Orlistat is a lipase inhibitor medication approved for weight management in adults with a body mass index (BMI) of 30 or greater, or 27 or greater with other risk factors such as hypertension, diabetes, or dyslipidemia. It functions by inhibiting gastric and pancreatic lipases in the GI tract, thereby reducing the hydrolysis of dietary triglycerides into absorbable free fatty acids and monoglycerides. This results in decreased caloric intake and supports sustainable weight loss when combined with a reduced-calorie, low-fat diet. Orlistat is available in both prescription (120 mg) and over-the-counter (60 mg) formulations, providing flexibility under appropriate medical guidance.

Features

• Contains orlistat as the active pharmaceutical ingredient
• Available in 120 mg prescription strength and 60 mg OTC formulation
• Lipase inhibitor mechanism of action
• Three-times-daily dosing regimen
• Requires concomitant reduced-calorie diet
• Manufactured under strict pharmaceutical quality standards

Benefits

• Promotes clinically significant weight loss when used as directed
• Reduces absorption of dietary fat by approximately 30%
• Supports improvement in obesity-related comorbidities
• Provides a non-systemic mechanism of action
• Facilitates development of healthier eating patterns
• Offers both prescription and OTC accessibility options

Common use

Orlistat is indicated for obesity management in adults with BMI ≥30 kg/m², or ≥27 kg/m² in the presence of other risk factors including hypertension, type 2 diabetes, or dyslipidemia. It is used as an adjunct to a reduced-calorie diet and should be incorporated into a comprehensive weight management program that includes behavioral modification and increased physical activity. The medication is typically prescribed when dietary changes alone have proven insufficient for achieving target weight loss goals.

Dosage and direction

The recommended dosage is one 120 mg capsule three times daily with each main meal containing fat (up to 30% of calories from fat). The capsule should be taken during the meal or up to one hour after eating. If a meal is missed or contains no fat, the dose of orlistat should be omitted. The medication works locally in the GI tract and requires the presence of dietary fat for optimal efficacy. Treatment should be discontinued if no meaningful weight loss occurs within 12 weeks.

Precautions

Patients should maintain a nutritionally balanced, reduced-calorie diet containing approximately 30% of calories from fat. Higher fat intake may increase gastrointestinal side effects. Orlistat may reduce the absorption of fat-soluble vitamins (A, D, E, K) and beta-carotene; therefore, patients should take a daily multivitamin supplement containing these nutrients at least 2 hours before or after orlistat administration. Use with caution in patients with history of hyperoxaluria or calcium oxalate nephrolithiasis. Monitor renal function in patients taking orlistat concomitantly with drugs that may cause nephrotoxicity.

Contraindications

Orlistat is contraindicated in patients with chronic malabsorption syndrome or cholestasis. It should not be used during pregnancy or by nursing mothers. The medication is contraindicated in patients with known hypersensitivity to orlistat or any component of the formulation. Use is not recommended for patients with anorexia nervosa or bulimia. Orlistat should not be used by patients taking cyclosporine or with organ transplantation history.

Possible side effects

The most common adverse reactions are gastrointestinal in nature and include: oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, and fecal incontinence. These effects are generally mild to moderate, decrease with continued use, and are positively correlated with dietary fat content. Other side effects may include abdominal pain/discomfort, nausea, infectious diarrhea, rectal pain/discomfort, tooth disorder, gingival disorder, headache, and upper respiratory infection. Rare cases of hepatic injury have been reported.

Drug interactions

Orlistat may reduce absorption of fat-soluble vitamins and beta-carotene. It may decrease plasma levels of cyclosporine; avoid concomitant use. Monitor INR values in patients taking warfarin or other anticoagulants, as orlistat may affect vitamin K absorption. Orlistat may reduce efficacy of amiodarone, antiepileptic drugs, and levothyroxine. Concurrent use with pravastatin may increase the latter’s bioavailability. Separate administration of other medications by at least 2 hours from orlistat dosing.

Missed dose

If a dose is missed, resume the regular dosing schedule with the next meal. Do not double the dose to make up for a missed administration. The medication should only be taken when consuming a meal that contains fat. If a meal is skipped or is fat-free, the corresponding dose should be omitted.

Overdose

There have been no reports of serious adverse events from orlistat overdose. Single doses of 800 mg and multiple doses up to 400 mg three times daily for 15 days have been studied without significant adverse effects. In case of suspected overdose, provide supportive care and monitor for gastrointestinal effects. Since orlistat acts locally in the gastrointestinal tract, systemic effects are not expected.

Storage

Store at room temperature between 15-30°C (59-86°F). Keep container tightly closed and protect from moisture. Keep out of reach of children. Do not use after the expiration date printed on the packaging. The medication should be stored in its original container to protect from light and humidity.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any weight management medication. Individual results may vary, and orlistat should be used as part of a comprehensive weight management program under medical supervision. The medication is not appropriate for all patients and requires careful consideration of individual health status and contraindications.

Reviews

Clinical studies demonstrate that orlistat produces significantly greater weight loss than placebo when combined with a reduced-calorie diet. In year-long trials, approximately 40% of patients achieved ≥5% weight loss, and 20% achieved ≥10% weight loss. The medication has shown beneficial effects on cardiovascular risk factors, including improvements in LDL cholesterol, total cholesterol, and blood pressure. Patient satisfaction varies, with gastrointestinal side effects being the most commonly reported reason for discontinuation. Long-term studies support the maintenance of weight loss with continued use alongside lifestyle modifications.