Lipase Inhibitors
Examples
Orlistat
Indications
Obesity - used in combination with a reduced calorie diet in patients with BMI of >30 or a BMI >28 with co-morbidities such as Type 2 Diabetes Meliitus, Hypercholesterolaemia or Hypertension.
Contraindications
- Cholestasis
- Chronic Malabsorption Syndrome
Cautions
Mechanism
Reversibly inhibits lipases by forming a bond with the active site of gastric and pancreatic lipases, thereby reducing the hydrolyzation and eventual absorption of dietary fats.
Administration
Oral
Adverse Reactions
Common:
- Abdominal Distension
- Abdominal Pain
- Anxiety
- Faecal Incontinence/urgency
- Flatulence
- Oily Stools
- Hypoglycaemia
Interactions
Orlistat may reduce the absorption of oral drugs given at the same time – so extra care should be taken with drugs with a narrow therapeutic index, antiretrovirals and antiepileptics.
Education
Vitamin D supplements should be considered alongside if fat soluble vitamin deficiency is a concern.
With those patients on concurrent oral medication, advise to take these at a different time from orlistat to prevent malabsorption of the medication.
Patients should concurrently be on a low fat diet as consumption of a high fat diet while on this medication will result in some deeply unpleasant bathroom effects.
Pharmacokinetics
Nil of note
