Orlistat 120 mg Capsule: Complete Guide to Weight Loss, Dosage & Side Effects

What is Orlistat 120 mg?

Orlistat 120 mg is an FDA-approved weight loss medication used in conjunction with a reduced-calorie, low-fat diet to help overweight and obese adults lose weight and maintain weight loss. Unlike appetite suppressants, orlistat works directly in the gastrointestinal (GI) tract to block the absorption of dietary fat.

🧬 How It Works:

Orlistat inhibits pancreatic and gastric lipases, the enzymes responsible for breaking down fat in the digestive system. When taken with meals, Orlistat prevents about 25–30% of dietary fat from being absorbed, and the undigested fat is excreted in the stool.

📋 Indications / Uses:

• Obesity management (BMI ≥30)
• Overweight individuals (BMI ≥27) with risk factors such as:
  • Type 2 diabetes
  • High blood pressure
  • High cholesterol
• Weight maintenance after initial weight loss
• Polycystic ovary syndrome (PCOS) (off-label use to support weight control)

💊 Dosage & Administration:

• Standard adult dose:
  🔸 120 mg capsule, taken three times daily
  🔸 Taken immediately before, during, or up to 1 hour after a meal containing fat
  🔸 Skip dose if a meal is missed or contains no fat
• Maximum daily dose: 360 mg (3 × 120 mg)

⚠️ Dietary Advice:

• Follow a low-fat, calorie-controlled diet
• Distribute fat intake evenly across meals to reduce gastrointestinal side effects
• Total daily fat intake should be <30% of total calories

⏱️ When to Expect Results:

• Weight loss starts within 2 weeks for most users
• Clinically significant weight loss (≥5% of body weight) often seen in 12 weeks
• Best results when combined with diet and exercise

⚠️ Side Effects:

✅ Common (GI-related and usually temporary):

• Oily or fatty stools (steatorrhea)
• Frequent or urgent bowel movements
• Flatulence with discharge
• Abdominal pain or cramping
• Diarrhea

These effects typically improve with a lower fat intake.

❗ Serious (Rare):

• Severe liver injury (extremely rare; monitor for yellowing skin, dark urine)
• Kidney stones (due to increased oxalate)
• Fat-soluble vitamin deficiency (A, D, E, K)

💊 Vitamin Supplementation:

• Take a multivitamin supplement containing A, D, E, K once daily
• Take it at least 2 hours before or after taking Orlistat (usually at bedtime)

🚫 Contraindications:

Do not use Orlistat 120 mg if you have:

• Chronic malabsorption syndrome
• Cholestasis (bile flow blockage)
• Known allergy to orlistat or capsule ingredients
• Pregnancy

⚠️ Use with Caution:

• Breastfeeding: Not recommended – unknown if passed in breast milk
• Diabetes: May require adjustment of hypoglycemic medications due to weight loss
• Thyroid problems: May reduce absorption of levothyroxine (space doses 4+ hours apart)
• Seizures: May alter antiepileptic drug levels in some patients

🔄 Drug Interactions:

Orlistat may reduce the absorption of:

• Fat-soluble vitamins (A, D, E, K)
• Cyclosporine (space dosing by at least 3 hours)
• Levothyroxine (space by at least 4 hours)
• Amiodarone, warfarin, and antiepileptic drugs (monitor levels)

🧪 Monitoring:

• Weight, BMI, waist circumference
• Liver function tests (if symptoms of liver injury appear)
• Blood sugar and lipid levels in patients with metabolic syndrome

📦 Storage:

• Store at 15–30°C (59–86°F)
• Keep in original container, tightly closed
• Protect from moisture
• Keep out of reach of children

📈 Effectiveness:

• Clinical studies show 5–10% weight loss over 6–12 months
• Also improves:
  • Blood cholesterol levels
  • Insulin sensitivity
  • Blood pressure
• Most effective when combined with diet, exercise, and behavior modification