Orlistat

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Orlistat (Xenical) - Interactions and Warnings


Orlistat has a cholesterol-lowering effect not seen with other diet medications. However, the three-times-daily administration and frequent gastrointestinal effects limit its use.
- Am J Health Syst Pharm 2001 Jul 15;58(14):1301-8 -- Pharmacologic options for the treatment of obesity. -- Campbell ML, Mathys ML.

Taking cyclosporine with orlistat may cause an adverse interaction or interfere with absorption.
- J Clin Pharmacol 2002 Sep;42(9):1011-9 -- Pharmacokinetic evaluation of the possible interaction between selected concomitant medications and orlistat at steady state in healthy subjects. -- Zhi J, Moore R, Kanitra L, Mulligan TE.

A case of significant additive gastrointestinal effects with concomitant use of orlistat and an olestra-containing snack food. All patients receiving orlistat for the management of obesity should be properly educated about this potential drug-food interaction.
- Ann Pharmacother 2002 Jun;36(6):1003-5 -- Additive gastrointestinal effects with concomitant use of olestra and orlistat. -- Heck AM, Calis KA, McDuffie JR, Carobene SE, Yanovski JA.

Orlistat can have an effect on blood sugar control.
- Diabetes Care 2002 Jun;25(6):1033-41 -- Clinical efficacy of orlistat therapy in overweight and obese patients with insulin-treated type 2 diabetes: A 1-year randomized controlled trial. -- Kelley DE, Bray GA, Pi-Sunyer FX, Klein S, Hill J, Miles J, Hollander P.

The main adverse events are related to fat malabsorption, with potential losses of fat-soluble vitamins and other compounds.
- Aliment Pharmacol Ther 1999 Aug;13(8):997-1002 -- Review article: malnutrition and maltreatment--a comment on orlistat for the treatment of obesity. -- Cahill A, Lean ME.

When beta-carotene was given during orlistat treatment, its absorption was reduced by approximately one-third.
- J Clin Pharmacol 1996 Feb;36(2):152-9 -- The effect of orlistat, an inhibitor of dietary fat absorption, on the pharmacokinetics of beta-carotene in healthy volunteers. -- Zhi J, Melia AT, Koss-Twardy SG, Arora S, Patel IH.

There have been recent, published reports of non-fatal acute hepatitis and systemic hypertension associated with its use.
- Med Sci Law 2002 Oct;42(4):309-12 -- Massive hepatocellular necrosis: was it caused by Orlistat? -- Lau G, Chan CL.

It may be prudent to monitor vitamin D concentrations in adolescents who take orlistat, even when a multivitamin is prescribed.
- Pharmacotherapy 2002 Jul;22(7):814-22 -- Effects of orlistat on fat-soluble vitamins in obese adolescents. -- McDuffie JR, Calis KA, Booth SL, Uwaifo GI, Yanovski JA.

A woman developed symptoms of constipation, polyuria, polydipsia, and increased lower-leg edema after 2 weeks of treatment with orlistat 120 mg 3 times daily. The drug was discontinued for 4 days and the symptoms resolved. On reinstitution of the orlistat treatment, the symptoms reappeared within 2 days. Thereafter, the medication was permanently discontinued. Common gastrointestinal adverse reactions associated with orlistat use include fecal urgency and abdominal pain and discomfort. Pedal edema has also been reported to occur, although less frequently.
- Ann Pharmacother 2002 Jul-Aug;36(7-8):1168-70 -- Constipation, polyuria, polydipsia, and edema associated with orlistat. -- Packard KA, Wurdeman RL, Reyes AP.

Consult with your physician if you are pregnant, planning to be or breastfeeding or if you have gastrointestinal problems before taking orlistat.





last update: November 2008



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