Xenical contains an active substance called Orlistat. Xenical is indicated for the treatment of obese patients who have a body mass index (BMI) ≥ 30 kg/m2. This medicine can also be used in patients with BMI ≥ 28 kg/m2 who have risk factors for cardiovascular and cerebrovascular diseases.

Xenical is almost never applied alone, but in combination with an appropriate hypocaloric diet. The therapy should be discontinued if after 3 months the patient did not lose more than 5% of the body weight measured at the beginning of the treatment.

Five clinical studies lasting two years showed that 37% of patients taking Orlistatsuccessfully lost more than 5% of body weight. After one year of treatment, as many as 20% of patients taking Xenical lost more than 10% of body weight compared to only 8% in the placebo group.

XenicalOrlistat has been declared the third most effective drug in treating obesity in 2017 (first place belonged to GarciniaCambogia).

Mechanism of Action

Xenical is a potent inhibitor of long-acting gastrointestinal lipases. It works in the lumen of the stomach and small intestine, where it binds to gastric and pancreatic lipases. By inactivatinglipases, the drug disables the degradation of fat to free fatty acids and monoglycerides, thereby preventing the absorption of fat.

Precautions

Xenical is contraindicated in the following conditions:

Chronic malabsorption syndrome. Orlistat may exacerbate the symptoms of this disease.
Cholestasis.
Breastfeeding.
A known allergic reaction to the active substance Orlistat.

Clinical studies have shown that weight loss is lower in patients with type 2 diabetes than in patients without diabetes. Patients who have type 2 diabetes and who lose weight may experience improved metabolism and thus leading to better regulation of blood sugar levels. It is therefore necessary to closely monitor theblood levels of sugar and adjust the dose of hypoglycemic drugs if needed.

The concomitant use of Xenical with the following drugs is contraindicated:

Cyclosporine – a drug used to prevent rejection of transplanted organ. Orlistatreduces the effectiveness of cyclosporine, which can lead to the rejection of the transplanted organ.
Leflunomide (Arava) – a drug used to treat rheumatoid arthritis. The simultaneous administration increases the risk of liver damage.
Teriflunomidea drug used to treat relapse of multiple sclerosis.The simultaneous administration increases the risk of liver damage.
Lomitapide and Mipomersendrugs used in patients who have high levels of cholesterol. The simultaneous administration increases the risk of liver damage.

Xenical may affect the efficacy of anticoagulant drugs (such as Warfarin) and caution should be exercised when these two drugs are administered concurrently. Orlistat can reduce the absorption of antiepileptic drugs that directly reduces their effectiveness, thus increasing the risk of epileptic seizures. This drug can also reduce the absorption and efficacy of HIV protease inhibitors (medicines used to treat HIV infection), therefore concomitant administration is not recommended.

Since Xenical can cause severe diarrhea, it can also reduce the effectiveness of oral contraceptive pills. For this reason, it is recommended that you use alternative contraceptive methods while using this medicine.

Studies have shown that Xenical reduces iodine absorption, which can cause hypothyroidism, or may worsen the condition in patients already suffering from hypothyroidism. Orlistat canalso cause gastrointestinal side effects, including abdominal pain, bowel urgency, oily rectal leakage, loose stools, increasedrate of defecation, flatulence, fecal incontinence, fatty stools,and rectal pain.The risk of these adverse effects is considerably higher if Xenical is taken with a fat-rich meal. For an average person whose daily needs are 2000 kcal, the daily intake of fat must not exceed 67 grams of fat, otherwise the risk of adverse effects is increased. Try to limit and divide fat intake evenly in all three meals.

There have been reported cases of increased oxalate excretion via urine, as well as cases of oxalate nephropathy in patients taking Orlistat. The risk of these side effects is higher in patients with chronic kidney disease.

Dosage

In adult patients, the recommended dose is 120mg taken with water, immediately before meals or within one hour after each main meal. If the meal is skipped or does not contain fat, the dose of Xenical should be omitted.

The patient must be on a hypocaloric diet with approximately 30% of the calories coming from fat while on the Xenical therapy.Diet should be rich in fruits and vegetables.

Doses greater than 120mg three times a day do not increase the efficacy of the drug. The maximum daily dose is 360mg and can easily be bought at meds4sure.com

Xenical should not be used in children, as well as in people who have severe liver or kidney damage.

Overdose

Xenical Orlistat has been used in healthy volunteers at doses of 400mg three times daily for 15 days, with no adverse events reported. Overdose is not expected, because administration of doses greater than 120mg does not exert any additional benefit.

However, if overdose occur, careful monitoring of the symptomsis recommended. In case of an overdose, supportive measures should be taken.

Pregnancy and Breastfeeding

There is insufficient data on the safety of Xenical use during pregnancy and breastfeeding. For this reason, the drug should not be used during pregnancy and breastfeeding. Animal studies have shown no harmful effect of Orlistat on embryo-fetaldevelopment.

Side Effects

In addition to gastrointestinal side effects, Xenical can also cause the following side effects:

Sinusitis
Pharyngitis
Laryngitis
Pneumonia
Stuffy nose
Back pain
Joint pain
Muscle pain
Pain in the legs
Tendon inflammation
Headache
Dizziness
Dry mouth
Anxiety
Depression
Urinary tract infections
Hypoglycemia
Elevated liver enzymes in the blood
Hepatitis
Oxalate nephropathy
Irregular menstrual periods
Inflammation of the vaginal mucosa
Middle ear infection
Allergic reactions, including bronchospasm and angioedema

Tell your doctor if you notice any side effects.

Drug Interaction

In addition to the above-mentioned interactions, the concomitant use of Xenical with the following drugs is also not recommended:

Amiodarone an antiarrhythmic drug. The simultaneous administration reduces the effectiveness of this medicine.
Entecavir and Boceprevirdrugs used to treat hepatitis B and C. The simultaneous administration reduces the absorption of these drugs, thereby reducing theireffectiveness in hepatitis treatment.
Bedaquilinea drug used to treat tuberculosis. The simultaneous administration increases the risk of hepatotoxic effects.
Naltrexone – a drug used to treat alcohol dependence. The simultaneous administration increases the risk of liver damage.
Epirubicina drug used to treat breast and lung cancer. The simultaneous administration increases the risk of liver damage.

Tell your doctor about all the medicines you are taking.