Xenical Online UK

Xenical contains orlistat, a gastrointestinal lipase inhibitor licensed for the treatment of obesity in conjunction with a mildly hypocaloric diet.

Orlistat acts locally in the gut by binding to gastric and pancreatic lipases, rendering them inactive and preventing the hydrolysis of dietary triglycerides into absorbable free fatty acids and monoglycerides.

Approximately 30% of ingested dietary fat passes through the gastrointestinal tract unabsorbed and is excreted in the faeces.

In clinical trials, patients taking orlistat 120 mg three times daily with meals lost approximately 2.7 kg more than those on placebo over 12 months.

Xenical is indicated for patients with a BMI of 30 kg/m² or above, or 28 kg/m² or above with associated risk factors such as type 2 diabetes, hypertension, or dyslipidaemia.

NICE recommends orlistat as a pharmacological option within a comprehensive weight management programme.

Treatment should be discontinued after 12 weeks if the patient has not lost at least 5% of initial body weight. The drug has negligible systemic absorption.

Take one 120 mg capsule with water immediately before, during, or up to one hour after each main meal. If a meal is missed or contains no fat, the dose should be omitted.

Do not take more than three capsules per day. Follow a nutritionally balanced, mildly hypocaloric diet with approximately 30% of calories from fat, distributed roughly equally across three meals.

Consuming a very high-fat meal substantially increases the risk of gastrointestinal side effects.

A daily multivitamin supplement containing fat-soluble vitamins (A, D, E, K) is recommended, taken at bedtime or at least 2 hours apart from orlistat.

Continue dietary and lifestyle modifications throughout treatment.

The standard dose is 120 mg three times daily with meals. No dose escalation is required or effective; higher doses do not provide additional weight loss.

No dose adjustment is needed for elderly patients or those with hepatic or renal impairment. Treatment duration is typically 6-12 months, subject to clinical review.

If less than 5% body weight loss is achieved after 12 weeks of consistent use, treatment should be stopped.

Orlistat may impair absorption of oral contraceptives during severe diarrhoea; additional barrier contraception is advised in this situation.

Gastrointestinal effects are the most frequently reported adverse reactions and relate directly to the pharmacological action of fat malabsorption.

Very common (≥1/10): Oily or fatty stools, oily spotting on undergarments, flatus with discharge, faecal urgency, increased defecation, abdominal pain.

Common (≥1/100 to <1/10): Faecal incontinence, liquid or oily stools, flatulence, soft stools, rectal pain or discomfort, headache, upper respiratory tract infection, influenza, hypoglycaemia in patients with type 2 diabetes, menstrual irregularity, anxiety.

Uncommon (≥1/1,000 to <1/100): Abdominal distension, tooth or gum disorder.

Rare (≥1/10,000 to <1/1,000): Hepatitis, cholelithiasis, diverticulitis, pancreatitis, allergic reactions (pruritus, rash, urticaria, angioedema, bronchospasm, anaphylaxis), oxalate nephropathy.

Gastrointestinal side effects can be minimised by adhering to a diet containing no more than 30% calories from fat.

Orlistat reduces the absorption of fat-soluble vitamins (A, D, E, K) and beta-carotene; supplementation is recommended.

It may reduce the absorption of levothyroxine, ciclosporin, and anticoagulants; separate dosing by at least 2 hours for levothyroxine and monitor INR closely with warfarin.

Rare cases of severe hepatotoxicity have been reported (MHRA Drug Safety Update); advise patients to discontinue treatment and seek medical attention if they develop jaundice, dark urine, pruritus, or abdominal pain.

Cases of oxalate nephropathy, particularly in patients with pre-existing renal disease or dehydration, have been documented. Adequate hydration should be maintained throughout treatment.

Xenical is contraindicated in patients with chronic malabsorption syndrome, cholestasis, known hypersensitivity to orlistat or any excipient, and during pregnancy and breastfeeding.

Patients taking ciclosporin should not use orlistat unless serum ciclosporin levels can be closely monitored, as absorption may be reduced.

It should not be used in patients with anorexia nervosa or bulimia.