potential for misuse and
drug interactions

alli^® has low potential for misuse and drug interactions because of its mechanism of action and minimal systemic absorption. The only known drug interactions can occur with cyclosporine and warfarin. The OTC label contains warning statements for these two drugs.

• Patients should not use alli if they have had an organ transplant or if they are taking medicine to reduce organ rejection
• Patients should not use alli if taking cyclosporine; alli can reduce levels of cyclosporine in the blood
• Patients on warfarin should be advised to talk with their doctor before taking alli; they will need to be monitored closely for changes in coagulation parameters and have their blood tested regularly, which is standard for any individual taking warfarin who is considering starting a new concomitant drug
• Patients taking medicine for thyroid disease should be advised to talk to their doctor before taking alli
• alli does not negatively interfere with diabetes medication; in fact, a clinical trial has demonstrated that patients taking orlistat have been able to reduce or discontinue their diabetes medicine¹
• No clinically relevant drug interactions were seen when alli was taken in combination with weight loss drugs, such as phentermine or sibutramine²

More important usage information

• A multivitamin containing vitamins A, D, E, K, and beta-carotene once daily at bedtime is recommended. Orlistat inhibits 25% of dietary fat, and may reduce the absorption of some fat-soluble vitamins. alli and a multivitamin should not be taken at the same time to gain the most benefit of a multivitamin. However, if they are taken at the same time, at least 70% of the fat-soluble vitamins would be absorbed
• Do not use if pregnant or breastfeeding
• Do not use if an individual has been diagnosed with problems absorbing food or is allergic to any of the ingredients in an alli capsule
• Do not use if BMI < 25
• Individuals should be advised to talk with their doctor before using alli if they have had gall bladder problems, kidney stones, pancreatitis or if severe abdominal pain occurs

References

1. Miles J, Leiter L, Hollander P, et al. Effect of orlistat in overweight and obese patients with type 2 diabetes treated with metformin. Diabetes Care. 2002;25:1123-1128.
2. Zhi J, Moore R, Kanitra L, Mulligan TE. Pharmacokinetic evaluation of the possible interaction between selected concomitant medications and orlistat at steady state in healthy subjects. Amer Coll Clin Pharmacol. 2002;42:1011-1019.