Indications
- Adults: Olistat is indicated alongside a mildly hypocaloric diet for treating obese patients with a BMI >30 kg/m² and overweight patients (BMI >28 kg/m²) with associated risk factors like type II diabetes, hyperlipidemia, and hypertension. Discontinue treatment after 12 weeks if at least 5% of initial body weight isn’t lost.
- Adolescents (12 years & older): Consider Olistat for obese adolescents if diet and increased physical activity fail to achieve adequate weight reduction, especially in the presence of obesity-related complications.
Pharmacology
Orlistat acts as a potent, specific, and long-acting lipase inhibitor, primarily inhibiting gastric and pancreatic lipases. This inhibition prevents the hydrolysis of dietary fats into absorbable forms, leading to a caloric deficit and aiding weight control without systemic absorption.
Dosage & Administration
- Take one 120 mg capsule of Orlistat immediately before, during, or up to one hour after each main meal.
- Skip the dose if a meal is missed or fat-free.
- Avoid doses exceeding 120 mg thrice daily, as additional benefits haven’t been demonstrated.
Interaction
- Cyclosporine plasma levels may decrease when coadministered with Orlistat.
- Orlistat may interfere with the absorption of certain vitamins and medications, necessitating caution and monitoring.
Contraindications
Avoid Orlistat in patients with chronic malabsorption syndrome, cholestasis, or hypersensitivity to Orlistat or its components.
Side Effects
Common gastrointestinal side effects include oily spotting, flatulence, fecal urgency, and abdominal discomfort. Rare hypersensitivity reactions and systemic symptoms like influenza and headache may occur.
Pregnancy & Lactation
Orlistat is contraindicated during pregnancy (Category X) due to potential fetal harm. Use during lactation requires caution.
Precautions & Warnings
- Exclude organic causes of obesity before prescribing Orlistat.
- Avoid concurrent use of Orlistat and cyclosporine.
- Monitor diabetic patients closely during Orlistat therapy, as glycemic control may improve.
Overdose Effects
Significant overdose effects of Orlistat are unlikely, with observed doses up to 400 mg three times daily showing no significant adverse effects in human and animal studies.
Therapeutic Class
Orlistat belongs to the class of appetite suppressant drugs/anti-obesity drugs.
Storage Conditions
Store Orlistat in a cool, dry place below 30°C, protected from light and moisture, and keep out of reach of children.
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