Orlistat
Indications for use
- Weight loss in adults who are overweight (body mass index ≥28 kg/m2) in conjunction with a mildly hypocaloric, lower-fat diet
Age
- 18 years +
Dose/Directions
- One 60 mg capsule taken with water immediately before, during or up to 1 hour after each main meal (three times daily). No more than three 60 mg capsules should be taken in 24 hours
Duration
- 6 months maximum, but if a patient has been unable to lose weight after 12 weeks of treatment, discussion with a pharmacist or GP is warranted as treatment may need to be stopped
Contra-indications/referral criteria
- Hypersensitivity
- Taking ciclosporin
- Chronic malabsorption syndrome
- Cholestasis
- Pregnancy
- Breast-feeding
- Taking warfarin or other anticoagulants
- Taking acarbose
- Other:
- patients who are taking a medicinal product for diabetes should consult a doctor before starting treatment with alli
- patients who are taking a medicinal product for hypertension or hypercholesterolaemia should consult a doctor or pharmacist when taking alli, in case it is necessary to adjust the dose of these medicinal products
- patients who are taking amiodarone should consult a doctor before starting treatment with alli
- patients taking levothyroxine should consult a doctor before starting treatment with alli, as orlistat and levothyroxine may need to be taken at different times and the dose of levothyroxine may need to be adjusted
- patients taking an antiepileptic medicinal product should consult a doctor before starting treatment with alli, as they should be monitored for possible changes in the frequency and severity of convulsions
- patients should consult a doctor before taking alli concomitantly with antiretroviral medicinal products
Examples of drug interactions
- Ciclosporin
- Warfarin/oral anticoagulants
Side-effects
- Very common: oily spotting, flatus with discharge, faecal urgency, fatty oily stool, oily evacuation, flatulence, soft stools
- Common: abdominal pain, faecal incontinence, liquid stools
Other pertinent information
- Since orlistat inhibits pancreatic and gastric lipase (which reduces the absorption of fat from the gut), if a meal is missed or contains no fat, the dose of orlistat should be omitted
- Treatment with orlistat may potentially impair the absorption of fat-soluble vitamins (A, D, E and K). For this reason, a multivitamin supplement should be taken at bedtime
- Cases of rectal bleeding have been reported in patients taking orlistat. If this occurs, the patient should consult a doctor
- Orlistat may indirectly reduce the availability of oral contraceptives and lead to unexpected pregnancies. Therefore, an additional contraceptive method is recommended in case of severe diarrhoea
- Reclassified POM→P: 2009