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.

Adverse 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.

Mechanism 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.