Side effects of the Xenical diet pills are associated mostly with its site of action – the gut. Oily spotting, flatus with discharge, fecal urgency, fatty/oily stool, oily evacuation, increased defecation & fecal incontinence are a few gastrointestinal side effects generally associated with this drug.

These and other commonly observed adverse reactions were generally mild. Over a period of a week most people get used to Xenical and the side effects largely disappear (to read visitor comments on Alli, the low dose, over the counter version of Xenical, click here!).  

One way of avoiding Xenical’s side effects is to limit the amount of fat in a meal. The gut disturbances are directly related to the fat content of a meal. Restricting fat content to 30% of total calories will decrease the side effects.

Other side effects of Xenical include a deficiency of fat-soluble vitamins like Vitamin A, D, E and K. Solution? A multi-vitamin taken two hours before Xenical can ensure that you do not become deficient.

Rare cases of hypersensitivity have been reported with the use of Xenical. Signs and symptoms of such include itching, rash, skin blebs, swelling of the lips and eyelids. In such cases, the drug needs to be stopped since repeated exposure in an allergic individual can cause shock and respiratory obstruction.

Xenical should not be taken by pregnant women and nursing mothers, as the drug may be excreted in their milk. It is not prescribed for children below the age of 12. The behavior of the drug in individuals above 65 years of age is also not clear and the drug is generally avoided in the elderly.

The drug should not be taken by people who have obesity as a result of a disease, such as hypothyroidism. Another consequence of decreased fat content (especially triglycerides), is an increased tendency to form gall-stones. Xenical is not a choice for persons with a past history of gall-stones or renal stones.

As with any weight loss agent, the potential exists for misuse of Xenical in people with eating disorders like anorexia nervosa or bulimia.

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Xenical diet pills belong to the class of weight loss drugs that work by inhibiting fat absorption in the gastrointestinal tract. Each Xenical diet pill is a capsule with 120 mg of white to off-white crystalline powder (these capsules also contain some inactive ingredients micro-crystalline cellulose, sodium starch, glycolate, sodium lauryl sulfate, povidone, and talc).

How does Xenical work?

Xenical inhibits the enzyme lipase that helps in the absorption of dietary fats in the stomach and the small intestine. The Xenical diet pills effectively inactivate the enzyme involved in the digestion of fats. As undigested fats are not absorbed, the resulting caloric deficit has a positive effect on weight control. Absorption of the drug is therefore not needed for activity. Therefore, systemic exposure to Xenical is minimal -in other words, the xenical doesn’t actually enter the bloodstream.

Xenical diet pills are indicated for weight loss and weight maintenance when used in conjunction with a reduced-calorie diet.

Xenical is also indicated to reduce the risk of weight regain after achieving weight loss. An initial body mass index of 30 kg/m2 (or 27 kg/m2 in the presence of other risk factors — hypertension, diabetes, and dyslipidemia), is generally seen as an indication to start Xenical drug therapy along with diet, lifestyle and activity modification (you can use this online calculator to determine your BMI!)

Xenical Contraindications:

Xenical is contraindicated in people who have an existing difficulty with digestion and absorption (chronic malabsorption syndrome).

Persons who demonstrate hypersensitivity to the drug — manifesting as rash, itching, transient blebs, eyelid or lip swelling — should also refrain from using Xenical diet pills for fear of inducing severe allergic reaction (anaphylaxis). Past history of renal or gall bladder stones is also a contraindication for the use of Xenical diet pills for fear of exacerbation or recurrence of the problem.

Use of Xenical diet pills is not recommended in pregnant women and nursing mothers, as the drug may be excreted in their milk. The use of obesity drugs is generally avoided in children below the age of 12 years.

Precautions:

Patients on the drug need to stick to dietary guidelines. Gastrointestinal side effects may increase when Xenical diet pills are taken with a meal high in fat (>30% total daily calories from fat). These can include “anal leakage.” Some users of Alli, the over the counter, low-dose version of Xenical have reported other side effects as well.  

The daily intake of fat should be distributed over 3 main meals. If Xenical is taken with any 1 meal very high in fat, the possibility of gastrointestinal effects increases.

When on therapy with Xenical, patients should take a multivitamin supplement that contains fat-soluble vitamins to counter the reduced absorption of fat soluble vitamins and beta-carotene (Xenical has been shown to reduce the absorption of some fat-soluble vitamins and beta-carotene).

In addition, the levels of vitamin D and beta-carotene may be low in obese patients compared with non-obese subjects. Therefore vitamin supplements should be taken once a day at least 2 hours before or after the administration of Xenical.

Xenical may be accompanied by improved control for diabetics, which might require a reduction in dose of oral diabetic medication.

Interactions:

Xenical interacts with a few drugs like warfarin (it increases its effect) and the antibiotic cyclosporine (it decreases the efficacy of the antibiotic). However, these are exceptions to the rule. Overall the Xenical diet pills do not have interactions with a wide spectrum of drugs

Dosage and Administration:

The recommended dose of Xenical is one 120 mg capsule three times a day with each main meal. The patient should be on a nutritionally balanced, reduced-calorie diet that contains approximately 30% of calories from fat. The daily intake of fat, carbohydrate, and protein should be distributed over 3 main meals. If a meal is occasionally missed or contains no fat, the dose of Xenical can be omitted.

Overdose:

As the systemic exposure (very little of the drug actually enters the bloodstream) to Xenical is minimal, complications due to overdose are rare. But if there is a significant overdose of xenical, the patient needs to be observed for 24 hours. Systemic effects of the lipase-inhibiting properties of Xenical are rapidly reversible.

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