Drug reference

Orlistat

Statin · Anti-obesity agent

Also known as OBELIT, ORIDUCE, ZEROFAT

StatinAnti-obesity agent

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

Azole AntifungalsSevereTextbookG&G 14e · p736
ErythromycinSevereTextbookKDT 7e · p637
GemfibrozilSevereTextbookG&G 14e · p736
Hiv Protease InhibitorSevereTextbookKDT 7e · p637

Mechanism

Orlistat is an inhibitor of gastric and pancreatic lipase. It interferes with the digestion and absorption of dietary triglycerides by inhibiting their hydrolysis. This action reduces the absorption of dietary fat from the gastrointestinal tract.

Indications

Management of obesity in patients with a BMI of 30 kg/m2Management of obesity in individuals with a BMI of 28 kg/m2 in the presence of other risk factorsTo maintain weight lossObesity

Dosing

Adult: 120 mg with meals 3 times a day

Side effects

Common

Fluid motionsSteatorrhoeaAbdominal painNauseaFlatulenceVitamin deficiency

Drug interactions

Azole Antifungals

Severe

Textbook

Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.

Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy.

Source: G&G 14e · p736

Erythromycin

Severe

Textbook

Increased risk of myopathy and rhabdomyolysis.

Concomitant use should be avoided or used with extreme caution, especially for statins metabolized by CYP3A4. Dose reduction of the statin and vigilant monitoring for muscle symptoms are necessary.

Source: KDT 7e · p637

Gemfibrozil

Severe

Textbook

Increased plasma concentration of statin hydroxy acids, leading to an increased risk of myopathy (including rhabdomyolysis).

Avoid coadministration. The FDA withdrew approval for statin drug combinations containing fibrates in 2016.

Source: G&G 14e · p736

Hiv Protease Inhibitor

Severe

Textbook

Increased risk of myopathy and rhabdomyolysis.

Concomitant use should be avoided or used with extreme caution, especially for statins metabolized by CYP3A4. Dose reduction of the statin and vigilant monitoring for muscle symptoms are necessary.

Source: KDT 7e · p637

Hiv Protease Inhibitors

Severe

Textbook

Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.

Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy. For simvastatin, coadministration is contraindicated.

Source: G&G 14e · p736

Ketoconazole

Severe

Textbook

Increased risk of myopathy and rhabdomyolysis.

Concomitant use should be avoided or used with extreme caution, especially for statins metabolized by CYP3A4. Dose reduction of the statin and vigilant monitoring for muscle symptoms are necessary.

Source: KDT 7e · p637

Macrolide Antibiotics

Severe

Textbook

Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.

Source: G&G 14e · p736

Nefazodone

Severe

Textbook

Increased plasma concentrations of statins and their active metabolites, leading to an increased risk of myopathy and rhabdomyolysis.

Consider using pravastatin, fluvastatin, or rosuvastatin, as they are not extensively metabolized by CYP3A4. Carefully weigh the benefits against the risk of myopathy.

Source: G&G 14e · p736

Niacin

Severe

Textbook

Increased risk of myopathy.

Avoid coadministration. The FDA withdrew approval for statin drug combinations containing niacin in 2016.

Source: G&G 14e · p736

Nicotinic Acid

Severe

Textbook

Increased risk of myopathy and rhabdomyolysis.

A lower dose of statin is advisable when nicotinic acid is given concurrently. Close monitoring for muscle symptoms is essential.