Orlistat (Xenical) is a gastrointestinal lipase inhibitor used for obesity management, including weight loss and weight maintenance. It works by inhibiting the absorption of dietary fats and must be used in combination with a low-calorie diet.
How to Use Orlistat (Xenical)
Administration Time and Frequency
Take one 120mg capsule during each main meal (containing fat) or within 1 hour after the meal, with a maximum of 3 times per day. If a meal contains no fat or is missed, skip the corresponding dose.
Adhere to a nutritionally balanced, low-calorie diet. Daily fat intake should not exceed 30% of total calories (e.g., no more than 50 grams of fat in a 1,500-calorie daily diet).
Management of Missed Doses
If a dose is missed, do not make up for it. Take the next dose as scheduled.
Vitamin Supplementation
Orlistat reduces the absorption of fat-soluble vitamins (A, D, E, K) and beta-carotene.
Patients need to take a daily multivitamin supplement, and the supplement should be taken at least 2 hours apart from Orlistat (e.g., taken before bedtime).
Dietary Coordination
Avoid high-fat diets (fat content > 30% of total calories per meal), as this may worsen gastrointestinal adverse reactions (such as oily stools, urgency to defecate, etc.).
Dosage Adjustment of Orlistat (Xenical)
Adjustment for Combined Medication
Cyclosporine: Administer cyclosporine 3 hours after Orlistat to avoid a decrease in cyclosporine blood concentration.
Levothyroxine: Take levothyroxine at least 4 hours apart from Orlistat, and monitor thyroid function.
Warfarin: Closely monitor coagulation parameters, as Orlistat may affect vitamin K absorption.
Antiepileptic drugs: Orlistat may reduce the efficacy of antiepileptic drugs; be alert to changes in the frequency of epileptic seizures.
Orlistat (Xenical) Use in Special Populations
Pregnant and Lactating Women
Contraindication: Orlistat is contraindicated during pregnancy, as weight loss is not beneficial and may be harmful to the fetus.
The safety of Orlistat during lactation has not been confirmed; carefully weigh the pros and cons before use.
Pediatric Patients
Adolescents aged 12-16 years: Can be used for patients with a BMI ≥ the 95th percentile for their age, with the same dosage as adults. Vitamin supplementation and behavioral intervention are required.
Children under 12 years: The effectiveness has not been established.
Patients with Hepatic or Renal Impairment
Hepatic impairment: Rare cases of severe liver injury have been reported. If jaundice, abdominal pain, or other symptoms occur, discontinue use immediately and check liver function.
Renal impairment: May increase the risk of oxalate nephropathy; monitor renal function, especially in patients with a history of kidney stones.
Patients with Chronic Diseases
Diabetic patients: Weight loss may improve blood glucose control; adjust the dosage of hypoglycemic drugs if necessary.
HIV-infected patients: Combined use with antiretroviral drugs may lead to failure of viral control; frequently monitor HIV RNA levels.
