Generic Name: Orlistat
Brand Name: Xenical
Classifications: gastrointestinal agent; anorectant; antiobesity agent; nonsystemic lipase inhibitor
Pregnancy Category:B
Availability
120 mg capsules
Actions Â
Nonsystemic inhibitor of gastrointestinal lipase. Reduces intestinal absorption of dietary fat by forming inactive enzymes with pancreatic and gastric lipase in the GI tract.
Therapeutic effects
Indicated by weight loss/decreased body mass index (BMI). Reduces the intestinal absorption of dietary fat because at least 95% of orlistat is eliminated in the feces; reduces caloric intake in obese individuals.
Uses Â
Weight loss and weight maintenance in patients with BMI >=30 kg/m2 or >=27 kg/m2 in patients with other risk factors. Reduce risk for weight regain after prior weight loss.
Contraindicatons
Hypersensitivity to orlistat; malabsorption syndrome; cholestasis; lactation; organic causes of obesity.
Cautious use Â
Gastrointestinal diseases including frequent diarrhea; known dietary deficiencies in fat soluble vitamins (i.e., A, D, E); pregnancy (category B). Safety & efficacy in children <18 y are not established.
Route & Dosage Â
Weight Loss
adult: PO 120 mg t.i.d. with each main meal containing fat
Administration
Oral
- Give during or up to 1 h after a meal containing fat.
- Omit dose with nonfat-containing meal or if meal is skipped.
- Store at 15°–30° C (59°–86° F). Keep bottle tightly close; do NOT use after the printed expiration date.
Adverse Effects
BodyWhole:Fatigue.
CNS:Headache, dizziness, anxiety.
CV:Hypertension, stroke.
GI:Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, fecal incontinence, abdominal pain/discomfort, nausea, infectious diarrhea, rectal pain/discomfort, tooth disorder, gingival disorder, vomiting.
Skin:Rash.
Urogenital:Menstrual irregularity.
Nursing Implications Â
Assessment & Drug Effects
- Monitor weight & BMI; closely monitor diabetics for hypoglycemia.
- Co administered drugs: Monitor PT/INR with warfarin.
- Monitor BP frequently, especially with preexisting hypertension.
Patient & Family Education  Â
- Take a daily multivitamin containing fat-soluble vitamins at least 2 h before/after orlistat.
- Remember common GI adverse effects typically resolve after 4 wk therapy.
- Avoid high fat meals to minimize adverse GI effects. Distribute fat calories over three main meals daily.
- Monitor weight several times weekly. Diabetics: Monitor blood glucose carefully following any weight loss.
- Do not breast feed while taking this drug.