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Orlistat

Xenical

Xenical is an FDA-approved medication that is indicated for use in the treatment of obesity, including weight loss and weight maintenance. The prescription medication contains orlistat as its active ingredient that helps the body prevent fats from being absorbed by the stomach and small intestines. In this manner, it can gradually aid in weight loss and calorie intake. The medication is usually taken three times a day while you are eating a meal or within one hour of eating. It is not recommended for use if you have chronic malabsorption syndrome, pregnancy, cholestasis, and a known hypersensitivity to the medication. Consult your doctor for personalized guidance and recommendations. 

Product Overview

Xenical is a prescription medication designed to aid in obesity management, including weight loss and maintenance. Its active ingredient, orlistat, blocks the absorption of fats in the stomach and small intestines, reducing calorie intake and assisting in weight control. This capsule is taken orally, three times daily, with meals that contain fat, and works best when combined with a healthy diet and regular physical activity.

Available in a 120 mg dosage, Xenical is suitable for adults and children over 12 years old struggling with obesity. It should be consumed during or up to one hour after a meal. If a meal is missed or contains no fat, the dose should be omitted. Consistent use as prescribed by a healthcare professional is crucial for safety and effectiveness.

Common side effects include gastrointestinal discomfort, such as oily stools, gas, and abdominal pain. It’s important to avoid high-fat meals to reduce these effects. Patients should not use Xenical if they are pregnant, have gallbladder problems, have chronic malabsorption syndrome, or have known hypersensitivity to orlistat. If a dose is missed, take it upon remembering unless it’s close to the time for the next dose—avoid doubling doses. Store the medication at normal room temperature, away from excess heat and moisture, and keep it out of reach of children. Consult with a healthcare provider for detailed guidance and to ensure safe and effective use.

Uses of Xenical

It is used for:

  • Obesity management, including weight maintenance and weight loss. 
  • Keeping the lost weight off for the long term. 

How to Use Xenical?

Dosage

It comes in the form of a capsule that is to be taken orally three times a day. It is available in the strength of: 

  • 120 mg

Recommended Dosage for Different Patients

For adults with obesity

  • 120 mg three times a day to be taken by mouth alongside a meal containing fat. 
  • The dose should be taken while you are having a meal or one hour after taking the meal. 

For children with obesity (12 years or older)

  • 120 mg three times a day to be taken by mouth alongside a meal containing fat. 
  • The dose should be taken while you are having a meal or one hour after taking the meal.

[Note: These recommendations may vary from person to person. Discuss them with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

  • Use Xenical exactly as your doctor prescribes, and carefully read the directions for use included with your prescription. 
  • If you have any query or concern regarding the medication, consult your doctor or a licensed healthcare professional. 
  • Do not use the medication in larger or smaller quantities or for longer than recommended. 
  • Do not share your prescription with anyone, even if they have the same symptoms as you. Never share it with people who have or had eating disorders. 
  • Xenical should be taken three times a day with meals that contain some fat. You may take the medication when you are taking the meal or after one hour of eating. 
  • If you have skipped a meal or that meal does not contain any fat, you can omit your dose for that meal. 
  • Xenical is only a part of your weight management plan, which includes exercise, weight control, and diet. 
  • Protein, fats, and carbohydrates should be evenly distributed in daily meals. Follow your diet and medication routine very carefully. 
  • Xenical can make it difficult for your body to absorb specific vitamins, and you may be required to take a supplement if your needs are not being met. 
  • It is crucial to keep track of your medication as Xenical is a medication that can be misused as a weight-loss drug. Be aware if anyone is using your medication without having a prescription. 
  • The medication should be stored at room temperature, away from direct light and heat. Keep the container of the medication tightly closed to avoid moisture. 
  • Do not use a medication that has passed its expiration date or is no longer needed. Safely discard such medications. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Xenical Work?

