a significant reduction of body weight and BMI, as compared to group 1 (placebo – no treatment). Group 2 (usual diet and fibre supplement) and group 4 (healthy diet & fibre supplement) showed a significant reduction in body fat %.
I previously reviewed a new weight loss ‘pill’ called Plenity. Since then, Plenity became available in the US for the management of weight loss. Plenity is taken before lunch and dinner. It mixes with food and absorbs water, making individuals feel fuller throughout the day. Plenity contains cellulose and citric acid and therefore works on a similar principle to discontinued Celevac. Plenity is not available in the UK.
Is Plenity effective in weight reduction?
In clinical trials, almost 6 out 10 individuals who took Plenity lost at least 5% of the bodyweight with an average weight loss of 10% (myplenity.com/faq).
Read more about Plenity.
Bulk-forming laxatives alternative to Celevac
Bulk-forming laxatives, which belong to the same class of laxatives, mainly contain ispaghula husk and sterculia.
1. Fybogel (contains: ispaghula husk)
Fybogel is one popular bulk-forming laxative which is available over the counter. The main ingredient, ispaghula husk, is composed of fibres, which swells and acts as a stool softener and bulking agent after absorbing the water.
Ispaghula husk works on the same principle as methylcellulose (Celevac) to relieve constipation symptoms.
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2. Psyllium Husks Fiber supplement capsules
It is possible to purchase different supplements which contain psyllium husks, another bulk-forming agent. Supplements like the one listed below are used in the management of constipation and as previously discussed to control appetite.
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Psyllium husks can be purchased in the form of different supplements, however the product listed above has the best reviews on Amazon.co.uk
Many studies demonstrated that increasing fibre in the diet positively affects satiety, reduces hunger, decreases food consumed, and promotes weight loss (Pal et al., 2011). Despite the lack of Celevac availability, many fibre supplements exist which can be used as an alternative. Different laxatives, including bulk-forming laxatives, can be prescribed or purchased over the counter (see: best over the counter laxatives). Currently, there are no products/prescribed medicines which are available in the UK, to control appetite. Only one product is available as weight loss medicine – Orlistat. Orlistat works completely different to fibre supplements. It is possible to buy Orlistast over the counter, without a prescription.
Has Celevac been discontinued?
Celevac was discontinued by the manufacturer and it is no longer available in the UK.
What is Celevac used for?
Celevac was licensed for constipation, to control appetite and treat obesity, to help with diarrhoea, and to control colostomy and ileostomy.
Is methylcellulose a laxative?
Methylcellulose is a laxative. It is classified as a bulk-forming laxative due to its fibre composition.
What can I use instead of methylcellulose?
Several fibre products can be used instead of methylcellulose. Alternative products to methylcellulose can be broadly divided as bulk-forming laxatives and supplements which control appetite.
Keithley JK, Swanson B, Mikolaitis SL, et al. (2013). Safety and efficacy of glucomannan for weight loss in overweight and moderately obese adults. J Obes. 2013;2013:610908. doi:10.1155/2013/610908 Available at: https://dx.doi.org/10.1155%2F2013%2F610908 Accessed on 09/05/2021
Pal S, Khossousi A, Binns C, Dhaliwal S, Ellis V. The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals. Br J Nutr. 2011 Jan;105(1):90-100. doi: 10.1017/S0007114510003132. Epub 2010 Aug 23. PMID: 20727237. Available at: https://doi.org/10.1017/s0007114510003132 Accessed on 11/05/2021
Zalewski BM, Chmielewska A, Szajewska H (2014). The effect of glucomannan on body weight in overweight or obese children and adults: a systematic review of randomized controlled trials. Nutrition. 2015 Mar;31(3):437-42.e2. doi: 10.1016/j.nut.2014.09.004. Epub 2014 Nov 25. PMID: 25701331. Available at: https://doi.org/10.1016/j.nut.2014.09.004 Accessed on 09/05/2021