Normofit (Orlistat)

Orlistat is indicated for conditions related to excess body weight and works by limiting dietary fat absorption.

• Obesity: helps achieve clinically significant weight loss when used with a calorie‑restricted, low‑fat diet.
• Overweight adults: assists in reducing body weight and improving metabolic parameters when dietary fat intake is controlled.
• Weight management: supports long‑term weight maintenance after initial loss in conjunction with lifestyle modifications.

• Orlistat acts locally in the gastrointestinal tract by covalently binding to the active sites of gastric and pancreatic lipases. This inhibition prevents the hydrolysis of dietary triglycerides into absorbable free fatty acids, thereby reducing the absorption of about 30% of ingested fat and decreasing caloric intake.

Orlistat may cause gastrointestinal and systemic reactions, most of which are related to its mechanism of reducing fat absorption.

Common Side Effects

• Oily spotting on undergarments: oily discharge after meals containing fat.
• Flatulence with oily discharge: increased gas with oily stool.
• Fecal urgency or incontinence: urgency to defecate after fatty meals.
• Increased stool frequency: more frequent bowel movements.
• Abdominal discomfort: cramping or pain.
• Reduced absorption of fat‑soluble vitamins: may require supplementation.

Serious or Rare Side Effects

• Severe allergic reactions: rash, itching, swelling, or anaphylaxis.
• Liver injury: rare cases of hepatitis or elevated liver enzymes.
• Pancreatitis: inflammation of the pancreas reported infrequently.
• Acute kidney injury: rare renal impairment.
• Severe gastrointestinal inflammation: colitis or ulcerative lesions.
• Persistent diarrhea leading to dehydration.

Before initiating therapy with Orlistat, several safety considerations should be observed.

• Assess BMI: confirm patient meets criteria for obesity or overweight treatment.
• Advise low‑fat diet: recommend ≤30% of total calories from fat to minimize side effects.
• Monitor vitamin levels: consider supplementation of vitamins A, D, E, K.
• Avoid in malabsorption syndromes: contraindicated in chronic malabsorption conditions.
• Caution with gallbladder disease: use only if benefits outweigh risks.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Orlistat can affect the absorption and efficacy of several concomitant medications.

Major Interactions (Avoid)

• Cyclosporine: reduced absorption may lower immunosuppressive effect.
• Levothyroxine: decreased absorption can compromise thyroid hormone replacement.
• Warfarin: potential alteration of INR, requiring close monitoring.

Moderate Interactions (Monitor Closely)

• Fat‑soluble vitamins (A, D, E, K): absorption reduced, consider supplementation.
• Oral contraceptives: efficacy may be diminished; advise backup contraception.
• Antidiabetic agents: possible increase in blood glucose levels; monitor glycemic control.