It works in your digestive system by blocking the absorption of about one-third of the fat from food by blocking lipases, the enzymes present in the stomach, and small intestines that are responsible for the breakdown of fat. This undigested fat does not get absorbed by your body and is excreted from your body in the form of feces. This helps you prevent gaining weight. However, this does not mean that it will necessarily cause you to lose weight. Hence, it is crucial to follow the recommended exercise routine and low-calorie diet plan for long-term weight management.  

Important Safety Information

Side Effects

Common side effects of Xenical may include: 

  • Gas with oily spotting from genitals 
  • Loose stools
  • More frequent bowel movements that are hard to control
  • Fatty or oily stool

Mild side effects of Xenical may include: 

  • Headache
  • Discomfort or pain in the stomach 
  • Rectal pain
  • Menstrual changes in women 
  • Nausea
  • Back pain

Adverse side effects of Xenical may include: 

  • More frequent or worse seizures
  • Severe or recurrent stomach pain
  • Liver injury. Symptoms may include- 
    • Loss of appetite
    • Discomfort or pain in the upper right stomach 
    • Pale-colored stools
    • Dark-colored urine
    • Yellowing of the skin or eyes
    • Itching
  • Kidney stones or kidney problems. Symptoms may include: 
    • Pain on the sides of your lower back
    • nausea/ vomiting
    • Blood in urine
    • Foul-smelling urine
    • Change in the appearance of urine

[Note: This list may not cover all possible side effects. Always consult with your healthcare provider for medical advice about side effects.]

Warnings

  • You should not take Xenical if you are pregnant. Losing substantial amounts of weight during pregnancy is not recommended as it may cause harm to the unborn baby and mother. 
  • You should not use this medication if you have gastrointestinal issues. 
  • Do not use this product if you use cyclosporine, had an organ transplant, or if you are obese or overweight. 
  • You should avoid meals that are high in fat alongside toxins as it can increase your risk of unwelcome side effects on your digestive system. 

Precautions

  • You should not use Xenical if you have a known hypersensitivity to orlistat or any of the ingredients present in the medication. 
  • It is not recommended for use in people with malabsorption syndrome. 
  • You should not use the medication if you have: 
  • Pregnancy 
  • Gallbladder issue
  • To make sure Xenical is safe for you, tell your doctor if you have ever had:
    • Gallbladder issue
    • Pregnancy
    • Kidney stones or kidney disease
    • Pancreatitis
    • Liver disease
  • Xenical is not approved for use by children less than 12 years old. 

Contraindications 

Xenical is contraindicated for use in patients who have:

  • Chronic malabsorption syndrome
  • Pregnancy 
  • Cholestasis
  • Known hypersensitivity to Xenical or any of the ingredients in the medication. 

Missed Dose

  • To get the best results from the medication, you must maintain consistency and take your medication as per your dosing schedule. 
  • If you miss a dose of Xenical, you should take it as soon as you remember. 
  • However, if it is time to take your next dose, you can skip the missed dosage and go back to your regular dosing schedule. 
  • Do not take double or extra doses of the same medication to compensate for the missed dose of Xenical, as it may have unwelcome side effects.  

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose 

You should not take Xenical more than prescribed by your doctor as it may cause unwelcome side effects. You should also not take it for longer than recommended. A possible side effect of an overdose of Xenical is significant liver damage. If someone has taken the medication more than prescribed, then they should be kept under observation for a day. If someone has overdosed on the drug and is having severe symptoms like difficulty breathing, seizures, and passing out, immediately call 911 or head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

  • Store Xenical in its original container at a controlled room temperature, away from excess heat, direct sunlight, and moisture. 
  • Keep all medications, including Xenical, away from the sight and reach of children and pets. 
  • Do not use medications that are outdated or no longer needed. Discard them properly. 
  • Do not flush or throw toxins in wastewater or household garbage. 
  • For more information on the safe disposal of the medication, contact your pharmacist or local waste disposal company. 

