Xenical (Orlistat) Dosage and Side Effects
XENICAL is used along with a mildly reduced calorie diet to assist in weight loss and to maintain the weight loss in obese patients and overweight patients who have health risk factors such as type 2 diabetes, high blood pressure, and blood lipid problems.
Warnings and Precautions
BEFORE you use XENICAL talk to your doctor or pharmacist and make sure they know if:
- you have ever had a bad reaction to orlistat (XENICAL) or any of the inactive ingredients of XENICAL
- you are allergic to other medicines, foods and dyes
- you are taking cyclosporine
- you are taking diabetes medicines such as insulin, metformin and/or a sulfonylurea
- you are taking any other medicines including those not prescribed by your doctor
- you always have problems absorbing your food (chronic malabsorption syndrome)
- you have bowel or rectal problems
- you have gallbladder problems
- you are pregnant, plan on becoming pregnant, or are breastfeeding
- you are taking birth control pills to prevent pregnancy. If you experience severe diarrhea, your birth control pills might not work as well and you might need to use an additional birth control method
- you are taking medicines to control seizures
- you are taking levothyroxine
Severe liver injury in patients taking XENICAL have been rarely reported. Promptly discontinue XENICAL and talk to your doctor if you have symptoms suggestive of liver impairment, such as loss of appetite, itching, yellowing of the skin, dark urine, light colored stools, or right upper quadrant pain that may be accompanied by nausea and vomiting.
This information will help your doctor and you decide whether you should use XENICAL, and what extra care may need to be taken while you are on the medicine.
Unwanted effects are possible with all medicines. Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking XENICAL.
The most common possible side effects from XENICAL are directly related to the way XENICAL works. By blocking the absorption of some dietary fat, it is likely that you will experience some change in bowel habits. These effects are generally mild and transient (occur for a short period of time). They can increase if you eat high fat foods. In clinical studies, only 3% of people experienced one of these effects more than twice:
- oily spotting
- gas with discharge
- urgent need to have a bowel movement
- fatty/oily stools
- oily discharge
- increased number of bowel movements
- inability to control bowel movements.
Due to the presence of undigested fat, the oil in your bowel movement may be clear, orange or brown in colour. These bowel changes are a natural effect of blocking the fat from being absorbed and indicate that XENICAL is working.
How can you deal with these unwanted effects?
- Unwanted side effects are more likely to occur if you eat meals that contain large amounts of fat. Sticking to a diet that contains no more than 30% of calories from fat in each meal will reduce side effects.
- Try to avoid eating fatty foods.
Some unwanted side effects may go away during treatment as your body adjusts to the medicine.
Pancreatitis (inflammation of the pancreas) has been reported with the use of XENICAL.
If You Have Type 2 Diabetes:
Also, symptoms of hypoglycemia (low blood sugar) may occur, such as:
Talk to your doctor for advice about how you can help avoid these symptoms and whether the dosage of the diabetes medications you may be taking might need to be lowered or discontinued.
Interactions with this medication
Drugs that may interact with XENICAL include cyclosporine, amiodarone, and levothyroxine.
If you experience severe diarrhea, your birth control pills might not work as well and you might need to use an additional birth control method.
Proper Use of this medication
Your doctor has prescribed XENICAL after carefully studying your case. Other people may not benefit from taking this medicine, even though their problems may seem similar to yours. Do not give your XENICAL to anyone else.
- Take one capsule (120 mg) during or just following each main meal (breakfast, lunch and dinner). Swallow the capsule whole along with some water. Take the capsule no later than 1 hour after the meal is eaten.
- For example, if you just finished eating lunch at 12:30 p.m., you should take your lunchtime dose before 1:30 p.m.
- XENICAL should be taken with a mildly reduced calorie diet that contains no more than 30% of calories from fat as recommended by your doctor, dietitian or other healthcare professional.
- XENICAL can reduce the absorption of fat-soluble vitamins and beta-carotene. In clinical studies, most people's vitamin and beta-carotene levels were within the normal range. However, your doctor may tell you to take a daily multivitamin supplement while taking XENICAL. If you are between the ages of 12 to 16, you should take a multivitamin while taking XENICAL. A multivitamin should be taken two hours before or after your XENICAL capsule, or at bedtime.
- If you occasionally miss a main meal or if your meal contains no fat, do not take your XENICAL capsule.
- Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
- You will not lose more weight or lose it more quickly if you take more XENICAL capsules than your doctor has instructed.
If You Have Type 2 Diabetes:
- Your reduced calorie diet should be consistent with the dietary recommendations of the Canadian Diabetes Association Guidelines for the Nutritional Management of Diabetes Mellitis in the New Millennium.
- You should talk with your doctor about diabetes medications you may be taking, as this dosage might need to be lowered.
Taking XENICAL can help you reach a healthier weight. This medicine works best when you take it as directed, eat less fat and become more physically active.
What else should you remember while you are taking XENICAL?
- As XENICAL works by partially blocking dietary fat absorption, the expected weight loss will not occur if you replace the fat calories with carbohydrates or protein.
- Eat foods from all food groups (for example, see “Canada's Food Guide to Healthy Eating”).
- Divide your day's calories and fat over 3 meals.
- Choose foods that have a lower fat content.
- Add less fat (butter, margarine or oils) to the foods you prepare.
- Develop healthy eating habits, like eating more fruits and vegetables.
- Gradually increase your physical activity as recommended by your doctor.
- If you have to go to the hospital or if you are given a new prescription medicine, you should tell the doctor(s) that you are taking XENICAL.
- Losing weight can affect the dose of other medicines you need, such as those for diabetes, high blood pressure or high cholesterol. Your doctor may need to adjust the doses of your other medicines. He or she may ask you to have regular blood tests to check your blood sugar and/or cholesterol level.
- If you have type 2 diabetes, you should follow the dietary recommendations of the Canadian Diabetes Association and test blood sugar and HbA1c levels regularly.
- If you forget to take a dose, it can be taken up to one hour after a meal and still be effective. Do not take double the amount if you miss one dose. XENICAL cannot work properly if many doses are missed.
In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.