Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Orlistat

Klassificering: B

Preparat: alli, Beacita, Orlistat Ebb, Orlistat STADA, Xenical®

ATC kod: A08AB01

Substanser: orlistat

Sammanfattning

Det saknas publicerade kontrollerade studier om skillnader mellan könen avseende effekt av orlistat, förutom en studie med patienter som samtidigt behandlades med clozapin eller olanzapin. Dock är denna kombination speciell, vilket begränsar generaliserbarheten.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pharmacokinetics and dosing

After a single dose of 360 mg orlistat in obese/overweight patients (5 men, 3 women) no difference in concentrations of orlistat metabolites in urine was found between men and women [1]. No studies with a clinically relevant sex analysis regarding the dosing of orlistat have been found.

Effects

The only study found with a sex-analysis of orlistat effects was in a randomized prospective study combining orlistat with clozapine or olanzapine (41 men, 22 women). The study showed that men had significant weight-loss over time but not women [2, 3].The effect of orlistat on eating behavior 17 and 33 months after initial weight loss among patients was evaluated in a randomized controlled trial (149 men, 157 women). There was no difference between the sexes with regard to change in dietary restraint, disinhibition and binge eating [4].

Adverse effects

Results from a large retrospective cohort study (43 295 men, 150 677 women) examining the risk of colorectal cancer associated with orlistat treatment, showed no evidence of an increased risk in analyses stratified according to sex [5].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

In a Taiwanese study (269 men, 791 women), the one-year prevalence of orlistat use was higher among men than women [6].

In a review the rates of dropouts from large randomized controlled trials of weight loss drugs with adult participants and at least a 1-year duration were summarized. Study groups with a high percentage of women had a higher dropout, compared to groups with low-percentage of women [7].

Försäljning på recept

Fler kvinnor än män hämtade ut kapslar innehållande orlistat (ATC-kod A08AB01) på recept i Sverige år 2015, totalt 6 656 kvinnor och 2 704 män. Det motsvarar 1,4 respektive 0,6 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 50-59 år hos båda könen. I genomsnitt var kapslar innehållande orlistat 2,8 gånger vanligare hos kvinnor [8].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2014-05-15

Referenser

  1. Zhi J, Melia AT, Funk C, Viger-Chougnet A, Hopfgartner G, Lausecker B et al. Metabolic profiles of minimally absorbed orlistat in obese/overweight volunteers. J Clin Pharmacol. 1996;36:1006-11. PubMed
  2. Joffe G, Takala P, Tchoukhine E, Hakko H, Raidma M, Putkonen H et al. Orlistat in clozapine- or olanzapine-treated patients with overweight or obesity: a 16-week randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2008;69:706-11. PubMed
  3. Tchoukhine E, Takala P, Hakko H, Raidma M, Putkonen H, Räsänen P et al. Orlistat in clozapine- or olanzapine-treated patients with overweight or obesity: a 16-week open-label extension phase and both phases of a randomized controlled trial. J Clin Psychiatry. 2011;72:326-30. PubMed
  4. Svendsen M, Rissanen A, Richelsen B, Rössner S, Hansson F, Tonstad S. Effect of orlistat on eating behavior among participants in a 3-year weight maintenance trial. Obesity (Silver Spring). 2008;16:327-33. PubMed
  5. Hong JL, Meier CR, Sandler RS, Jick SS, Stürmer T. Risk of colorectal cancer after initiation of orlistat: matched cohort study. BMJ. 2013;347:f5039. PubMed
  6. Liou TH, Wu CH, Chien HC, Lin WY, Lee WJ, Chou P. Anti-obesity drug use before professional treatment in Taiwan. Asia Pac J Clin Nutr. 2007;16:580-6. PubMed
  7. Fabricatore AN, Wadden TA, Moore RH, Butryn ML, Gravallese EA, Erondu NE et al. Attrition from randomized controlled trials of pharmacological weight loss agents: a systematic review and analysis. Obes Rev. 2009;10:333-41. PubMed
  8. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk

Författare: Linnéa Karlsson Lind, Desirée Loikas

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson