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Xenical (Orlistat) is used with a low-calorie diet to help you lose weight and to maintain your weight after weight loss. Xenical is used in patients with a certain weight who may also have high blood pressure, diabetes, high cholesterol, or heart disease.

Xenicalt is in a class of drugs called lipase inhibitors. It works in your intestines, where it blocks some of the fat you eat from being absorbed and disgested. This undigested fat is then removed in your bowel movements.

Before taking orlistat,

• tell your doctor and pharmacist if you are allergic to orlistat or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, especially anticoagulants (''blood thinners'') such as warfarin (Coumadin); medications for diabetes, such as glipizide (Glucotrol), glyburide (DiaBeta, Dynase, Micronase), metformin (Glucophage), and insulin; other medications for weight loss; pravastatin (Pravachol); vitamins such as beta-carotene and vitamins A, E, and K; and herbal products. If you are taking cyclosporine (Neoral, Sandimmune), take it 2 hours before or 2 hours after orlistat.
• tell your doctor if you have or have ever had anorexia nervosa or bulimia, gallstones, thyroid disease, diabetes, kidney problems, or if you consistently have problems absorbing food (malabsorption syndrome).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

Follow the diet program your doctor has given you. You should evenly divide your daily intake of fat, carbohydrates, and protein over three main meals. If orlistat is taken with a meal very high in fat (30% total daily calories from fat), you may experience more side effects from the medication.

Xenical blocks your body's uptake of some fat-soluble vitamins and beta carotene. Therefore, when you use orlistat you should take a daily multivitamin supplement that contains vitamins A, E, K, and beta-carotene. Take the vitamin once a day, 2 hours before or 2 hours after taking orlistat, or take the vitamin at bedtime.

To help you get started on reducing the fat in your diet to about 30%, read the labels on all the foods you buy. While you are taking orlistat, you should avoid foods that have more than 30% fat. When eating meat, poultry (chicken) or fish, eat only 2 or 3 ounces (about the size of a deck of cards). Choose lean cuts of meat and remove the skin from poultry. Fill up your meal plate with more grains, fruits, and vegetables. Replace whole-milk products with nonfat or 1% milk and reduced- or low-fat dairy items. Cook with less fat. Use vegetable oil spray when cooking. Salad dressings; many baked items; and prepackaged, processed, and fast foods are usually high in fat. Use the low- or non-fat versions of these foods and/or cut back on serving sizes. When dining out, ask how foods are prepared and request that they be prepared with little or no added fat.

The most common side effect of orlistat is changes in bowel movement (BM) habits. This generally occurs during the first weeks of treatment; however, it may continue throughout your use of orlistat. Tell your doctor if any of these symptoms are severe or do not go away:

• orange or brown color of bowel movements
• urgent need to have a bowel movement
• increased number of bowel movements
• inability to control bowel movements
• oily, spotting bowel movements
• irregular menstrual periods
• gas with discharge
• oily or fatty stools
• an oily discharge
• stomach pain

If you experience any of the following symptoms, call your doctor immediately:

• difficulty breathing
• skin rash or hives
• redness of skin
• chest pain
• swelling
• itching
• fever

Keep all appointments with your doctor. Read the patient information before starting treatment with orlistat and each time you refill the medication.

You should also follow a program of regular physical activity, such as walking. However, before you start any new activity or exercise program, talk with your doctor or health care professional.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.