Xenical

Brand Name:Xenical

Prescription needed: Yes

What is this drug used for?

Orlistat is used to assist people in losing weight. For maximum benefit it is usually prescribed along with a nutritionally sound calorie reduction plan.

Orlistat is in a class of drugs called lipase inhibitors. It works in your intestines. It blocks the stomach and pancreatic enzymes from absorbing and digesting some of the fats you eat. These undigested fats pass through the body and are eliminated in your bowel movements. Because these fats are no longer available, the body begins to burn stored fat for energy which leads to weight loss.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to orlistat. Before taking this medication, tell your doctor specifically if you have or have ever had:

  • anorexia nervosa or bulimia
  • chronic malabsorption syndrome or problems absorbing food
  • bowel disease
  • diabetes
  • problems with your gall bladder, kidneys, liver or thyroid

What about possible side effects?

The most common side effects are:

  • flatulence
  • increase in bowel movements
  • liquid or oily stools
  • stomach pain
  • orange or brown color stool
  • inability to control bowel movements

These side effects are directly related to the way orlistat works. It is likely that you will experience some change in bowel habits by blocking the absorption of dietary fat. These effects are usually mild and may go away during treatment as your body adjusts to the medicine. Clear, orange or brown color stool are due to the presence of undigested fat or oil, which indicates that orlistat is working. Sticking to a diet that contains no more than 30% calories from fat in each meal can reduce unwanted side effects. However, check with your doctor if any side effects continue or are bothersome.

Other less common side effects include:

  • anxiety
  • fatigue
  • headache
  • menstrual irregularities
  • moodiness
  • nausea
  • nasal congestion

Side effects caused by orlistat usually disappear within 2 to 3 days after stopping it.

Other very rare and potentially serious side effects include:

  • itching
  • skin rash or hives
  • swelling
  • anxiety
  • chest pain or tightness
  • difficulty breathing
  • fever
  • hearing problems

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • Anti-diabetes drugs (e.g. gliclazide, glyburide, insulin) - weight loss may improve blood sugar control, which may require an adjustment of doses of diabetes medications
  • Cyclosporine - may lower cyclosporine levels; cyclosporine should be taken at least 2 hours before or after orlistat. Blood levels of cyclosporine should be closely checked when orlistat is added to or discontinued from therapy to determine if adjustment of cyclosporine dose is needed.
  • Fat-soluble vitamins (vitamin A, D, E, K), supplements containing beta carotene - amount may be reduced; space the administration of orlistat and these supplements by at least 2 hours
  • Warfarin - may increase warfarin effect in the body; blood levels should be closely checked to determine if adjustments of warfarin dose is needed

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Administration: The drug is usually prescribed until you have achieved your weight goal, although some weight may be regained after you stop treatment.

While you are on orlistat your doctor may also prescribe fat-soluble vitamin supplements since the absorption of these vitamins in the body may be reduced. Take the vitamin supplements at bedtime or at least 2 hours before or after orlistat.

Orlistat prevents the absorption of some of the fat you eat. Therefore, you should take it during the meal that contains fat or within 1 hour of eating. If you occasionally miss a meal or eat a meal that contains no fat, you should skip the dose of orlistat.

When using orlistat, your diet should contain no more than 30% of calories as fat. More fat in your diet will increase the side effects of this medicine. Your diet should be nutritionally balanced and your daily intake of fat, carbohydrates and protein should be distributed over three main meals to maintain a healthy weight. Talk to your doctor or dietician.

Children: Not usually prescribed for children under 12 years of age. Talk to your doctor.

Seniors: No known problems

Pregnant women: Safety not studied. Since orlistat may decrease the amount of fat soluble vitamins in your body, talk to your doctor.

Women who are nursing: Safety is not yet established. Talk to your doctor.

People who drive or operate machinery: No known problems.

Alcohol: No known problems. If you drink, always drink in moderation.

Overdose: A large overdose of this medicine could cause unusual symptoms. If you experience any unusual reactions, or if you seriously exceed the recommended dosage, call your doctor or 911.

Stopping the drug: You can stop taking orlistat when you no longer need it but when you stop, tell your doctor.

If you miss a dose: Take the missed dose as soon as you remember it unless it is more than 1 hour since you ate a main meal. If it is longer than 1 hour since you ate a main meal, skip the missed dose and continue on your regular dosing schedule. Do not take a double dose to make up for a missed one.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.

Dietary precautions: Your doctor may recommend that you follow a calorie reduced diet. Follow the diet program your doctor or dietician has given you. You should evenly divide your daily intake of fat, carbohydrates and protein over your main meals. If orlistat is taken with a meal very high in fat (30% total daily calories from fat), you may experience more stomach side effects from the medication.

Orlistat may reduce absorption of some fat-soluble vitamins and beta carotene. Therefore, when you use orlistat your doctor may recommend taking a daily multivitamin supplement that contains vitamins A, E, K, and beta-carotene. Take the vitamin once a day, 2 hours before or 2 hours after taking orlistat, or take the vitamin at bedtime.