Orlistat

Question 1

When to give Orlistat 60mg

Answer 1

if BMI is above 28

Question 2

When to not give Orlistat

Answer 2

When taking:
- Levothyroxine
- Amiodarone
- Ciclosporin
- Warfarin + NOACs
- Acarbose
- Anti-epileptics

Question 3

How do Orlistat and Levothyroxine interact

Answer 3

reduces control of hypothyroidism

Question 4

How do Orlistat and Amiodarione interact

Answer 4

decreases plasma levels of orlistat

Question 5

How do Orlistat and Ciclosporin interact

Answer 5

decrease plasma levels of orlistat

Question 6

How do Orlistat and Warfarin and NOACs interact

Answer 6

INR affected by low vitamin K

Question 7

How do Orlistat and Anti-epileptics interact

Answer 7

increase risk of convulsions

Question 8

Why should you advice caution if a patient is taking orlistat and oral contraceptive

Answer 8

increase diarrhoea
- take antidiarrhoeal

Question 9

Why should you advice caution if a patient is taking orlistat and has ADEK vitamin deficiency

Answer 9

impaired absorption of fat soluble vitamins
- take vitamin supplements and night or 2 hour +- orlistat dose

Question 10

Which conditions should be a referral if a patient is in need of orlistat

Answer 10

• diabetes mellitus
• hypertension
• high cholesterol
• chronic malabsorption syndrome
• cholestatis (flow of bile from liver is blocked)
• pregnancy or breastfeeding
• kidney disease
• failure to lose weight after 3 months

Question 11

Orlistat OTC supply criteria

Answer 11

• BMI obove 28
• 18+
• 6 months in conjunction with lower fat diet

Question 12

How does Orlistat work

Answer 12

Potent lipase inhibitor, preventing absorption of dietary fat

Question 13

How to take Orlistat

Answer 13

ONE 60mg capsule TDS

• before three main meals or up to 1 hour after
• omit dose of meal had no fat or skipped

Question 14

Side effects of Orlistat

Answer 14

• oily stools
• faecal incontinece

Question 15

Advice when taking orlistat

Answer 15

• not a substitute for healthy diet and exercise
• 5 portions of fruit and veg
• 18 to 30g of fibre per day
• 2.5L of fluids
  -Alcohol 2 to 3 units a day interspaces with alcohol free days
  (14 units max)