Drug name: Orlistat
Brand names: Xenical, Alli
Use: Obesity management, weight loss
Orlistat is a lipase inhibitor that reduces the absorption of dietary fat -- about 30% of the fat intake from meals passes through the gut undigested.
Orlistat can help reduce weight (or maintain a lower body weight) by reducing the absorption of fat from the bowel, not by suppressing your appetite.
Xenical is licensed for sale over-the-counter in the USA & on prescription in the UK.
Alli is half the strength of xenical & may soon be available over-the-counter in the UK.
Over-the-counter anti-obesity drugs work best when combined with a reduced calorie, low-fat diet and regular exercise. When taking orlistat, each meal should contain no more than 15g of fat.
Contraindications:
- chronic malabsorption syndrome
- cholestasis
- pregnancy and breastfeeding
Side effects:
- flatulence (gas)
- increased urgency to open the bowels
- oily discharge or fatty stools
- abdominal distension (bloating) and pain
- faecal incontinence
Orlistat acts only in the gut, but it potentially inhibits the absorption of the fat-soluble vitamins A, D, E & K. Longer term this could carry risks of vitamin deficiency -- the manufacturer GlaxoSmithKline advises taking a daily multi-vitamin pill to protect against this.
Dose:
120mg at mealtime (max 3 doses per day).
If a meal is missed or contains no fat, the dose of orlistat should be omitted.
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