Xenical (orlistat 120 mg) is a prescription-only lipase inhibitor indicated for weight management in adults with obesity or overweight with associated risk factors. It functions by blocking the absorption of approximately one-third of dietary fat, providing a non-systemic, mechanistically distinct approach to pharmacologic weight reduction. This medication is intended as an adjunct to a reduced-calorie diet, enhancing long-term weight loss and maintenance when combined with lifestyle modifications. Clinical trials demonstrate its efficacy in not only promoting significant weight reduction but also improving various obesity-related comorbidities.

Features

• Contains orlistat 120 mg as the active pharmaceutical ingredient
• Lipase inhibitor class; acts locally within the gastrointestinal tract
• Prevents dietary fat absorption by inhibiting gastric and pancreatic lipases
• Available in hard gelatin capsules
• Requires prescription; not available over-the-counter at this strength
• Manufactured under strict pharmaceutical quality standards

Benefits

• Achieves clinically meaningful weight loss when combined with diet and exercise
• Reduces absorption of dietary fats by approximately 30%
• Improves obesity-related parameters including waist circumference and BMI
• May positively affect lipid profiles and glycemic parameters in patients with comorbidities
• Supports long-term weight maintenance when used as part of comprehensive management
• Non-systemic mechanism with primarily local gastrointestinal effects

Common use

Xenical is indicated for obesity management in adults with a body mass index (BMI) ≥30 kg/m², or ≥28 kg/m² with associated risk factors such as hypertension, type 2 diabetes, or dyslipidemia. It is used alongside a nutritionally balanced, reduced-calorie diet containing approximately 30% of calories from fat. Treatment should be continued only if patients have lost at least 5% of their initial body weight within 12 weeks. The medication is typically prescribed as part of a comprehensive weight management program that includes dietary counseling, physical activity, and behavioral modification.

Dosage and direction

The recommended dose is one 120 mg capsule taken with water immediately before, during, or up to one hour after each main meal containing fat. If a meal is occasionally missed or contains no fat, the dose may be omitted. The capsule should be swallowed whole and not chewed or crushed. Maximum daily dosage should not exceed three capsules. Treatment should be initiated under medical supervision with appropriate dietary guidance regarding fat intake distribution.

Precautions

Patients should be advised to follow a nutritionally balanced, reduced-calorie diet with no more than 30% of calories from fat to minimize gastrointestinal adverse effects. Fat-soluble vitamin (A, D, E, K) levels should be monitored during long-term therapy, and supplementation may be required, taken at least 2 hours before or after Xenical administration. Use with caution in patients with history of hyperoxaluria or calcium oxalate nephrolithiasis. Not recommended for use during pregnancy or breastfeeding. Periodic monitoring of weight loss progress and potential adverse effects is essential.

Contraindications

Xenical is contraindicated in patients with chronic malabsorption syndrome or cholestasis. It should not be used by patients with known hypersensitivity to orlistat or any component of the formulation. Contraindicated in organ transplant recipients receiving cyclosporine therapy due to interaction potential. Not recommended for use in children under 12 years of age or patients with anorexia nervosa or bulimia.

Possible side effects

The most common adverse reactions are gastrointestinal in nature and result from increased fat content in feces: oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation, and fecal incontinence. These effects are generally mild to moderate, decrease with continued use, and are associated with high-fat meals. Other reported effects include abdominal pain/discomfort, nausea, infectious diarrhea, rectal pain/discomfort, tooth/gum disorder, headache, upper respiratory infection, and menstrual irregularity.

Drug interactions

Xenical may reduce absorption of fat-soluble vitamins (A, D, E, K) and beta-carotene; separate vitamin supplementation by at least 2 hours. May decrease plasma levels of cyclosporine; concomitant use is contraindicated. Can reduce absorption of amiodarone, anticonvulsants (particularly valproate), levothyroxine, and oral contraceptives; monitor therapeutic effect and consider separation of administration. May potentiate anticoagulant effect of warfarin; monitor INR regularly. Possible interaction with antidiabetic medications requiring dosage adjustment.

Missed dose

If a dose is missed, it should be skipped and the regular dosing schedule resumed with the next meal. Do not take a double dose to make up for a missed dose. The medication is only effective when taken with meals containing fat, so taking it without dietary fat provides no therapeutic benefit while potentially increasing side effect risk.

Overdose

Cases of overdose have been reported with doses up to 800 mg daily. The most likely manifestations are gastrointestinal events similar to the known adverse effects but potentially more severe. There is no specific antidote for orlistat overdose. Treatment should be symptomatic and supportive, with particular attention to maintaining hydration. Given its local mechanism of action, systemic toxicity is not expected even with substantial overdose.

Storage

Store at room temperature between 15-30°C (59-86°F). Keep container tightly closed and protect from moisture. Do not freeze. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly discard any unused medication according to local regulations.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Xenical is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual results may vary. Patients should consult their physician for proper diagnosis, treatment recommendations, and monitoring. Never disregard professional medical advice or delay seeking treatment based on information contained in this document.

Reviews

Clinical studies involving over 5,000 patients demonstrated that Xenical plus diet produced significantly greater weight loss than placebo plus diet at 1 and 2 years. In a 4-year study, Xenical produced mean weight loss of 5.8 kg vs. 3.0 kg with placebo at 1 year, with 2.7 kg vs. 0.4 kg maintained at 4 years. Patients also showed improvements in lipid levels, glycemic control, and blood pressure. Real-world evidence supports these findings, though individual responses vary based on adherence to dietary recommendations and lifestyle modifications.