Active Ingredient: Orlistat
Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed.
Throw away any unused orlistat after the expiration date on the medicine label has passed. Keep track of your medicine. What happens if I miss a dose?
Take the missed dose as soon as you remember, but no more than 1 hour after eating a meal. If it has been more than an hour since your last meal, skip the missed dose and take the medicine at your next regularly scheduled time.
Do not take extra medicine to make up the missed dose. What happens if I overdose? What should I avoid while taking orlistat? Sibutramine can increase blood pressure and heart rate.
Other common adverse effects of sibutramine are dry mouth, anorexia, insomnia, irritability, and constipation. Case 2: Part 2 SK had only a partial improvement on the MAOI treatment, and subsequently, it was stopped but her weight gain was not alleviated.
She was ultimately treated with a complex polypharmacy antidepressant regimen with near remission of her symptoms.
Similar to Case 1, she was given metformin and orlistat with gradual, but not complete weight loss. To gain final remission of depression symptoms she was placed on a stimulant methylphenidate medication which was titrated to a moderate dose.
Her depression resolved and she continued to lose weight to her baseline level.
Orlistat, a fat or lipase blocker, has safety and efficacy data for use, up to two years.
Specifically, it inhibits gastric and pancreatic lipases by binding covalently to the serine residue at the active site of these enzymes. This allows fat not to be absorbed by the GI system when taken with meals. It decreases triglycerides, total cholesterol, and low-density lipoprotein cholesterol while increasing high-density lipoprotein cholesterol.
The drug also improves glycemic control.
The most common adverse effects are gastrointestinal, including increased defecation, soft stools, anal leakage, fatty or oily stools, and vitamin A and E deficiencies. Patients take orlistat 120 mg three times daily and must take a multivitamin to avoid deficiencies and eat a low-fat diet.
Two large placebo-controlled trials document the efficacy of orlistat use for up to two years. After one year, the orlistat group lost 10.
Patients must take other medications one hour before or after orlistat to avoid change in absorption. One study in the mentally ill reported that 13 consecutive patients with psychotropic-induced weight gain lost 34.
Nine of the 13 subjects suffered from major depressive disorder and were taking serotonergic antidepressants. The average weight gain from psychotropics prior to orlistat initiation was 16.