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Xenical
Xenical (generic name: orlistat) is a medication used to aid in weight loss and prevent weight regain in individuals who are overweight or obese. It works by blocking the absorption of fat from the food you eat, reducing caloric intake. Xenical is typically prescribed alongside a reduced-calorie diet and exercise plan for long-term weight management. It is often used in individuals with risk factors such as high blood pressure, diabetes, or high cholesterol.
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Frequently Asked Questions
How long does it take for Xenical to start working?
Xenical begins working immediately to block fat absorption from the food you eat. However, weight loss typically becomes noticeable within the first 2 weeks of treatment when combined with a healthy diet and exercise.
Can I eat a high-fat meal while taking Xenical?
No, it is recommended to follow a low-fat diet while taking Xenical. Eating high-fat meals can increase the risk of unpleasant side effects like oily stools, diarrhea, and abdominal pain.
What should I do if I miss a dose of Xenical?
If you miss a dose of Xenical, take it as soon as you remember, provided it is within 1 hour of your meal. If more than an hour has passed, skip the missed dose and resume your regular dosing schedule.
Can I take Xenical if I am pregnant?
No, Xenical is contraindicated during pregnancy, as weight loss is not recommended. Consult your healthcare provider for alternatives if needed.
Can Xenical be used long-term?
Yes, Xenical can be used long-term for weight management. However, regular monitoring by your healthcare provider is recommended to ensure that you are meeting your nutritional needs, especially with respect to fat-soluble vitamins.
Comprehensive Drug Guide
How Does Xenical Work?
Xenical works by inhibiting pancreatic and gastric lipases, enzymes responsible for breaking down dietary fats in the intestine. By blocking these enzymes, Xenical prevents approximately 30% of the fat you eat from being absorbed, causing it to be excreted in the stool. This reduction in fat absorption leads to lower calorie intake and promotes weight loss.
Common Dosages
- 120 mg capsule taken three times daily with meals containing fat.
Typical Dosing
- The typical dose of Xenical is 120 mg taken three times a day with each main meal that contains fat (during or up to 1 hour after the meal).
- If a meal contains no fat, the dose of Xenical can be skipped.
Typical Dosing
FDA Approved Indications
- Obesity management, including weight loss and weight maintenance.
- Reducing the risk of weight regain after prior weight loss.
Who Shouldn't Take Xenical?
- Chronic malabsorption syndrome (inability to absorb nutrients properly).
- Cholestasis (a condition where bile flow from the liver is blocked).
- Pregnancy, as weight loss is not recommended during pregnancy.
Advice From The Pharmacist
- Take Xenical with meals that contain fat to help block fat absorption. If a meal contains no fat, you can skip the dose.
- Follow a reduced-calorie, low-fat diet while using Xenical to minimize gastrointestinal side effects such as oily stools.
- Take a multivitamin daily, as Xenical can reduce the absorption of fat-soluble vitamins (A, D, E, K). Multivitamins should be taken at least 2 hours before or after Xenical.
- Avoid high-fat meals, as eating a meal high in fat while taking Xenical can lead to unpleasant gastrointestinal side effects.
Side Effects of Xenical
Common Side Effects
- Oily or fatty stools
- Increased bowel movements
- Urgency to have a bowel movement
- Flatulence with discharge
- Abdominal pain
Uncommon/Severe Side Effects
- Severe liver injury (dark urine, yellowing of the skin or eyes, loss of appetite).
- Kidney stones (pain in the back or side, blood in urine).
Risks and Warnings of Xenical
- Gastrointestinal Effects: The most common side effects of Xenical are gastrointestinal, including oily stools, flatulence, and frequent bowel movements. These effects are usually mild and tend to decrease with continued use.
- Vitamin Deficiencies: Because Xenical blocks the absorption of fat-soluble vitamins, long-term use can lead to deficiencies in vitamins A, D, E, and K. A multivitamin should be taken to prevent deficiencies.
- Liver Injury: Although rare, Xenical has been associated with severe liver injury. Patients should report any symptoms such as jaundice, dark urine, or abdominal pain to their healthcare provider.
Interactions with Xenical
Common Drug Interactions
- Cyclosporine: Xenical may reduce the absorption of cyclosporine, an immunosuppressive drug. Separate doses by at least 3 hours and monitor cyclosporine levels.
- Levothyroxine: Xenical may reduce the absorption of levothyroxine, a thyroid medication. Separate doses by 4 hours.
- Warfarin: Xenical may affect vitamin K absorption and potentially alter the effects of warfarin. Patients on warfarin should have their INR levels monitored closely.
Alternatives to Xenical
- Phentermine: A sympathomimetic amine used for short-term weight loss.
- Liraglutide (Saxenda): A GLP-1 receptor agonist used for weight loss in patients with a BMI of 30 or higher.
- Topiramate/phentermine (Qsymia): A combination medication used for chronic weight management.
- Bariatric surgery: For individuals with severe obesity, surgical options such as gastric bypass or gastric sleeve may be considered.
