Orlistat
Mechanism :
A reversible inhibitor of gastric and pancreatic lipases, thus inhibiting absorption of dietary fats by 30%.
Indication :
Contraindications :
Hypersensitivity to orlistat or to any component of the formulation; pregnancy; chronic malabsorption syndrome; cholestasis.
Dosing :
≥12 years:
60-120 mg 3 times daily with each main meal containing fat (during or up to 1 hour after the meal); omit dose if meal is occasionally missed or contains no fat.
Adverse Effect :
Pedal edema, headache, anxiety, fatigue, sleepiness, xeroderma, hypoglycaemia, menstrual disease, oily rectal leakage, abdominal distress, abdominal pain, steatorrhea, faecal incontinence, rectal pain, cholelithiasis, back pain, leg pain, myalgia.
Interaction :
Anticonvulsants: Orlistat may decrease the serum concentration of Anticonvulsants.
Antiretroviral Agents: Orlistat may decrease the serum concentration of Antiretroviral Agents.
Levothyroxine: Orlistat may decrease the serum concentration of Levothyroxine.
Vitamin D Analogs: Orlistat may decrease the serum concentration of Vitamin D Analogs.
Vitamins (Fat Soluble): Orlistat may decrease the serum concentration of Vitamins (Fat Soluble)
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Unlikely to be dialysed. Dose as in normal renal function |
| HDF/High flux | Unlikely to be dialysed. Dose as in normal renal function |
| CAV/VVHD | Unlikely to be dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are needed. During treatment, if signs or symptoms of liver injury occur, discontinue treatment. Some guidelines suggest avoidance of orlistat and other weight-loss medications in patients with severe hepatic disease.