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Xenical Interactions

Xenical is an obesity management medication that may interact with the following drugs and affect how it may work: 

  • Cyclosporine: Cyclosporine levels are known to decrease when coadministered with Xenical. It is advised that cyclosporine should be administered at least 3 hours after Xenical to avoid reduced plasma levels and potential drug-drug interactions.
  • Levothyroxine: Co-administration with Xenical can lead to decreased absorption and potential hypothyroidism. To minimize interaction, levothyroxine should be taken at least 4 hours apart from Xenical, and thyroid function should be monitored regularly.
  • Amiodarone: Concomitant use of Xenical and amiodarone has shown a reduction in systemic exposure to amiodarone and its metabolite, desethylamiodarone. This may diminish the therapeutic effect of amiodarone. It is crucial to consider the potential reduction in amiodarone efficacy when starting treatment with Xenical.
  • Antiepileptic Drugs (AEDs): When taken with Xenical, the absorption of lipophilic AEDs such as vigabatrin, valproate, lamotrigine, and gabapentin may be reduced. This could lead to decreased plasma concentrations and an increase in seizure frequency or severity. Monitoring of serum AED levels is recommended.
  • Antiretroviral Drugs: There have been reports of loss of virological control in HIV-infected patients taking Xenical with antiretroviral drugs. Monitoring of HIV RNA levels is necessary, and discontinuation of Xenical should be considered if HIV viral load increases.
  • Warfarin and Other Anticoagulants: Xenical may decrease the absorption of Vitamin K, affecting prothrombin time and INR. Patients on stable doses of warfarin or other anticoagulants should be closely monitored for changes in coagulation parameters.
  • Vitamin Supplements: Xenical can decrease the absorption of beta-carotene and fat-soluble vitamins. To ensure adequate nutrition, patients should be advised to take a multivitamin supplement containing fat-soluble vitamins at least 2 hours before or after taking Xenical, preferably at bedtime.
  • Alcohol: No significant interaction has been observed between Xenical and moderate alcohol consumption; however, the overall effects of alcohol on weight loss should be considered.
  • Glyburide, Nifedipine, Oral Contraceptives, Phenytoin, and Pravastatin: Studies have shown that Xenical does not significantly alter the pharmacokinetics or pharmacodynamics of these drugs when coadministered.

[Note: This isn’t a complete list, and there could be other drugs that interact with Xenical. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Xenical Alternatives

  • Imcivree (setmelanotide)
  • Alli (orlistat) 
  • Contrave (bupropion-naltrexone)
  • Saxenda (liraglutide)
  • Qsymia (phentermine-topiramate)
  • Wegovy (semaglutide)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

How does Xenical interact with thyroid medications like levothyroxine?

Xenical can interfere with the absorption of thyroid medications such as levothyroxine, potentially leading to hypothyroidism. To minimize this interaction, it’s recommended that levothyroxine be taken at least four hours apart from Xenical. Regular monitoring of thyroid function is also advised to ensure the effectiveness of the thyroid medication.

Can Xenical affect the efficacy of oral contraceptives?   

Studies indicate that Xenical does not significantly alter the pharmacokinetics or pharmacodynamics of oral contraceptives. However, because Xenical can cause gastrointestinal side effects, which might lead to increased instances of diarrhea or vomiting, there could be a potential risk of reduced absorption of oral contraceptives. It’s important to consult a healthcare provider for advice on using additional contraceptive methods if severe gastrointestinal symptoms occur.

Is it safe to use Xenical while on antiretroviral therapy for HIV?

Xenical may impact the effectiveness of antiretroviral drugs. Some reports suggest a potential loss of virological control in HIV-infected patients taking Xenical alongside antiretroviral medications. It’s crucial to monitor HIV RNA levels regularly, and consultation with a healthcare provider is essential to determine if Xenical is appropriate for use in this context.

What are the considerations for using Xenical with antiepileptic drugs?

The absorption of lipophilic antiepileptic drugs (AEDs), such as vigabatrin, valproate, lamotrigine, and gabapentin, may be reduced when taken with Xenical. This reduction can lead to decreased plasma concentrations of the AEDs and potentially increase seizure frequency or severity. Monitoring serum levels of AEDs is recommended for patients using these medications concurrently with Xenical to ensure their therapeutic levels remain effective.

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