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.