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There is a possibility of drug interactions, if certain medications are taken together. To avoid that kind of side effects, tell your healthcare provider about your weight loss plans before taking orlistat (prescription Xenical or over the counter Alli). He or she may decide to monitor you more closely, change some medicines you are already taking or adjust your dosages.
Some of the medicines that may interact with orlistat include:
Amiodarone
Orlistat can make amiodarone less effective, since it may interfere with the absorption of amiodarone from your digestive tract.
Cyclosporine
Orlistat can make cyclosporine less effective, if taken at the same time. Orlistat may decrease the absorption of cyclosporine into your body and your healthcare provider may recommend that you take cyclosporine at least two hours before or after orlistat in order to avoid this interaction.
Diabetes Medications
Often, when people with diabetes lose weight, their diabetes medications need to be adjusted (typically with lower dosages). In studies, many people who took orlistat were able to decrease (or even stop) their diabetes medications.
Thyroid Medications
While you are taking orlistat, your thyroid function should be monitored, because hypothyroidism (low thyroid function) has been reported in people who are also taking a thyroid medication.
Take orlistat and thyroid medications at least four hours apart, as this may reduce the chance of a drug interaction. However, your healthcare provider may still need to adjust the dose of your thyroid medication.
Vitamins
Orlistat blocks the fat and thus can decrease the absorption of fat-soluble vitamins, such as vitamin A, vitamin D, vitamin E, and beta-carotene from your food. You should take a multivitamin tablet (at least two hours before or after orlistat) to avoid vitamin deficiency.
Warfarin
Orlistat can affect the level of vitamin K in your body, which may affect the way you respond to warfarin. Your healthcare provider may need to monitor you more closely and adjust your warfarin dosage as necessary.
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