Reviewed by Virginia Chachati MPharm
(2013, University College London)
GPhC Registration number: 2087654
Information last reviewed 06/04/21
Orlistat (generic Xenical.) is a type of weight-loss medicine that is prescribed to patients struggling with obesity. Taking orlistat in combination with a low-fat diet and regular exercise can help you lose weight effectively.
Orlistat 120mg is a prescription-only medicine that can only be prescribed by a doctor or healthcare professional. You can request to buy orlistat 120mg capsules from Dr Felix in pack sizes of 42, 84 or 168 capsules.
Doctors can prescribe orlistat to people with a BMI over 30. It can also be prescribed to people with a BMI over 28 who have certain risk factors such as high blood pressure.
Orlistat blocks an enzyme in the stomach from digesting fat. As a result, you cannot absorb at least a third of the fat you eat. This fat will be passed out of your body with your stools. You will lose weight if you follow a low-calorie, low-fat diet and exercise regularly alongside taking orlistat.
Orlistat can help you start losing weight within two weeks. You should try to weigh yourself regularly to monitor your weight loss. If you have not lost at least 5% of your initial body weight within 3 months, you should see your doctor. They may discuss your treatment plan and alternative weight-loss methods.
When using orlistat, you may want to weigh yourself weekly to see if there are any changes in your body weight. Orlistat should start working within two weeks, but it should be accompanied by a healthy diet and regular exercise.
Orlistat is prescribed to patients who are struggling with obesity and have failed to lose weight using other methods. Orlistat should never be used by someone who is not overweight or obese.
If someone you know may be struggling with an eating disorder, you can offer them support and suggest that they speak to a healthcare professional. This can be difficult, as people suffering from eating disorders may not be willing to accept help. Visit the Beat Eating Disorders website for advice on how to help if someone you know has an eating disorder.
The effectiveness of orlistat differs from patient to patient. Results are reliant on dietary changes and whether you are following an exercise programme.
You should see some weight loss after two weeks of taking orlistat. It is expected that you will lose at least 5% of your body weight after three months. If this does not occur, you should speak to your doctor to check if orlistat is suitable for you.
Dose |
One capsule with each of the 3 main meals each day |
Type of medicine |
Lipase inhibitor (fat-binder) |
Mechanism |
Blocks the body’s uptake of fats from food |
Available Size |
42, 84, 169 or 252 capsules |
Available Strengths |
120mg |
Active Ingredient |
Orlistat 120mg |
Price |
From 44p per tablet |
Side Effects |
Can include oily stools, headache, abdominal pain/discomfort |
The active ingredient in orlistat 120mg tablets is orlistat.
The inactive ingredients in orlistat are cellulose microcrystalline PH 112, sodium starch glycolate (type A), silica, colloidal anhydrous, sodium laurilsulfate, gelatine, titanium dioxide (E171) and indigo carmine (E132).
Please Note: Generic orlistat is made by a range of different manufacturers and may contain different ingredients than those listed above. Please check the patient information leaflet provided for further details.
Always take orlistat as instructed by your doctor. Orlistat should be taken in combination with a well-balanced calorie-controlled diet containing plenty of fruit and vegetables. You should also aim to consume about 30% of your calories from fat.
You should also try to distribute your daily intake of fat, carbohydrate and protein evenly across your three daily meals. Swallow one orlistat 120 mg capsule with water immediately before, during or within an hour of each meal. For best results, avoid eating fat-containing foods between meals, such as biscuits, chocolates and crisps.
If you miss a meal, or have a fat-free meal, you do not need to take an orlistat capsule. If you forget to take an orlistat capsule, try and remember to take it within an hour of your last meal. If an hour has already passed, just skip the dose and take your next one as planned with your next meal. Never take a double dose to make up for a missed one.
Your doctor or pharmacist will decide the dose of orlistat that is right for you. The usual dose is one orlistat 120 mg capsule three times a day, with each of your three main meals. If you eat fewer than three meals a day, you can take fewer orlistat tablets. Aim to take orlistat within 1 hour of every meal.
Orlistat can be continued for 12 months or longer if advised by your doctor. When taking orlistat, you should lose at least 5% of your initial body weight within three months. If this does not occur, you should speak to your doctor, who may discontinue orlistat sooner. Always take orlistat as prescribed.
