In Australia and New Zealand, orlistat is currently [update] available over-the-counter in 120 mg size (84 capsules to the pack). Initially available only with a prescription, it was reclassified as a " Pharmacist Only Medicine " in October 2003. In 2007 the Committee decided to keep orlistat as a Schedule 3 drug , but withdrew its authorization of direct-to-consumer Xenical advertising, stating this "increased pressure on pharmacists to provide orlistat to consumers...this in turn had the potential to result in inappropriate patterns of use".  Xenical has recently [ when? ] began being advertised direct-to-customers again.
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New back pain in patients with cancer suggests epidural spinal cord compression. Pain that worsens when the patient is lying down or with percussion of vertebral bodies is characteristic of this condition. 32 Late neurologic signs such as incontinence and loss of sensory function are associated with permanent paraplegia. 2 Plain radiographs usually show lesions in patients with solid tumors. 2 , 33 Magnetic resonance imaging (MRI) has surpassed myelography as the imaging study of choice. 2 , 32 If possible, the spinal column should be imaged with non-contrast MRI. 2 , 32 Figure 2 is an MRI scan showing spinal cord compression. 32 If neurologic symptoms are present, the patient should receive a dexamethasone (Cortastat) bolus (10 mg intravenously) followed by 4-mg doses every six hours. This treatment should not be delayed while awaiting diagnostic study results. 34 Use of high-dose dexamethasone (up to 100 mg) is controversial; clinical trials have shown that it has unclear benefits and significantly more serious side effects at higher doses. 33 , 35 , 36 Most patients with epidural spinal cord compression need radiation treatment (up to 3,000 Gy) or surgery. 1 , 2 , 4 Asymptomatic patients should be considered for immediate radiation therapy, and patients with progressive symptoms despite radiation therapy should be considered for surgical intervention. 31 , 33