Thursday July 12, 2007
Xenical (alli) and other life saving drugs

Anti-obesity drug Xenical (Alli or orlistat) went over the counter with a big bang. Counters get cleared at major stores and pharmacies within hours.

It may be of importance to know its possible effect with warfarin (coumadin), cyclosporin and amiodarone. Alli is a reversible inhibitor of lipases. It forms a covalent bond with gastric and pancreatic lipases. The inactivated enzymes are thus unavailable to hydrolyze dietary fat in the form of triglycerides into absorbable free fatty acids and monoglycerides. As a side effect deficiency of fat-soluble vitamins like Vitamin A, D, E and K may occur. Recommendation is to take a multi-vitamin two hours before Alli. Patients on coumadin (warfarin) may have potential of bleed due to increase INR (as absorption of Vitamin K is decrease). We cannot find any mention in literature describing any such real case so far but frequent INR check is recommended for safety. Also to remember, Xenical can decrease the amount of cyclosporine and 25-30% reduction in systemic exposure to Amiodarone.


References: Click to see abstract/article

1. Mechanism of Action - Orlistat - Rxlist.com
2.Important Patient Information Patient Information about XENICAL - rocheusa.com
3.XENICAL - roche-australia.com