Therapeutic: weight-control agents
Pharmacologic: lipase inhibitors
Obesity management (weight loss and maintenance) when used in conjunction with a reduced-calorie diet in patients with an initial BMI ≥30 kg/m2 or ≥27 kg/m2 in the presence of additional risk factors (diabetes, hypertension, hyperlipidemia). Reduces the risk of weight regain after prior loss. May delay onset of type 2 diabetes in prediabetic patients.
Decreases the absorption of dietary fat by reversibly inhibiting enzymes (lipases), which are necessary for the breakdown and subsequent absorption of fat. Therapeutic Effects: Weight loss and maintenance in obese patients. Delayed onset of type 2 diabetes.
Adverse Reactions/Side Effects
With initial use; incidence decreases with prolonged use
GI: fecal urgency, flatus with discharge, increased defecation, oily evacuation, oily spotting, fecal incontinence.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Counsel patients about additional interventions to help control obesity and improve cardiovascular health, including dietary modification, regular exercise, moderation of alcohol consumption, and smoking cessation.
Advise patient about the likelihood of GI problems, including increased bowel movements, flatulence, and possible incontinence. Instruct patient to report severe or prolonged GI problems.
Absorption: Minimal systemic absorption.
Distribution: Action is local, within the GI tract.
Protein Binding: Minimally absorbed drug is >99% bound to plasma proteins.
Metabolism and Excretion: Major route is fecal elimination of unabsorbed drug.
TIME/ACTION PROFILE (effects on fecal fat)
|ROUTE ||ONSET ||PEAK ||DURATION |
Contraindicated in: Hypersensitivity; Chronic malabsorption syndrome or cholestasis; OB: Pregnancy or lactation.
Use Cautiously in: Pedi: Children <16 yr (safety not established).
Drug-Drug: Reduces the absorption of some fat-soluble vitamins and beta-carotene.
PO (Adults and adolescents ≥16 yr): 60–120 mg tid with each meal containing fat.
Capsules: 120 mg, 60 mg OTC.