orlistat (Xenical, Alli)

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Introduction

Tradenames: Xenical, Alli (OTC). C29H53NO5.

Indications

* no long-term effectiveness[14]

Contraindications

malabsorption syndrome

Dosage

Xenical 120 mg. Alli 60 mg (OTC)[6]

Pharmacokinetics

not systemically absorbed

Adverse effects

(generally diminish with time)

Drug interactions

Mechanism of action

Notes

Alli (OTC) about $2/day (2007)[7]

More general terms

References

  1. Roche product information
  2. Kaiser Permanente Northern California Regional Drug Formulary, Update 9/99
  3. 3.0 3.1 Prescriber's Letter 8(9):50, 2001
  4. Journal Watch 22(17):132, 2002 Miles JM et al, Diabetes Care 25:1123, 2002
  5. 5.0 5.1 Journal Watch 25(14):111, 2005 Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005 Jun 15;293(23):2873-83. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15956632
    Joffe A. Pharmacotherapy for adolescent obesity: a weighty issue. JAMA. 2005 Jun 15;293(23):2932-4. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15956639
  6. 6.0 6.1 6.2 Prescriber's Letter 13(3): 2006 Acomplia (Rimonabant) and OTC Orlistat for Weight Loss Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220313&pb=PRL (subscription needed) http://www.prescribersletter.com
  7. 7.0 7.1 Prescriber's Letter 14(3): 2007 FDA Approves Orlistat for Over-the-Counter Use Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230310&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. Prescriber's Letter 14(7): 2007 OTC Orlistat (Alli) for Weight Loss: An Update Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230702&pb=PRL (subscription needed) http://www.prescribersletter.com
  9. 9.0 9.1 FDA MedWatch http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm180025.htm http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213448.htm
  10. 10.0 10.1 Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
  11. 11.0 11.1 Douglas IJ et al. Orlistat and the risk of acute liver injury: Self controlled case series study in UK Clinical Practice Research Datalink. BMJ 2013 Apr 12; 346:f1936. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23585064
  12. Hong J-L et al. Risk of colorectal cancer after initiation of orlistat: Matched cohort study. BMJ 2013 Aug 27; 347:f5039. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23982291 <Internet> http://www.bmj.com/content/347/bmj.f5039
  13. 13.0 13.1 Weir MA, Beyea MM, Gomes T et al Orlistat and acute kidney injury: an analysis of 953 patients. Arch Intern Med. 2011 Apr 11;171(7):703-4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21482850
  14. 14.0 14.1 14.2 14.3 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/

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