Normostat (Orlistat)

Orlistat acts as a lipase inhibitor to reduce dietary fat absorption, supporting weight‑management strategies.

• Obesity: assists in achieving clinically meaningful weight loss when used with calorie‑restricted diet.
• Overweight: helps reduce body weight in overweight adults with associated risk factors.
• Weight management in adults with comorbidities: contributes to weight reduction that may improve metabolic parameters such as blood glucose and lipid levels.

• Orlistat binds covalently to the active sites of gastric and pancreatic lipases, inhibiting their ability to hydrolyze dietary triglycerides. This blockade prevents the breakdown of triglycerides into absorbable free fatty acids, resulting in a reduction of fat absorption of approximately 30% of ingested fat, thereby decreasing caloric intake and supporting weight loss.

Orlistat may cause gastrointestinal and metabolic reactions due to reduced fat absorption.

Common Side Effects

• Oily spotting: oily discharge from the rectum after bowel movements.
• Flatulence with discharge: increased gas accompanied by oily stool.
• Fecal urgency: sudden need to defecate.
• Increased defecation frequency: more frequent bowel movements.
• Abdominal pain: mild to moderate discomfort.
• Oily stool: pale, oily, and foul‑smelling stools.

Serious or Rare Side Effects

• Severe allergic reactions: rash, swelling, or anaphylaxis.
• Liver injury: rare cases of hepatitis or elevated liver enzymes.
• Pancreatitis: inflammation of the pancreas.
• Fat‑soluble vitamin deficiency: reduced absorption of vitamins A, D, E, K.
• Acute kidney injury: rare reports of renal impairment.

Before initiating therapy with Orlistat, consider the following precautions.

• Assess dietary fat intake: ensure patients follow a low‑fat diet to minimize gastrointestinal side effects.
• Monitor vitamin levels: supplement fat‑soluble vitamins (A, D, E, K) as needed.
• Evaluate for malabsorption syndromes: avoid use in patients with chronic malabsorption.
• Review concomitant medications: consider potential interactions that may affect drug efficacy.
• Counsel on gastrointestinal symptoms: educate patients about possible oily spotting and urgency.
• Store at ambient temperature: keep in the original packaging, protect from moisture and heat.

Orlistat can affect the absorption of several medications and nutrients.

Major Interactions (Avoid)

• Cyclosporine: reduced absorption may decrease immunosuppressive effect.
• Levothyroxine: decreased absorption can impair thyroid hormone replacement.
• Warfarin: altered absorption may affect anticoagulation control.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: reduced efficacy; consider alternative or supplemental contraception.
• Fat‑soluble vitamins (A, D, E, K): decreased absorption; monitor levels and supplement if needed.
• Antidiabetic drugs: potential improvement in glycemic control; monitor blood glucose.