Doctors may prescribe Xenical for weight loss to help patients diagnosed with obesity or weight-related health problems. Xenical is an FDA-approved medication with the active ingredient orlistat intended to be used in combination with a reduced-calorie diet to promote weight loss. This medication is also available as an over-the-counter medication called Alli. Common side effects associated with Xenical are oily, loose stools, and gas with oily discharge.
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What Is Xenical?
Xenical (orlistat) is a medication that is FDA-approved for the treatment of weight loss in combination with a reduced-calorie diet.1, 2 Having FDA approval means that it has been confirmed by regulatory bodies that the medication is both safe and effective for that specific purpose. It belongs to a class of medications called lipase inhibitors, and it works by blocking the absorption of dietary fats during digestion. Xenical is available as a generic as well as an over-the-counter drug.
How Does Xenical Work for Weight Loss?
Xenical helps to promote and maintain weight loss by decreasing the amount of dietary fat absorbed in the intestines. When taken with a meal, Xenical interferes with enzyme activity, which helps break down and eat the fats within your food, allowing some of the fat to pass through your body without being digested. This eventually leads to weight loss.1, 2
Who Might Benefit From Taking Xenical for Weight Loss?
Xenical is indicated for adult patients who are looking to lose weight and are classified as obese with an initial body mass index (BMI) of 30 or more may benefit from Xenical. Xenical is also approved for those with a BMI of 27 or more if they have other risk factors, such as hypertension, diabetes, and dyslipidemia. Current recommendations suggest that it may benefit those who have failed behavioral methods of weight loss but can demonstrate at least 2.5 kg weight loss by diet and exercise the month prior to starting Xenical.3
Side Effects of Xenical for Weight Loss
Xenical works on the digestion of fats within the body, so commonly, the side effects are associated with the fat that is not absorbed by the intestines. Loose, oily stools and more bowel movements are common side effects of Xenical. Some patients may experience serious side effects, such as gallstones, liver injury, and kidney stones. Patients may experience temporary effects when they start a medication that go away with continued usage, which is notably different from side effects, which typically persist up until the medication is stopped.
Common Side Effects of Xenical
Xenical is associated with increased fat in the stool, which can lead to loose stools and increased bowel movements. Oily discharge may occur where it may be clear or even orange or brown. These side effects do not typically need medical care, and approximately 50% of all episodes of gastrointestinal side effects associated with Xenical lasted for less than 1 week.1, 2
Common side effects of Xenical include:1, 2
- Oil spotting on underwear or clothes
- Gas with oily discharge
- Difficulty controlling bowel movements
- Fatty/oily stool
- Increased bowel movements
*All medications, including Xenical, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Serious Side Effects of Xenical
Xenical, like all medications, can have serious side effects. It can result in serious injuries to the liver or kidneys, which require medical intervention. Many of these side effects will cause a person to feel pain in their abdomen, a general sense of feeling unwell, and nausea or vomiting. If there are changes to your consciousness or you show signs of serious side effects, immediately call 911 or go to an emergency room.
Serious side effects of Xenical include:1, 2
- Severe liver injury or failure
- Allergic reactions
- Gallstones
- Kidney stones
- Kidney failure
- Lower intestine bleeding
*All medications, including Xenical, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
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Xenical for Weight Loss Warnings & Precautions
There are warnings and precautions associated with taking Xenical. It may be necessary to seek medical care for some of these warnings as they can result in serious harm or even death. The warnings associated with Xenical involve its potential for liver and kidney damage. It may also cause allergic reactions in those who are sensitive to Xenical or its components.
There is also a safety concern for those who are pregnant since there is a focus on minimum weight gain and no weight loss. If you have any concerns with Xenical and how it works for you, talk with your doctor.
Warnings and precautions for taking Xenical include:1, 2
- Allergic reactions: Some people may be sensitive to Xenical or its ingredients, resulting in an allergic reaction. Signs and symptoms of a serious allergic reaction include swelling of the face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; and very rapid heartbeat.
- Liver injury: Although rare, severe liver injury that may require liver transplants or result in death can occur in patients treated with Xenical. Patients should seek immediate medical care if they see any signs of liver dysfunction.
- Increased levels of oxalate: An increase in urinary oxalate levels following treatment with Xenical may result in kidney stones or kidney failure.
