Orlistat
Indications
Orlistat is used for:
Obesity
Adult Dose
Oral
Obesity
Adult:
Indicated in patients with pretreatment BMI >30 kg/m², or BMI >27 kg/m² in presence of other risk factors or diseases (eg, HTN, DM, hyperlipidemia)
120 mg tid w/ each main meal.
Patients w/ BMI >28 kg/m2 irrespective of any risk factors: 60 mg tid.
Omit dose if a meal is missed or contains no fat. Discontinue if patient is unable to lose at least 5% of the body wt during the 1st 12 wk of therapy.
Child Dose
<12 years: Safety and efficacy not established
Renal Dose
Administration
Should be taken with food. Take immediately before or during or up to 1 hr after each main meal. If a meal is missed or contains no fat, the dose may be omitted.
Contra Indications
Chronic malabsorption syndrome. Cholestasis. Lactation
Precautions
Patient w/ history of hyperoxaluria or Ca oxalate nephrolithiasis. Monitoring Parameters Monitor BMI, diet, LFT, serum glucose (in patient w/ DM), thryroid function (in patient w/ thyroid disease).
Lactation: Not recommended; not known if orlistat is distributed in breast milk
Pregnancy-Lactation
Interactions
May decrease absorption of oral fat-soluble vitamins, amiodarone, propafenone. May decrease plasma levels of ciclosporin. May alter the effects of warfarin (monitor INR). May elevate plasma levels of pravastatin.
Side Effects
Side effects of Orlistat :
1-10%
Oily spotting (5%)
Frequency Not Defined
Faecal urgency and incontinence, flatulence, fatty stools or discharge, increased defecation; headache, anxiety, fatigue, menstrual irregularities; abdominal pain/discomfort.
Potentially Fatal: Anaphylaxis; angioedema.
Mode of Action
Orlistat is a reversible gastric and pancreatic lipase inhibitor. It exerts antiobesity effects by limiting the absorption of dietary fats through inhibition of triglyceride hydrolysis. It does not exert appetite suppressant effects.