Classifications: anorectant; nonsystemic lipase inhibitor; Therapeutic: nonsystemic lipase inhibitor
Pregnancy Category: B
60 mg, 120 mg capsules
Nonsystemic inhibitor of gastrointestinal lipase. Reduces intestinal absorption of dietary fat by forming inactive enzymes
with pancreatic and gastric lipase in the GI tract.
Indicated by weight loss/decreased body mass index (BMI). Reduces the intestinal absorption of dietary fat because at least
95% of orlistat is eliminated in the feces; reduces caloric intake in obese individuals.
Weight loss and weight maintenance in patients with BMI ≥30 kg/m2 or ≥27 kg/m2 in patients with other risk factors. Reduce risk for weight regain after prior weight loss.
Hypersensitivity to orlistat; malabsorption syndrome; cholestasis; gallbladder disease; hypothyroidism; organic causes of
obesity; anorexia nervosa, bulimia nervosa; organic causes of obesity, lactation. Safety and efficacy in children <12 y
are not established.
Gastrointestinal diseases including frequent diarrhea; known dietary deficiencies in fat soluble vitamins (i.e., A, D, E);
history of calcium oxalate nephrolithiasis or hyperoxaluria; older adults; pregnancy (category B).
Route & Dosage
Adult/Adolescent (>16 y): PO 60120 mg t.i.d. with each main meal containing fat
- Give during or up to 1 h after a meal containing fat.
- Omit dose with nonfat-containing meal or if meal is skipped.
- Store at 15°30° C (59°86° F). Keep bottle tightly closed; do NOT use after the printed expiration date.
Adverse Effects (≥1%)Body as a Whole: Fatigue
. CNS: Headache,
dizziness, anxiety. CV:
Hypertension, stroke. GI: Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation,
fecal incontinence, abdominal pain/discomfort,
nausea, infectious diarrhea
, rectal pain/discomfort, tooth disorder, gingival disorder, vomiting. Skin:
Diagnostic Test Interference
Monitor PT/INR in patients on chronic stable doses of warfarin.
may increase absorption of pravastatin;
may decrease absorption of fat soluble vitamins
(A, D, E, K).
In feces. Half-Life:
Assessment & Drug Effects
- Monitor weight & BMI; closely monitor diabetics for hypoglycemia.
- Coadministered drugs: Monitor PT/INR with warfarin.
- Monitor BP frequently, especially with preexisting hypertension.
Patient & Family Education
- Take a daily multivitamin containing fat-soluble vitamins at least 2 h before/after orlistat.
- Remember common GI adverse effects typically resolve after 4 wk therapy.
- Avoid high fat meals to minimize adverse GI effects. Distribute fat calories over three main meals daily.
- Monitor weight several times weekly. Diabetics: Monitor blood glucose carefully following any weight loss.