Orlistat

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Alli, Xenical; Belgium: Alli, Xenical; Cyprus: Alli, Xenical; Czech Republic: Alli, Xenical; Denmark: Alli, Xenical; Estonia: Alli, Xenical; Finland: Alli, Xenical; France: Alli, Xenical; Germany: Alli, Xenical; Greece: Alli, Xenical; Hungary: Alli, Xenical; Ireland: Alli, Xenical; Italy: Alli, Xenical; Latvia: Alli, Xenical; Lithuania: Alli, Xenical; Luxembourg: Alli, Xenical; Malta: Alli, Xenical; Netherlands: Alli, Xenical; Poland: Alli, Xenical; Portugal: Alli, Xenical; Romania: Alli, Xenical; Slovakia: Alli, Xenical; Slovenia: Alli, Xenical; Spain: Alli, Xenical; Sweden: Alli, Xenical; UK: Alli, Xenical.

North America

Canada: Xenical; USA: Alli, Xenical.

Latin America

Argentina: Crisplus, Fingras, Frugal, Liposol, Oleofin, Xenical, Xinplex; Brazil: Xenical; Mexico: Amsafast, Lindeza, Lysthin, Redustat, Ventu, Xenical.

Asia

Japan: Xenical.

Drug combinations

Chemistry

Orlistat: C~29~H~53~NO~5~. Mw: 495.73. (1) L-Leucine, N-formyl-, 1-[(3-hexyl-4-oxo-2-oxetanyl)methyl]dodecyl ester, [2S-[2α(R*),3β]]-; (2) N-Formyl-L-leucine, ester with (3S,4S)-3-hexyl-4-[(2S)-2-hydroxytridecyl]-2-oxetanone. CAS-96829-58-2 (1991).

Pharmacologic Category

GI Drugs, Miscellaneous. Lipase Inhibitor. (ATC-Code: A08AB01).

Mechanism of action

Decreases intestinal lumen absorption of dietary fat (triacylglycerol) by reversibly inhibiting gastric and pancreatic lipase-mediated triglyceride hydrolysis (decreases intestinal concentrations of absorbable free fatty acids and monoglycerides). Decreases concentrations of LDL and total cholesterol. Variable effects on serum triglycerides and HDL-C.

Therapeutic use

Management of obesity (weight loss and weight management) when used in conjunction with reduced-calorie and low-fat diet.

Pregnancy and lactiation implications

There are no adequate studies in pregnant women. Not recommended for use during pregnancy. Excretion in breast milk unknown. Nursing not recommended.

Unlabeled use

Contraindications

Hypersensitivity to orlistat or any component of the formulation. Chronic malabsorption syndrome or cholestasis.

Warnings and precautions

Some patients may develop increased levels of urinary oxalate following treatment (caution if history of hyperoxaluria or calcium oxalate nephrolithiasis). Gastrointestinal adverse events may increase if taken with high-fat diet (>30% total daily calories from fat). If taken with any one very high-fat meal, possibility of gastrointestinal effects increases (daily intake of fat should be distributed over three main meals). Orlistat shown to reduce absorption of some fat-soluble vitamins and β-carotene. Patients who have had an organ transplant should not use orlistat. As with any weight-loss agent, potential exists for misuse in appropriate patient populations (e.g. patients with anorexia nervosa or bulimia).

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