1. Pay attention if you are taking orlistat Owing to orlistat ’ s mechanism of action, a decrease in the absorption of fat-soluble vitamins (vitamin A, D, E, and K) has been noted. This occurs because orlistat inhibits the lipase that breaks down fat-soluble vitamins into absorbable components. It is recommended that the patient take a multivitamin containing fat-soluble vitamins in order to ensure adequate intake. Multivitamin administration should be separated from orlistat by at least 2 hours or should occur at bedtime. Orlistat was found to decrease serum concentrations of amiodarone, cyclosporine, levothyroxine, and antiepileptic medications. It is recommended to separate doses of orlistat from cyclosporine by 3 hours and from levothyroxine by 4 hours. Patients who are taking antiepileptic medications concurrently should be monitored closely for any changes in frequency or severity of convulsions. Because of decreased vitamin K absorption, warfarin concentrations may also be affected, resulting in an increased international normalized ratio; patients should be monitored closely when this vitamin is taken with orlistat. It is also important to tell patients with diabetes who are taking orlistat that weight loss may increase the risk of lower blood sugar and that they should watch for signs of low blood sugar, such as dizziness, headache, feeling weak or shaky, sweatiness, or a

2. fast heartbeat. Orlistat is contraindicated in patients who are pregnant, have chronic malabsorption syndrome or cholestasis, or have known orlistat hypersensitivity. It is also important to tell patients with diabetes who are taking orlistat that weight loss may increase the risk of lower blood sugar and that they should watch for signs of low blood sugar, such as dizziness, headache, feeling weak or shaky, sweatiness, or a fast heartbeat. Orlistat is contraindicated in patients who are pregnant, have chronic malabsorption syndrome or cholestasis, or have known orlistat hypersensitivity. Reference 1."Orlistat: theoretical interaction with antiretroviral HIV medicines". MHRA. 13 March 2014. Retrieved 16 November 2014. 2. PDB: 2PX6​ ; Pemble CW, Johnson LC, Kridel SJ, Lowther WT (August 2007). "Crystal structure of the thioesterase domain of human fatty acid synthase inhibited by Orlistat". Nat. Struct. Mol. Biol. 14 (8): 704–9. doi:10.1038/nsmb1265. PMID 17618296. S2CID 2105534. 3. Heck, A. M.; Yanovski, J. A.; Calis, K. A. (March 2000). "Orlistat, a new lipase inhibitor for the management of obesity". Pharmacotherapy. 20 (3): 270–279. doi:10.1592/phco.20.4.270.34882. ISSN 0277-0008.

3. PMC 6145169. PMID 10730683. 4. Higham, George. "ᐅ Orlistat & Xenical: Do Weight Loss Pills Work? | e-Surgery". e-surgery. Retrieved 9 June 2020. https://www.cmoapi.com/ https://www.cmoapi.com/product/orlistat/ https://www.facebook.com/Cmoapi-114510347044359/ https://www.pinterest.com/cmoapibiotech/boards/