Orlistat, also known as tetrahydrolipstatin, is the generic name for the brands, Xenical and Alli. It is intended as a treatment for obesity. Orlistat prevents the body from digesting and absorbing the fat from food, thus reducing the intake of calories. It is intended to be used along with a proper low-calorie dietary plan proposed by a physician. Orlistat was approved by the FDA as a prescription drug in 1999. In 2007, Alli, which is low dose form of orlistat, was approved as a non-prescription drug.
Function
The pancreas produces an intestinal enzyme called lipase, which breaks down the fat in food. Orlistat works by inhibiting lipase, so the fat in the food remains undigested and is excreted through the feces. A 60mg dosage of orlistat prevents 25% of the fat present in food from being digested, while the 120mg dosage prevents 30% of the fat from being digested. Increasing the dosage doesn't increase the efficiency of orlistat.
Dosage
Orlistat is available in the form of a capsule, meant to be taken before a meal or within an hour after a meal, three times a day. Xenical and Alli come in a standard 120mg and 60mg dose respectively. Orlistat works best for patients who maintain a low-calorie diet, which consists of no more than 30% of calories derived from the fat in the food. If a patient misses a meal or eats a meal that has no fat, then the dose of orlistat can be omitted.
Side Effects
Like all drugs, orlistat also has its side effects. Some side effects may not be reported. The most common side effects include: body ache, cough, fever, nasal congestion, increased bowel movements, and increased flatulence. The most noticeable side effect is the appearance of oily smudges on underwear. Other less common side effects include: tightness in chest, tooth problems, breathing problems, anxiety, back pain, and rectal discomfort. These side effects usually disappear within two weeks of stopping the use of orlistat.
Interactions
There are certain drugs that may cause adverse effects if used in conjunction with orlistat. People using levothyroxine, a thyroid hormone, along with orlistat have been reported to suffer from hypothyroidism. It is advisable that both medications be used no less than four hours apart. It has also been reported that the use of cyclosporine along with orlistat causes a reduction in the levels of cyclosporine present in the blood, making it ineffectual. There should be at least a two hour gap between the administration of cyclosporine and orlistat.
Precaution/Warning
Since orlistat prevents fat from being digested, it also prevents the absorption of some vital vitamins that are present in the fat. Patients suffering from obesity may also have a vitamin D and beta-carotene deficiency. Therefore, it is highly advisable for people suffering from obesity to complement the use of orlistat with a proper dietary plan which includes some form of multivitamin intake. There should be a gap of at least two hour between taking a multivitamin supplement and Orlistat.
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