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Orlistat
Orlistat is the generic version of the brand-name drug Xenical and Alli (over-the-counter). It is a weight loss medication designed to help individuals with obesity lose weight or prevent weight gain by blocking the absorption of fat from food. Orlistat belongs to the lipase inhibitors drug class, which works by preventing fat digestion and absorption in the body. It is used alongside a reduced-calorie diet and physical activity to help patients manage obesity and reduce the risks associated with excess weight, such as high blood pressure and diabetes.
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Frequently Asked Questions
Can Orlistat be used long-term?
Yes, Orlistat can be used long-term as part of a weight management program. However, it’s important to be monitored by a healthcare provider for any potential side effects or nutrient deficiencies.
What should I avoid while taking Orlistat?
Avoid eating high-fat meals, as this increases the risk of unpleasant gastrointestinal side effects like oily stools and diarrhea. Stick to a low-fat, reduced-calorie diet for the best results.
How quickly does Orlistat work?
You may start seeing weight loss results within two weeks of taking Orlistat, especially if combined with a healthy diet and exercise program.
Can I take Orlistat if I have diabetes?
Yes, Orlistat may help with weight management in people with type 2 diabetes and can potentially improve blood sugar control. However, you should consult your doctor to adjust any diabetes medications if needed.
Can I take Orlistat if I'm pregnant?
Orlistat is not recommended for use during pregnancy. Weight loss is not advised during pregnancy, and Orlistat may reduce nutrient absorption, which can affect fetal development.
Comprehensive Drug Guide
How Does Orlistat Work?
Orlistat works by inhibiting the enzyme lipase, which is responsible for breaking down dietary fats into smaller molecules that can be absorbed by the body. By blocking lipase activity, Orlistat prevents about 25% of the fat consumed in food from being absorbed. Instead, the undigested fat is excreted through bowel movements. This reduction in fat absorption helps reduce calorie intake and promote weight loss over time.
Common Dosages
- Prescription strength (Xenical): 120 mg capsule, taken three times daily with meals containing fat
- Over-the-counter (Alli): 60 mg capsule, taken three times daily with meals containing fat
Typical Dosing
- The typical dose for Xenical (prescription Orlistat) is 120 mg, taken three times a day with each main meal containing fat.
- For Alli (over-the-counter Orlistat), the recommended dose is 60 mg, taken three times a day with each fat-containing meal.
- It’s important to follow a reduced-calorie, low-fat diet to minimize gastrointestinal side effects.
Typical Dosing
FDA Approved Indications
- Obesity management in adults and adolescents 12 years and older
- Weight loss and prevention of weight regain when used in conjunction with a reduced-calorie diet and increased physical activity
- Reducing the risk of developing type 2 diabetes in overweight individuals
Who Shouldn't Take Orlistat?
- Chronic malabsorption syndrome, where the body has difficulty absorbing nutrients
- Cholestasis, a condition where bile flow from the liver is blocked
- Hypersensitivity to Orlistat or any of its components
Advice From The Pharmacist
- Take Orlistat with meals that contain fat. It is ineffective if your meal does not contain fat.
- To reduce side effects like diarrhea and oily stools, stick to a low-fat diet.
- Orlistat can decrease the absorption of fat-soluble vitamins (A, D, E, K). Consider taking a multivitamin at least 2 hours before or after Orlistat.
- If you miss a meal or the meal does not contain fat, skip that dose of Orlistat.
- Inform your doctor if you have a history of kidney stones, as Orlistat can increase the risk of oxalate kidney stones.
Side Effects of Orlistat
Common Side Effects
- Oily stools or leakage
- Frequent bowel movements
- Abdominal discomfort or cramping
- Gas with an oily discharge
Uncommon/Severe Side Effects
- Severe liver injury, with symptoms like yellowing of the skin or eyes (jaundice)
- Kidney stones or increased levels of oxalate in the urine
- Severe allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Orlistat
- Liver Damage: Orlistat has been associated with rare but severe liver injury. Seek immediate medical attention if you notice symptoms of liver issues, such as dark urine, yellow skin or eyes, or unusual tiredness.
- Kidney Stones: Orlistat can increase the amount of oxalate in the urine, which may lead to the formation of kidney stones in some patients.
- Vitamin Deficiency: Since Orlistat reduces the absorption of fat-soluble vitamins, patients are at risk of vitamin deficiencies. A daily multivitamin supplement is recommended.
Interactions with Orlistat
Common Drug Interactions
- Multivitamins: Orlistat reduces the absorption of fat-soluble vitamins (A, D, E, K), so take a multivitamin supplement at least 2 hours before or after taking Orlistat.
- Cyclosporine: Orlistat can reduce the absorption of cyclosporine, a drug used in organ transplants. It should be taken at least 3 hours before or after cyclosporine.
- Levothyroxine: Orlistat may interfere with the absorption of thyroid medications. Separate the doses by at least 4 hours.
Alternatives to Orlistat
- Phentermine: A prescription weight-loss medication that suppresses appetite, used for short-term weight loss.
- Liraglutide (Saxenda): A prescription medication used to help control weight by mimicking a hormone that regulates appetite.
- Topiramate-phentermine (Qsymia): A combination drug for weight loss.
- Diet and exercise: Non-drug approaches that are foundational for weight management.
