Alli (Orlistat)

What Is Alli (Orlistat)?

Alli is the over-the-counter (OTC) form of the drug orlistat, which is used to help people lose weight when combined with a low-calorie diet and an exercise program.
Orlistat is sold as Xenical in a prescription-strength formulation, and as Alli in the OTC form.
Alli contains one-half the dosage of orlistat as prescription-strength Xenical.
Alli is in a class of drugs known as lipase inhibitors, which work by preventing the fat you eat from being absorbed by the body.
The Food and Drug Administration (FDA) approved prescription orlistat in 1999. OTC Alli was approved in 2007.
Alli is manufactured by GlaxoSmithKline.
Both forms of orlistat have been the subject of controversy because of their possible risks and side effects.
In 2009, Consumer Reports advised people to avoid orlistat because of its side effects (including liver toxicity) and modest weight-loss results.
However, the European Medicines Agency (EMA) announced in 2012 that the small risk of liver disease was outweighed by the benefits of even modest weight loss.
A 2014 report in the journal Drug Safety found that orlistat "has a good safety profile, and serious adverse events (including reports of severe kidney and liver injury) are rare."
But the journal also noted that people are less likely to continue using orlistat because of its gastrointestinal side effects.

Alli Warnings

Before taking alli, tell your doctor if you have or have ever had:
  • An eating disorder such as anorexia or bulimia
  • Type 1 or type 2 diabetes
  • Kidney stones or kidney disease
  • Pancreatitis (inflammation of the pancreas)
  • Gallbladder disease
  • Thyroid disease
  • Liver disease
  • An organ transplant
  • Cholestasis (a condition where the flow of bile from the liver is blocked)
  • Malabsorption syndrome (a condition that causes problems with absorbing food)
This medicine might make it harder for your body to absorb vitamins A, D, E, and K.
You can take a multivitamin to counteract this effect, but make sure you take it at bedtime or two hours before or after taking Alli.
Alli is only part of a complete program that should involve diet, exercise, and weight control. Follow any dietary instructions your doctor gives you carefully.
When you take this medicine, divide the amount of daily fat, carbohydrates, and protein you consume into three main meals. Avoid foods that contain more than 30 percent fat.
It's dangerous to purchase this medicine over the Internet or from vendors outside of the United States.
Some samples of Alli that were purchased over the Internet contained sibutramine (Meridia), which can cause serious side effects in some people.
Alli should only be used by adults who are 18 years of age or older.
Don't share Alli with anyone else, especially someone with an eating disorder.

Pregnancy and Alli

Alli is dangerous to an unborn baby. Stop taking this medicine and call your doctor right away if you become pregnant.
The drug may make it harder for your body to absorb certain vitamins, which could affect a breastfeeding baby's diet.
If you're breastfeeding, talk to your doctor before taking Alli.

Alli (Orlistat) Side Effects

Common Side Effects of Alli

Tell your doctor if any of the following side effects are severe or don't go away:
  • Oily, fatty, or loose stools
  • Gas with oily spotting
  • Oily spotting on underwear or clothing
  • Urgent need to have a bowel movement or an increased number of bowel movements
  • Stomach pain
  • Pain in the rectum
  • Irregular menstrual cycles
  • Anxiety
  • Headache

Serious Side Effects of Alli

Tell your doctor right away if you experience any of the following serious side effects:
  • Hives, rash, or itching
  • Difficulty breathing or swallowing
  • Severe stomach pain
  • Severe fatigue or weakness
  • Nausea or vomiting
  • Loss of appetite
  • Pain in the upper right part of your stomach
  • Dark-colored urine or bloody urine
  • Light-colored stools
  • Yellowing of the eyes or skin (jaundice)

Alli (Orlistat) Interactions

Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking, especially:
  • Anticoagulants (blood thinners) such as warfarin (Coumadin)
  • Cyclosporine (Neoral, Sandimmune)
  • Medicines for diabetes such as glipizide (Glucotrol), glyburide (DiaBeta, Micronase), metformin (Glucophage), and insulin
  • Medicines to control blood pressure
  • Medicines for seizures
  • Medicines for thyroid disease such as levothyroxine (Synthroid)
  • Any other medications for weight loss

Alli and Other Interactions

Avoid a high-fat diet while taking Alli. Meals that are high in fat may increase your risk of experiencing unwanted side effects.

Alli (Orlistat) Dosage

Alli comes as a capsule and is usually taken three times a day with each meal that contains fat.
Take this medicine during a meal or up to one hour after a meal.
Skip your dose if you miss a meal or if a meal you consume doesn't contain fat.
Follow the instructions on your product label carefully when taking Alli. Don't take more or less of the drug than is recommended.

Alli Overdose

If you suspect an overdose, contact a poison control center or emergency room immediately.
You can get in touch with a poison control center at (800) 222-1222.

Missed Dose of Alli

If you miss a dose of Alli, take it as soon as you remember unless it's more than one hour since you consumed a main meal.
If it's longer than one hour since your meal, skip the missed dose and continue on your regular schedule.
Don't double up on doses to make up for a missed one.

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