- Gallstones: Substantial weight loss can increase the risk of gallstones.
- Pregnancy: Xenical is not to be used during pregnancy. There is no potential benefit to pregnant women, and it may result in fetal harm.
- Decreased Vitamin Absorption: Xenical can cause reduced absorption of vitamins from food. Because of this, it is recommended that a fat-soluble multivitamin is taken while taking Xenical. These vitamins should be taken at least 2 hours before or after Xenical to prevent these vitamins from being blocked from absorption by the medication.
Interactions With Xenical
As with all medications, there is a potential for interactions between Xenical and other medications, herbals, and substances that may result in unintended effects. Taking the medications too close together can result in the other medications not working as intended, which can make the therapy ineffective. This can be especially dangerous, especially with medications like blood thinners and HIV medications. If you are starting a new medication, talk with a doctor and pharmacist to ensure that drug interactions are kept to a minimum.
6 substances you should avoid while taking Xenical include:1, 2
- Cyclosporine: When taken together, Xenical can lower the levels of cyclosporine within the body. Patients on this immunotherapy may be directed to administer cyclosporine 3 hours after Xenical.
- Levothyroxine: Hypothyroidism has been reported in patients who take this medication and Xenical. This medication should be taken at least 4 hours apart from Xenical. While on both medications, patients may have their thyroid functions monitored.
- Antiretrovirals: Xenical may prevent the absorption of antiretroviral medications, resulting in a loss of control for patients with HIV. A patient’s RNA levels may be monitored more frequently while taking Xenical.
- Blood thinners, including Warfarin: There may be a risk of increased bleeding due to decreased absorption of Vitamin K by Xenical. A patient’s coagulation levels may be monitored when taking blood thinners.
- Amiodarone: When taken with Xenical, amiodarone may not be absorbed properly, which can potentially cause amiodarone to be less effective.
- Antiepileptics: There have been reports of convulsions in patients treated with both Xenical and anti-seizure drugs. When starting Xenical, patients may be monitored for changes in severity and frequency of seizures.
This is not a comprehensive list of the possible interactions with Xenical. You should talk with your healthcare provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Xenical.
Xenical Dosages for Weight Loss
Xenical is available as a 120 milligram (mg) capsule to be taken by mouth. The recommended dose of Xenical is one capsule three times a day, with each main meal containing fat. Doses above 120 mg three times a day have not been shown to have extra benefits for patients. Dosages are meant to be taken with meals so that they can prevent the body from reducing the absorption of fat. It should be noted that dosages may vary from person to person, depending on a person’s individual factors, such as their dietary contents.
How Do I Take Xenical for Weight Loss?
Take Xenical by mouth up to 3 times a day with each main meal that contains fat. Capsules should be taken during or up to 1 hour after the meal. While on this medication, follow a nutritionally balanced, reduced-calorie diet where 30% of calories are from fats. If a meal is skipped or contains no fat, then the dose of Xenical can be omitted. It is important to take this medication as directed by your doctor to ensure your medication use is both effective and safe.
What Happens If I Miss a Dose of Xenical?
If you miss a dose of Xenical, take the dose as soon as you remember it. If it has been more than 1 hour since you ate a main meal, then skip the missed dose and continue on your regular dosing schedule. Do not take extra doses to make up for the missed one. Taking more Xenical than intended may result in unintended side effects.
If you have missed a dose and aren’t sure if you should take it, contact your pharmacist or healthcare professional.
How to Get Xenical for Weight Loss
Xenical is a weight loss medication that can only be obtained by prescription. A doctor or nurse who is contracted under a supervising physician can write you a prescription for this medication. Before writing you a prescription, the physician may ask you questions about your history of weight loss and see if you may be a good candidate for weight loss with Xenical, such as your dietary habits and exercise plan. They may also discuss other treatment options available to you. If you are interested in medications for weight loss, have a discussion with your doctor.
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Can You Buy Xenical Over the Counter?
Xenical can only be prescribed to you by your doctor. However, an over-the-counter medication with the brand name Alli has the same active ingredient, orlistat, and is used for weight loss. It can be purchased without a prescription in retail stores and pharmacies. Both medications work similarly to help patients lose weight. It is important to follow the instructions on the box or to use it as your doctor directs you.
