2 March 2006

NPS recommends consumers exercise caution following a decision by the Federal Government's National Drugs and Poisons Schedule Committee to allow direct advertising of the weight loss drug, Xenical (orlistat).

NPS conducted an independent review of orlistat in 2004 when it was rescheduled from a prescription-only medicine to a pharmacist-only medicine and has since been available over-the-counter in pharmacies.

The NPS review, which was featured in the November 2004 issue of NPS RADAR, reports that orlistat produces average weight loss of up to 4.5 kg in the first year in addition to weight loss through lifestyle changes. The degree of weight loss reduces with time however, and orlistat will not help all patients achieve the weight loss required for improved health.

Furthermore, acting by reducing the absorption of dietary fat means the drug commonly causes gastrointestinal side effects such as steatorrhoea (oily stools) and incontinence and may also cause vitamin deficiencies.

The NPS review of orlistat concluded that diet, exercise and behaviour therapy are first-line treatment for overweight and obese patients.

“Pharmacists now have a greater role to play in advising patients on lifestyle changes. Setting realistic weight loss goals is the first step. Reducing daily energy intake, limiting alcohol, exercising regularly for at least 3-5 hours a week and commencing counseling are a few suggested measure.

Orlistat should be considered when lifestyle changes alone have been unsuccessful for obese (Body Mass Index (BMI) ≥ 30 kg/m2) or overweight people (BMI ≥ 27 kg/m2) with co-existing morbidities. Still, it is vital that lifestyle changes be maintained throughout the therapy period,” said Dr Peter Roush, Chair, NPS New Drugs Working Group and Brisbane GP.

Because orlistat can interact with some medicines, people are advised to inform their doctors if they are using it as part of their weight loss regimen.

ENDS

National Prescribing Service Limited (NPS) is a member-based organisation providing accurate, balanced, evidence-based information and services to health professionals and the community on Quality Use of Medicines (QUM). To achieve this we work in partnership with GPs, pharmacists, specialists, other health professionals, Government, pharmaceutical industry, consumer organisations and the community.