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Orlistat
Aka: Orlistat, Xenical
- See Also
- Medications Associated with Weight Gain
- Lorcaserin (Belviq)
- Phentermine (Ionamin, Fastin)
- Phentermine and Topiramate (Qsymia, Qnexa)
- Obesity
- Obesity in Children
- Obesity Evaluation
- Obesity Measurement (or Obesity Screening)
- Obesity Risk (or Obesity Comorbid Conditions)
- Obesity Management
- Obesity Medication
- Dietary Supplements in Obesity
- Exercise in Obesity
- Obesity Resources
- Indication: Obesity Management
- Body Mass Index over 30 kg/m2
- Body Mass Index over 27 kg/m2 with comorbidity
- Diabetes Mellitus
- Hypertension
- Dyslipidemia
- Mechanism
- Pentanoic acid ester binds gastric, pancreatic Lipase
- Lipase Inhibitor (Blocks Fat absorption)
- Decreased Triglyceride absorption
- Decreased Cholesterol absorption
- Pharmacokinetics
- Minimal systemic absorption
- 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
- Year one
- Orlistat: 9-10 kg loss (10% of baseline weight)
- Placebo: 6 kg (6% of baseline weight)
- Year two
- Orlistat: 1.5-3 kg regained weight
- Placebo: 4-6 kg regained weight
- References
- Sjostrom (1998) Lancet 352:167 [PubMed]
- Davidson (1999) JAMA 281:235 [PubMed]
- 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)
- Vitamin A
- Vitamin D
- Vitamin E
- Vitamin K
-
Drug Interactions
- Does not interfere with absorption of other medications
- Coumadin
- Oral Contraceptives
- Antihypertensives
- 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
- Precautions
- Avoid fat-soluble Vitamins within 2 hours of Orlistat
- Maintain Dietary Fat intake <30% of calories
- References
- (1999) Med Lett Drugs Ther 41(1055):55-6 [PubMed]
- Erlandson (2016) Am Fam Physician 94(5): 361-8 [PubMed]