II. Indication: Obesity Management
- Body Mass Index over 30 kg/m2
-
Body Mass Index over 27 kg/m2 with comorbidity
- Diabetes Mellitus
- Hypertension
- Dyslipidemia
III. Mechanism
- Pentanoic acid ester binds gastric, pancreatic Lipase
-
Lipase Inhibitor (Blocks Fat absorption)
- Decreased Triglyceride absorption
- Decreased Cholesterol absorption
IV. Pharmacokinetics
- Minimal systemic absorption
V. Efficacy
- Weight loss is greater with 120 mg (7.5 lb or 3.4 kg) than with 60 mg (5.5 lb or 2.5 kg)
- Combined results of two large Placebo controlled trials
- References
VI. Adverse effects
- Gastrointestinal side effects (40%)
- Flatus with discharge
- Oily stool with spotting
- Fecal urgency
- Fecal Incontinence
- Abdominal Pain
- Fat soluble Carotenoid (fruit, vegetable) malabsorption
- Fat soluble Vitamin malabsorption (daily MVI recommended in package insert)
VII. Drug Interactions
- Does not interfere with absorption of other medications
VIII. Dosing
- Take three times daily with each meal containing fat
- Prescription dose: 120 mg orally three times daily
- OTC dose: 60 mg orally three time daily
IX. Precautions
- Avoid fat-soluble Vitamins within 2 hours of Orlistat
- Maintain Dietary Fat intake <30% of calories
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