Orlistat Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Obesity

120 mg orally three times a day with each main meal containing fat. The dose may be taken during the meal or within 1 hour of completing the meal.

Usual Pediatric Dose for Obesity

12 years or older:
120 mg orally three times a day with each main meal containing fat. The dose may be taken during the meal or within 1 hour of completing the meal.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

If a meal is occasionally missed or contains no fat, the dose of orlistat may be skipped.

Precautions

The use of orlistat is contraindicated in patients with chronic malabsorption syndrome or cholestasis. Organic causes of obesity, such as hypothyroidism, should be excluded before prescribing orlistat.

Gastrointestinal effects may increase when orlistat is taken with any one meal high in fat.

Orlistat may reduce the absorption of some fat-soluble vitamins and beta-carotene. In addition, levels of vitamin D and beta-carotene may often be low in obese patients. To ensure adequate nutrition, supplementation with a multivitamin is recommended. The supplement should be taken at least two hours before or after the administration of orlistat, such as at bedtime.

Elevated levels of urinary oxalate may develop in some patients treated with orlistat. Cases of oxalate nephrolithiasis and oxalate nephropathy with renal failure have been reported. In patients at risk for renal impairment, it is recommended that renal function be monitored. Caution should be exercised when prescribing orlistat to patients with a history of hyperoxaluria or calcium oxalate nephrolithiasis.

Improved control of diabetes may accompany the weight-loss seen with orlistat. A dosage reduction of oral hypoglycemics or insulin may be needed.

There is an increased risk of cholelithiasis with substantial weight loss.

Dialysis

Data not available

Other Comments

Orlistat reduces the absorption of some fat-soluble vitamins, therefore, multivitamin supplementation is necessary. The multivitamin should be administered once a day, at least 2 hours before or after orlistat is taken.

The patient should be started on a nutritionally balanced, reduced-calorie diet that contains approximately 30% of calories from fat. The daily intake of fat, carbohydrate, and protein should be distributed over three main meals.

Dosages greater than 120 mg orally three times a day have not been shown to provide additional benefit.

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