If you want to stop taking orlistat, you should speak to your doctor. After finishing orlistat, you should try to maintain a balanced diet and exercise to avoid weight gain.
Before taking orlistat, your doctor will recommend a healthy diet that is low in fat and regular exercise. You should begin this diet and exercise regime prior to treatment, for the duration and after you finish taking orlistat. Orlistat works best with a calorie-reduced and low-fat diet.
Like all medicines, orlistat can cause side effects in some patients. If you feel unwell while taking orlistat, tell your doctor or pharmacist as soon as possible.
The most common side effects of orlistat include headaches, flatulence, abdominal pain and low blood sugar levels (experienced by some people with type 2 diabetes). It can also commonly cause oily or fatty stools, liquid stools, incontinence and bloating.
The risk of experiencing stomach side effects may be higher if you take Orlistat with a meal that’s very high in fat. For a complete list of possible side effects, please read the patient information leaflet.
Orlistat blocks the stomach and intestine from absorbing two thirds of the fat you consume. Therefore, side effects such as cramps, oily stools and diarrhoea are common.
To reduce these side effects, maintain a low-fat diet, eat smaller portions and limit yourself to three meals a day. Your meals should include wholegrains, fruits and vegetables, low fat dairy products and lean cuts of meat. You should also reduce the amount of dietary fat and high-fat snacks that that you consume.
You should not take orlistat if you are allergic to orlistat or any of the other ingredients in the capsules. It should also not be taken if you have cholestasis or chronic malabsorption syndrome. Breastfeeding women should also not take orlistat because it may be excreted in breastmilk.
Inform your doctor if you suffer from kidney problems, as orlistat can be associated with renal stones in patients with chronic kidney disease.
Before taking orlistat, let your doctor or pharmacist know if you are taking any other medicines, including those purchased over the counter at a pharmacy without a prescription.
Remember that weight loss may lead to the dose of your other medicines being changed. Medicines that can interact with orlistat include warfarin, ciclosporin, levothyroxine, amiodarone, and medicines used to treat HIV. For a complete list of interacting medicines, see the patient information leaflet.
If you experience severe diarrhoea whilst taking orlistat, it may reduce the effectiveness of the contraceptive pill. If this happens, you should use an additional contraceptive method.
Orlistat reduces how quickly you can break down alcohol, making you more likely to feel drowsy or intoxicated after drinking. You should avoid drinking alcohol immediately after taking orlistat.
Orlistat and Saxenda are currently the only weight-loss treatments recommended by doctors. You should not take these medications together. Other weight loss treatments should be avoided when taking orlistat, unless approved by your doctor or a pharmacist. Meal replacement products may be used help you maintain a low-calorie low-fat diet while using orlistat.
Orlistat is the generic version of Xenical. Both orlistat and Xenical contain the same active ingredient in the same amount. Therefore, there should not be any differences in their effectiveness. As a branded drug, Xenical is slightly more expensive than orlistat.
There are many weight loss treatments available over the counter and online, however, the safety and effectiveness of these products can vary considerably. Speak to a doctor or pharmacist to explore your options so you find the most appropriate weight loss medication.
Orlistat is available on prescription and in lower doses, over the counter. Alli is one of the products that contains a lower dose of orlistat. It contains only 60mg instead of 120mg.
Be aware of any product that claims to be a ‘quick fix’ or to help you lose weight without any dietary changes. These products are likely making false claims and could be dangerous. Seek professional advice if you are unsure.
Orlistat is not an appetite suppressant. Orlistat works by limiting your body’s absorption of fat through blocking fat-digesting enzymes directly.
Exercising regularly helps accelerate and maintain weight loss. You should begin exercising before taking orlistat, and continue throughout your treatment course.
Orlistat may cause changes to your period. If this happens, it could mean that your body is not absorbing enough of the nutrients it needs. For this reason, it is important to speak to your doctor and your treatment may need to be discontinued. If you are worried about disruptions to your menstrual cycle while taking orlistat, speak to your doctor for advice.
The amount of weight you can lose with orlistat is variable. To lose the most weight, you should follow a low-fat calorie-reduced diet and regular exercise programme. The initial weight-loss aim is 5 % of your overall body weight within the first three months. People with a higher body weight when they start taking orlistat, may lose more weight overall.
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