hearing loss, painful or difficult urination along with
frequent urges to urinate, and ear pain and earache. If
these side effects do not subside, contact a medical
professional, especially with regards to abdominal
pain or severe diarrhea.
To minimize side effects, foods with a high fat
content should be avoided. Physicians recommend a
low-fat, reduced-calorie diet when taking ortistat. In
addition, a well balanced diet should consist of even
proportions ofcarbohydrates, fat, andproteinthat
are distributed throughout one day over three large
meals. If a main meal is missed or contains no fat, the
pill can be eliminated, too. It is recommended that
whole-milk products be replaced with nonfat milk or
1% milk and low-fat or reduced-fat dairy items. Baked
items and prepackaged, processed, and fast foods
should be avoided because they are usually high in
fat content. In general, people taking orlistat should
actively read food labels before buying and eating in
order to avoid foods high in fat.
Because orlistat can impair the absorption ofvita-
mins(especially A, D, E. and beta-carotene, which are
classified as fat-soluble vitamins) and other nutrients
into the body, a multivitamin should be taken daily, at
least two hours before or several hours after taking
ortistat, or at bedtime.
Interactions
Problems with interactions may arise if orlistat is
taken along with anticoagulants (blood thinners) such
as warfarin (CoumadinÒ). A physician should monitor
patients who are taking both drugs. Orlistat can
also cause problems with diabetic medicines such as
glipizide (GlucotrolÒ), glyburide (DiaBetaÒ, DynaseÒ,
MicronaseÒ), metformin (GlucophageÒ,DiabexÒ,
FortametÒ), and insulin. Diabetics should consult
with their doctor because the amount of oral diabetic
medicine may need to be changed when weight loss has
occurred.
Orlistat can also reduce the effectiveness of
cyclosporine while being taken as an immunosup-
pressant drug to reduce the body’s risk of organ
rejection after transplants. Make sure that cyclospor-
ine is taken at least two hours before or after the
taking of orlistat. The drug can also increase the
absorption of pravastatin (PravacholÒ, SelektineÒ),
which is used to improve cholesterol levels and to
prevent cardiovascular diseases.
The drug ortistat can also cause problems if other
medicines for weight loss are taken along with the
drug. According to the NIH, always consult with a
medical physician before taking orlistat and to inform
your doctor of any currently used medicines or allergic
reactions (such as with animals, foods, dyes, or pres-
ervatives) before starting ortistat. Pregnant and nurs-
ing women should not take orlistat. Anyone with
problems with an eating disorder, gallbladder, malab-
sorption syndrome (difficulty absorbing food), or kid-
ney stones should not take orlistat.Complications
The use of orlistat has been shown to increase the
risk of breastcancerand colon cancer. However, such
medical claims are preliminary in nature and further
scientific research is necessary. Orlistat has also been
shown to increase the risk for problems with the gall-
bladder and kidneys, along with complications in
pregnancies andbreastfeeding. It may cause compli-
cations if patients have problems withanorexia nerv-
osaor bulimia, and thyroid disease.Parental concerns
According to the Mayo Clinic, orlistat has only
been tested on adults. Information is not currently
available on how children are affected by orlistat. In
addition, studies performed on pregnant animals do
not show evidence of harm to fetuses. However,
according to the Mayo Clinic, orlistat is not recom-
mended for pregnant women. Also, due to lack of
medical studies, it is not recommended for women
who are nursing newborn babies. Proper dosage
amounts for children have not been determined.
When considering the use of orlistat for children, a
medical professional should be consulted as to the
amount given for each individual child.
On February 7, 2007, the FDA approved AlliÒas
an over-the-counter drug. AlliÒis a lower dose version
(60 milligrams) of the prescription drug XenicalÒ.
Made by GlaxoSmithKline PLC, it is the first weight
loss drug to be approved for over-the-counter (OTC)
use. Partially due to controversy with its release, when
buying AlliÒthe package also includes Welcome and
Companion Guides, a Calorie and Fat Counter, Quick
Fact Cards, a Guide to Healthy Eating, a Daily Jour-
nal, and free access to an online action program. The
company recommends AlliÒonly to people over the age
of 18 years. Consumer advocacy organizations, such as
Public Citizen, opposed the easy availability of AlliÒas
being potentially dangerous to the health of consumers.Resources
BOOKS
Bray, George A., and Claude Bouchard, eds.Handbook of
Obesity: Etiology and Pathophysiology. New York:
Marcel Dekker, 2004.Orlistat