Orlistat (Xenical)

Losing weight can be particularly challenging during menopause. Hormonal changes, a slower metabolism, changes in fat distribution, and sometimes fatigue all play a part. Orlistat can then be a useful aid for obesity or being overweight. 

This medication works locally in the intestines and ensures that part of the fat from food is not absorbed. This fat and the associated calories leave the body through the stool. 

Preparation and use  

Orlistat is taken three times a day with a 120 mg capsule. Swallow the capsule with water: 

• just before, during, or up to 1 hour after a meal; 
• only with meals that contain fat; 
• never take a double dose to make up for a missed dose. 

Always follow the dietary advice given by your doctor or pharmacist. Avoid high-fat meals and distribute fat, carbohydrates, and proteins evenly throughout the day. 

Stepwise dosing 

• Adults: 1 capsule of 120 mg with each main meal (breakfast, lunch, and dinner). 
• Use a maximum of 3 capsules per day. 
• After 12 weeks: consult your doctor. If you have lost less than 5% of your starting weight, the treatment is usually discontinued. 

Used too much?  

Contact your doctor or pharmacist. Possible complaints include abdominal pain, diarrhoea, and an increased risk of side effects. 

Missed dose 

• Up to 1 hour after the meal: take the capsule anyway. 
• More than 1 hour after the meal: skip the dose and continue with your normal schedule. 
• Never take a double dose. 

If you stop using Orlistat  

Do not stop using Orlistat without discussing it with your doctor. Only a doctor can assess whether it is safe and appropriate to discontinue the treatment. 

When should you not use Orlistat? 

Do not use Orlistat if you: 

• are allergic to orlistat or any of the excipients; 
• suffer from chronic malabsorption syndrome; 
• suffer from cholestasis (a liver disease); 
• are under 18 years of age; 
• are breastfeeding. 

Be extra cautious with Orlistat 

• Weight loss can affect the dosage of other medicines, such as those for diabetes or high cholesterol. 
• With a high-fat diet, there is a greater chance of oily stools and diarrhoea. 
• With severe diarrhoea or oily stools, the contraceptive pill may be less effective. In that case, temporarily use additional contraception, such as a condom. 
• Orlistat can increase the risk of kidney stones in people with existing kidney problems. 
• Do not use Orlistat during pregnancy. 

This is an overview of the most important warnings. The package leaflet contains a complete overview of all precautions. 

Use with other medications 

Always tell your doctor which other medicines you are taking. Orlistat can interact with, among others: 

• Acarbose (medicine for type 2 diabetes): concurrent use not recommended. 
• Anticoagulants (such as warfarin): blood clotting monitoring required. 
• Ciclosporin: concurrent use not recommended. 
• Iodine salts and/or levothyroxine: may lead to hypothyroidism. 
• Amiodarone: consult your doctor. 
• Anti-epileptics: absorption may decrease, risk of more seizures. 

In addition, Orlistat reduces the absorption of fat-soluble vitamins (including vitamin E and beta-carotene). A multivitamin may be recommended. 

Driving and use of machines 

Orlistat has no direct effect on your ability to drive. 

Side effects 

• Very common (≥1 in 10): headache, abdominal pain, flatulence with stool, oily/fatty stools, diarrhoea, low blood sugar in type 2 diabetes. 
• Common (≤1 in 10): pain or discomfort in the rectum, soft stools, (faecal) incontinence, bloating, dental or gum problems, irregular menstruation, fatigue. 

This list is not complete. An overview of all side effects can be found in the package leaflet. 

Serious side effects 

• Allergic reactions: itching, skin rash, swelling of the face, lips or throat, breathing problems. 
• Inflammation of the pancreas (pancreatitis) with severe abdominal pain. 
• Liver problems (hepatitis), sometimes with jaundice, dark urine, or pain in the upper abdomen. 
• Kidney stones or kidney problems (oxalate nephropathy). 
• Inflammation of the intestines (diverticulitis). 
• Effect on blood clotting when using anticoagulants. 

This list is not complete. An overview of all side effects can be found in the package leaflet. 

The active ingredient in Orlistat is orlistat.  
Each capsule contains 120 mg orlistat. 

Other ingredients: 

• microcrystalline cellulose; 
• sodium starch glycolate (type A); 
• colloidal anhydrous silica; 
• sodium lauryl sulphate; 
• gelatine; 
• titanium dioxide (E171); 
• indigo carmine (E132). 

Manufacturer  

Pharmaceutical Works Polpharma S.A.  
19 Pelplińska Street  
83-200 Starogard Gdański  
Poland 

Marketing authorisation holder: Sandoz B.V., Almere, Netherlands.