Xenical (orlistat 120 mg) is a prescription-only lipase inhibitor indicated for weight management in adults with obesity. It functions by blocking the absorption of approximately one-third of dietary fat from the intestine, supporting significant and sustained weight reduction when combined with a reduced-calorie diet. This medication is a cornerstone in the pharmacological management of obesity, particularly for patients with a body mass index (BMI) of 30 kg/m² or greater, or 27 kg/m² or greater in the presence of other risk factors such as hypertension, type 2 diabetes, or dyslipidaemia. Its efficacy is well-documented in long-term clinical studies, making it a trusted option for healthcare providers.

Features

• Active ingredient: Orlistat 120 mg
• Pharmaceutical class: Lipase inhibitor
• Presentation: Turquoise blue, hard gelatin capsules
• Pack sizes: 21, 42, 84, and 100 capsules
• Requires a prescription
• Manufactured under strict Good Manufacturing Practice (GMP) standards

Benefits

• Achieves clinically significant weight loss, typically 5–10% of initial body weight within 6 months
• Improves obesity-related comorbidities, including reductions in LDL cholesterol, total cholesterol, and blood pressure
• Supports long-term weight maintenance when used as part of a comprehensive management plan
• Provides a non-systemic mechanism of action, acting locally in the gastrointestinal tract
• Encourages adherence to a healthier, reduced-calorie, lower-fat diet through its mode of action

Common use

Xenical is indicated for obesity management in adults. It is used adjunctively with a mildly hypocaloric diet (approximately 30% of calories from fat) for patients with an initial BMI ≥30 kg/m², or ≥27 kg/m² in the presence of other risk factors (e.g., type 2 diabetes, dyslipidaemia, hypertension). Treatment should be continued beyond 12 weeks only if a weight loss of at least 5% has been achieved since starting therapy.

Dosage and direction

The recommended dose of Xenical is one 120 mg capsule taken with water immediately before, during, or up to one hour after each main meal that contains fat. If a meal is occasionally missed or contains no fat, the dose of Xenical should be omitted. The daily intake should not exceed three capsules. Doses above 120 mg three times daily have not been shown to provide additional benefit.

Precautions

Use with caution in patients with a history of hyperoxaluria or calcium oxalate nephrolithiasis, as orlistat has been associated with these conditions. Monitor patients for any signs of hepatic dysfunction. A multivitamin supplement containing fat-soluble vitamins (A, D, E, K) should be taken once daily at least 2 hours before or after taking Xenical, or at bedtime, to prevent potential deficiency. Not recommended for use in paediatric populations.

Contraindications

Xenical is contraindicated in patients with chronic malabsorption syndrome, cholestasis, known hypersensitivity to orlistat or any excipients of the formulation, and during pregnancy and breastfeeding. It should not be used by patients with anorexia nervosa or bulimia.

Possible side effects

The most common side effects are gastrointestinal in nature, related to the mechanism of action, and generally diminish after the first few weeks of treatment. These may include:

• Oily spotting from the rectum
• Flatus with discharge
• Faecal urgency
• Fatty or oily stool
• Oily evacuation
• Increased defecation
• Faecal incontinence Rare but serious side effects can include hepatotoxicity, hypothyroidism, oxalate nephropathy, and pancreatitis. Patients should be advised to discontinue use and consult their physician if they experience symptoms of allergic reaction, liver disorder (e.g., itching, yellow eyes/skin, dark urine), or kidney stones.

Drug interaction

Orlistat may reduce the absorption of fat-soluble vitamins and some lipophilic drugs. It is recommended to take the following medications at least 2 hours before or after Xenical, or at bedtime: cyclosporine, levothyroxine, warfarin and other anticoagulants, amiodarone, anticonvulsants (e.g., valproate, lamotrigine), and antiretroviral drugs. Patients on warfarin should have their INR monitored closely. Orlistat may also affect the efficacy of oral contraceptives; a secondary non-hormonal method of contraception is advised.

Missed dose

If a dose is missed, it should be skipped and the next dose taken at the regular time with the next fat-containing meal. Do not take a double dose to make up for a missed one.

Overdose

There have been no reports of serious adverse events from 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 outcomes. In cases of suspected overdose, provide supportive treatment and monitor for any gastrointestinal effects.

Storage

Store below 25°C. Keep the container tightly closed to protect from moisture. Do not use after the expiry date printed on the packaging. Keep out of the sight and reach of children.

Disclaimer

This information is intended for healthcare professionals and patients under medical supervision. It is not exhaustive. Always read the accompanying package leaflet or consult a physician or pharmacist for complete information. Xenical should only be used under the guidance of a qualified healthcare provider as part of a managed weight loss programme. Individual results may vary.

Reviews

Clinical trials and post-marketing surveillance demonstrate that Xenical is effective for weight loss and maintenance when used as directed. In a 4-year XENDOS study, orlistat plus lifestyle changes resulted in significantly greater weight loss and reduced incidence of type 2 diabetes compared to placebo. Patient satisfaction is often correlated with dietary adherence and management of gastrointestinal effects, which typically subside with continued use and dietary fat moderation.