orlistat (Xenical, Alli)

• Orlistat is combined with a reduced-caloriedietto promoteweight loss.
• Orlistat also may be used to preventweight gainafter weight has been lost.
• Candidates for treatment with orlistat are patients who areobesewith a body mass index (a measure ofobesity) of more than 30 kg/m2.
• Candidates also include patients with a body mass index of between 27 and 30 kg/m2 if other risk factors forarteriosclerosisare present such ashigh blood pressure,diabetes, and elevated bloodcholesterolortriglycerides.
• Based on several scientific studies, the averageweight lossthat is achieved when orlistat is taken as recommended for six months to one year is 12.4 to 13.4 pounds.

What brand names are available for orlistat?

Xenical, alli

Is orlistat available as a generic drug?

No

我需要奥利司他的药方吗?

奥利司他是的,Alli

The most common side effects of orlistat are:

• oilyspottingon underwear,
• flatulence,
• urgent bowel movements,
• fatty or oily stools,
• increased number of bowel movements,
• abdominal painor discomfort, and
• inability to controlstool(incontinence).

From 1 in 250 and 1 in 70 patients experienced one or more of these symptoms in the first year. Generally, the side effects occurred within three months of starting therapy. In about 50% of patients, the side effects resolved within one to four weeks, but the effects in some patients lasted six months or longer. To reduce the occurrence of these side effects, meals should contain no more than 30% fat because it is the unabsorbed fat that causes most of the symptoms. alli causes fewer side effects because it contains half the dose of prescription-strength orlistat. Patients receiving orlistat with a history of oxalatekidney stonesmay develop increased levels of oxalate in their urine, which may increase the risk of kidney stones.

Liverfailure has been reported in patients treated with orlistat. Orlistat should be discontinued if symptoms of liver failure (loss of appetite,anorexia,itching,jaundice,dark urine, light colored stools, or right upperabdominal pain) occur while taking orlistat.

Other serious side effects of orlistat include:

• Seriousallergicreactions
• Angioedema
• Deficiency in fat-solublevitamins

• The recommended prescription dose for Xenical is one capsule (120 mg) three times daily.
• The recommended dose for alli is 60 mg three times daily.
• Orlistat should be taken one hour after or during a meal containing about 15 mg of fat. Meals without fat do not require orlistat.
• No additional benefit has been shown when orlistat was taken in doses greater than 120 mg.
• Patients should eat a nutritionally balanced, reduced caloriedietthat contains approximately 30% of calories from fat.
• alli includes an individually tailored online weight loss support program.

Some dietaryvitaminsbind to fat (vitamins A, D, E and beta- carotene). When orlistat is taken, these vitamins are not absorbed and are eliminated in thestoolin increased amounts along with the fat. Therefore, patients taking orlistat should take a multivitamin containing these "fat-soluble" vitamins to ensure that adequate amounts of the vitamins are available for absorption. To ensure that the vitamins in themultivitaminsare not bound to fat like the vitamins in the diet, the multivitamin should be taken at least two hours before or several hours after the orlistat.

• The blood thinning effect ofwarfarin(Coumadin,Jantoven) depends on the amount ofvitamin K在体内,维生素K是一种维生素that binds to fat. Patients receiving warfarin who begin orlistat should have their blood clotting monitored closely because the orlistat may cause levels of vitamin K to decline. This will increase the effects of warfarin and lead to abnormal bleeding from the warfarin. There is no evidence that a deficiency of vitamin K occurs in patients who are taking orlistat.
• Orlistat may reduce the absorption and blood levels ofcyclosporine(Sandimmune) when bothdrugsare administered together. Therefore, cyclosporine should be administered two hours before or after orlistat, and more frequent monitoring of cyclosporine levels may be needed.
• Hypothyroidismhas been reported when orlistat and levothyroxine (Synthroid,Levoxyl,Levothroid,Unithroid) were combined. Patients treated with both orlistat and levothyroxine should be monitored for changes in thyroid function. The orlistat and levothyroxine should be taken at least four hours apart.

• Safe use of orlistat duringpregnancyhas not been established. Therefore, orlistat is not recommended during pregnancy.
• It is not known if orlistat is secreted inbreast milk. Therefore, it probably should not be taken bynursingmothers.

What preparations of orlistat are available?

Capsules: 60 mg (alli), 120 mg (Xenical)

How should I keep orlistat stored?

Capsules should be stored at room temperature, 15 C - 30 C (59 F - 86 F)