Orlistat Diet Tablets, Prescription Only – How It Works

Orlistat Diet tabletsOrlistat is a weight loss medication that comes in two strengths. Full strength Orlistat, often distributed under the Xenical brand name, provides 120mg of Orlistat. The reduced strength version, called Alli, only contains 60mg of Orlistat.

Orlistat is a fat blocking drug that suppresses the abilities of the digestive enzymes the body uses for breaking down food-provided fat.

These enzymes are located in the intestines and normally break down dietary fats into molecules that are small enough to be absorbed through the intestinal walls. When people take Orlistat only 70% of dietary fat is absorbed. The other 30% passes through the intestines untouched and is passed with the stool.

Xenical is the brand name for Orlistat – if you were to be prescribed Orlistat in the UK, Ireland, USA, Canada or Australia it would most likely be Xenical. Read more on Xenical here

Orlistat v Alli

Orlistat (120mg) is only available to people who have a doctor’s prescription. Alli (60mg) can be obtained over-the-counter at pharmacies, but restrictions are in place and pharmacists have strict guidelines they must adhere to when considering selling Alli to their customers. Doctors have their own guidelines they must adhere to and they are stricter still.

Guidelines for Doctors Include:


·      The patient must be aged 28+
·      The BMI must be 30+
·      The patient must have a medical condition that is made worse/more dangerous by their obesity.


Guidelines for Pharmacists Include:


·      The customer must be aged 18+
·      The BMI must be 28+
·      The BMI must be checked each time Orlistat is requested.

Both strengths are designed to be used alongside diet and exercise, so the doctor/pharmacist will provide suggestions on this. If a patient fails to show a 5% decrease in body weight after 3 months of treatment the doctor will terminate the prescription, but if satisfactory results are apparent the prescription may be continued for several more months/years or until the patient reaches a healthy weight. The maximum Alli usage period is six months.

Usage Guidelines

Capsules can be taken up to 60 minutes before eating a meal and up to 60 minutes after a meal has been consumed. Three doses are required per day (breakfast, lunch, dinner). If a meal is missed, or provides a negligible amount of fat, the dose corresponding to that meal may be skipped because there will be no fat for the drug to block.

Orlistat By Prescription


Orlistat is unsuitable for certain types of people.

  • Women who are pregnant or nursing a child.
  • People suffering from kidney stones.
  • People who have an underactive thyroid.
  • People suffering from cholestasis.
  • People suffering from malabsorption syndrome.

Unfavorable Interactions & Other Considerations

Orlistat is not suitable for use alongside certain medications.

A few examples are:

  • Warfarin
  • Acarbose
  • Amiodarone
  • Ciclosporin
  • Some drugs used for treating epilepsy
  • Some drugs used for treating HIV or Aids

People who are using Orlistat may have to supplement their diet with extra vitamins because the drugs fat blocking abilities may lead to a deficiency in vitamins A, D, E, and K. All of which are fat soluble vitamins. Orlistat may also interfere with the way contraceptive pills work.

Potential for Side Effects

Flatulence and stomach pain are a possibility, but the main side effect likely to be experienced is greasy stools. Things may get more unpleasant if high amounts of fat are consumed while using the drug because it will have an increased quantity of fat to block and all that extra undigested fat in the intestines could seek its exit with little or no warning, leading to embarrassing situations.

Some research suggests a link between Orlistat usage and liver/kidney damage. An initial review conducted by the FDA brought to light 32 cases of serious liver injury and 6 cases of liver failure. A later review identified 13 instances of severe liver injury. Twelve of them were attributed to full strength Orlistat, the other was due to Alli. Two of the patients died and three of them had to undergo a liver transplant procedure.

However, more than 40 million people have used Orlistat without encountering such problems, so the FDA has not renounced its approval of the drug. The label has been revised though, and now draws attention to the fact that Orlistat may be damaging to important organs.

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