Xenical Vs. Other Weight Loss Methods
There are several medications approved for weight loss available on the market. Medications work in different ways to promote weight loss, such as reducing appetite and limiting fat absorption. Also, a medical device called Plenity is available and is taken like an oral drug to promote fullness.
Wegovy and Saxenda are injectables that are effective for weight loss and are known to cause gastrointestinal side effects such as diarrhea, nausea, and vomiting. Ozempic contains the active ingredient semaglutide, which is the same active ingredient in Wegovy. Ozempic is not a medication meant for weight loss as it is approved by the FDA to control the blood sugar in type 2 diabetes. Wegovy is approved for weight loss.4, 5
Phentermine and Qsymia (phentermine-topiramate) are medications taken by mouth that have stimulating effects, working to decrease appetite and cravings. They commonly have the side effects of insomnia, dry mouth, and constipation. Imcivree is unique in that it is used in patients with specific rare genetic disorders that cause their obesity.
Contrave is another weight loss medication that is made up of a combination of two medications called bupropion and naltrexone. It is used in combination with diet and exercise, and insomnia, headache, and constipation are common side effects of Contrave. On all these medications, patients may lose 5% or more of their body weight, depending on individual factors. With so many options, it is important to discuss with your doctor if you are interested in weight loss.
Xenical in Combination With Lifestyle Changes
Adding Xenical to both diet and physical activity changes is effective for causing weight loss. It helps patients to lose more weight than if they were dieting alone. The drawback is that you may need to change what is in your diet outside of reducing calories. High amounts of fat could potentially worsen gastrointestinal side effects commonly seen with Xenical. Diet-related side effects may also last for hours, even 2 to 3 days, depending on how fast it takes the food to go through your intestines alongside your medication.
FAQs About Xenical
Below are some frequently asked questions that can help you guide your conversation with your doctor.
Is Xenical Better Than Alli?
Xenical and Alli are both effective medications used to aid weight loss when combined with dieting and exercise. They are medications that contain the same active ingredient, orlistat, with the difference being that Alli is a 60 mg capsule while Xenical is 120 mg. Xenical is also meant to remove 30% of dietary fats, while Alli removes 25%.2, 6 You may see faster results on Xenical, but they are both effective products for weight loss.7
How Effective Is Xenical for Weight Loss?
Xenical is proven to help obese patients with weight loss, especially in comparison to diet alone in the same group. The results were small but significant with a weight loss of around 3% more than people who only dieted. There was also a greater reduction in waist circumference with Xenical compared to placebo, which was about 0.7 to 3.4 cm.8
How Much Weight Can You Lose With Xenical?
How much weight you lose depends on personal factors such as if you have any health conditions, your age, and what other medications you are on. According to a study, Xenical patients saw a weight loss of 13.4 lbs and 5.8 lbs in the placebo-patients at the end of one year of treatment. Out of those who completed the treatment, 57% of patients on Xenical and 31% of patients on placebo saw at least a 5% weight loss of their baseline body weight.2
How Fast Does Xenical Work?
The effects of Xenical can be seen as soon as 24-48 hours after dosing. This medication works to block the absorption of fats within your digestive system, so it works as long as it takes for food to pass through the intestines. Upon consistent usage of Xenical, you may see results within a couple of weeks of using the medication.
Questions to Ask Your Healthcare Provider About Xenical for Weight Loss
Losing weight can be a challenging experience. If you are thinking of starting your weight loss journey, you should come to your appointment with a list of questions for your physician to answer. Together, you may be able to find which medications and weight loss plans fit with your lifestyle.
Questions to ask your care team about Xenical include:
- How safe is Xenical?
- How long will it take for me to adjust to taking Xenical?
- Am I at risk for more serious symptoms if I am already taking other medications?
- Will Xenical allow me to lose weight and keep it off long-term?
- How does Xenical compare to Alli?
- How much does Xenical cost me with my insurance?
- What should my diet look like to support my weight loss on Xenical?
- How long must I wait to see results from Xenical?
- How long can I take Xenical?
How to Know if Xenical Is Right for You
Xenical might be right for you if you follow a reduced-calorie diet. It is important to note that the benefits of this medication will be reduced without sufficient diet changes, as Xenical will block only a portion of your dietary fats. For specific factors, like if you meet the qualifications to be on this medication, talk with your doctor.
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