Orlistat is used for obesity management, including weight loss and weight maintenance. The medication is most effective when it is combined with a diet of a mildly reduced calorie intake. Orlistat is also used to reduce the risk of regaining weight for obese people after weight loss. This medication works by preventing fat from being absorbed from food. It is recommended only for people with an initial body mass index (BMI) of 30 or greater (or greater than or equal to 27 if the person has other risk factors such as high blood pressure, diabetes, or high cholesterol). Orlistat may also be used in combination with diabetes medications to improve blood glucose control for overweight or obese people with type 2 diabetes.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult dose is 120 mg three times daily with each main meal (with food or up to one hour after the meal). If a meal is occasionally missed or contains no fat, the dose of orlistat may be omitted.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Each capsule, with a turquoise cap and a turquoise body, with "Roche Xenical 120" printed in black ink, contains 120 mg of orlistat. Nonmedicinal ingredients: gelatin, indigo carmine, microcrystalline cellulose, povidone K30, sodium lauryl sulfate, sodium starch glycolate, talc, and titanium dioxide.

Orlistat should not be taken by anyone who has:

• chronic malabsorption syndrome
• cholestasis (a condition where bile excretion in the liver is stopped)
• an allergy to orlistat or any ingredient of the medication

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Your health professional may be able to help you deal with some of the effects.

The following side effects may go away as your body becomes used to the medication; check with your doctor if they continue or become bothersome.

More common
• gas with leaky bowel movements
• inability to hold bowel movements
• increases in bowel movements
• oily bowel movements
• oily spotting of underclothes

Less common
• abdominal pain or discomfort
• anxiety
• back pain
• menstrual changes
• nausea
• rectal pain or discomfort

Check with your doctor as soon as possible if any of the following side effects occur:

More common
• body ache
• cough
• fever
• headache
• nasal congestion
• runny nose
• sneezing
• sore throat

Less common
• tooth or gum problems
• troubled breathing
• wheezing

Rare
• bloody or cloudy urine
• change in hearing
• decreased energy
• difficult or painful urination
• earache
• frequent urge to urinate

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Fat intake: It is very important to follow dietary guidelines. The risk of side effects associated with the stomach (such as gas with leaky bowel movements or oily spotting of underclothes) increases when orlistat is taken with a high-fat diet. Your daily intake of fat should be distributed over three main meals.

Kidney stones: People with a history of kidney stones should use this medication with caution.

Vitamins: Orlistat has been shown to reduce the absorption of fat-soluble vitamins such as vitamin A, vitamin D, vitamin E, and vitamin K. Talk to your doctor or pharmacist about taking a multi-vitamin supplement. Take the vitamin at least two hours before or after taking orlistat, or at bedtime.

Pregnancy: The safe use of orlistat by women who are pregnant has not been established. This medication is not recommended for use during pregnancy unless the benefit clearly outweighs any potential risk.

Breast-feeding: It is not known whether orlistat passes into breast milk. This medication is not recommended for use by nursing mothers unless the benefits outweigh the risks.

Children and adolescents: The safety and effectiveness of orlistat have not been established for use by children and adolescents younger than 17 years. Its use by this age group is not recommended.

Orlistat may affect how cyclosporine and vitamin supplements work.

Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than that listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.