Can I get it?
Yes, if a doctor decides it is right for you. Orlistat 120mg is authorised in the EU and can be prescribed after a medical review.
Orlistat 120mgPrescription only
Online medical consultation for Orlistat 120mg.
An EU-licensed doctor reviews your case and, if eligible, issues an electronic prescription valid at any EU pharmacy under Directive 2011/24/EU.
- A capsule — no injections
- Acts locally in the gut, not system-wide
- An alternative when GLP-1s aren't the right fit
Start consultationStart consultation · €25/month
Full refund if a review is not approved · Medication, if prescribed, is dispensed and paid for separately at a pharmacy.
IN PLAIN TERMS
What Orlistat 120mg is, and how to get treatment
Orlistat is a capsule you swallow with meals. It is not a hormone and does not act on the brain or on appetite: it blocks the gut enzymes that digest fat, so roughly a third of the fat in a meal leaves the body in the stool instead of being absorbed. In the EU it is sold as Xenical and is taken alongside a slightly reduced-calorie, lower-fat diet. Because that undigested fat has to go somewhere, oily, loose or urgent bowel movements are common, and they are more likely after a fatty meal.
Orlistat 120mg has been authorised for use in the EU since 29 July 1998, so a licensed doctor can prescribe it when it is clinically appropriate for you.
What can I take instead?
Our doctors review every Weight loss option and recommend what fits your history and goals.
See all Weight loss optionsWhat do the studies show?
Every trial behind Orlistat 120mg is listed below with how many people took part and whether the results are peer-reviewed or a company announcement.
Jump to the studiesVERIFIED EVIDENCE
Orlistat 120mg: evidence and regulatory guide.
WHAT IT IS
How it works
It blocks the enzymes in the stomach and gut that break down fat, so about a third of the fat in a meal passes through the body instead of being absorbed.
DEVELOPMENT STAGE
EU-authorised medicine
Trial register2 registered trials
Every NCT identifier links to its ClinicalTrials.gov record. A readout is not the same as peer-reviewed publication.
| TRIAL / NCT | POPULATION | PARTICIPANTS | STATUS | READOUT / COMPLETION |
|---|---|---|---|---|
| XENDOS | Adults with a BMI of 30 kg/m² or more with normal (79%) or impaired (21%) glucose tolerance; all made lifestyle changes | 3,305 | Read out | 2004-01-01 |
| European Multicentre Orlistat Study | Adults with a BMI of 28–47 kg/m² recruited at 15 European centres, on a mildly reduced-calorie diet | 743 | Read out | 1998-07-18 |
What the studies reported
Results are grouped by source and evidence grade so journal data and manufacturer announcements cannot be confused.
Peer-reviewed
Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study. Diabetes Care. 2004;27(1):155-161. doi:10.2337/diacare.27.1.155 (PMID 14693982)| DOSE OR GROUP | MEAN WEIGHT CHANGE | WEEKS |
|---|---|---|
| 120 mg three times daily | −5.8 kg | 208 |
| Placebo | −3.0 kg | 208 |
XENDOS was designed to test prevention of type 2 diabetes rather than weight loss alone, only 52% of the orlistat group and 34% of the placebo group completed the four years, and everyone also made lifestyle changes.
NAMED SAFETY SIGNALS
What has been reported with Orlistat 120mg.
Oily or urgent bowel movements
The EU Summary of Product Characteristics lists oily spotting from the rectum, fatty or oily stools, wind with discharge, urgent need to open the bowels and increased bowel movements as very common (affecting more than 1 in 10 people).
Stomach pain and wind
Abdominal pain or discomfort, flatulence and liquid stools are listed as very common (more than 1 in 10 people) in the EU Summary of Product Characteristics.
Loss of bowel control
Faecal incontinence and soft stools are listed as common (between 1 in 100 and 1 in 10 people) in the EU Summary of Product Characteristics.
Lower absorption of fat-soluble vitamins
Orlistat can reduce absorption of vitamins A, D, E and K; the EU product information advises a diet rich in fruit and vegetables and says a multivitamin supplement may be considered, taken at bedtime.
Headache
Listed as very common (more than 1 in 10 people) in the EU Summary of Product Characteristics.
€25/month (billed €25 every 28 days)Start a medical consultation
FormOral capsule
FrequencyWith each main meal
ResultsReviewed at month 3
What you pay Hi-Doctor€25/month (billed €25 every 28 days)
IN 60 SECONDS
Orlistat 120mg at a glance
- A lipase inhibitor, taken as a hard capsule; it acts only inside the gut.
- Adults with obesity, alongside a mildly reduced-calorie diet.
- One 120 mg capsule with each main meal, up to three capsules a day.
- Oily stools are very common; yellowing skin can signal serious liver injury.
- Hi-Doctor consultation fee; the medicine is paid separately at a pharmacy
About
What is Orlistat 120mg?
Also sold as alli, Xenical.
Active ingredient: Orlistat · Dosages: 120 mg with each main meal
Orlistat is a lipase inhibitor: it blocks the intestinal enzyme that digests fat, reducing the absorption of part of the fat you eat. Unlike GLP-1s, it does not act on appetite — its effect depends on keeping an appropriate diet while taking it.
It's a valid alternative for people who cannot or do not want injectables, although average weight loss is usually lower. A licensed doctor proposes the approach that best fits your clinical history.
HOW IT WORKS
What Orlistat 120mg does in your body
Orlistat blocks intestinal lipase, so part of the dietary fat passes through unabsorbed. Because it works locally in the gut rather than on hunger signals, results depend on a suitable, lower-fat diet.
It switches off fat-digesting enzymes
Orlistat binds to lipases, the enzymes your stomach and small intestine release to digest fat. It forms a chemical bond with the active site of gastric and pancreatic lipase and switches the enzyme off inside the gut. It is not an appetite medicine and does not act on the brain.
Dietary fat stays undigested
The inactivated enzyme cannot break dietary fat, which arrives as triglycerides, into the smaller free fatty acids and monoglycerides that the gut wall is able to take up. The fat therefore stays whole, and whole fat molecules are too large to cross into the body.
The blocked fat leaves in stool
The unabsorbed fat passes along the bowel and out in the stool, so those calories never reach you. The European Medicines Agency describes the 120 mg dose as letting about 30% of the fat eaten in a meal pass through undigested.
How it helps
Three ways it supports weight loss.
No injections
A capsule taken with meals — the non-injectable route in this category.
Local, not systemic
Acts in the gut rather than on the whole body's hormone signalling.
Adjunct to diet
Reinforces a structured nutrition plan; adjusting fat intake also eases side effects.
What to expect
How to take it.
One capsule with each main meal that contains fat. Your doctor explains the routine and the vitamin supplementation that goes with it.
- Days 1–7 · Adjust meals towards lower fat
- Weeks 2–8 · Consistent use with each main meal
- Month 3 · Response reviewed by your doctor
- Ongoing · A, D, E, K multivitamin taken separately, as advised
Doses your doctor can prescribe
- Standard dose120 mg with each main meal
Your schedule is personal
These are typical steps only. Your doctor adjusts the plan to how you respond and tolerate it — and you can message them at any point.
DAY TO DAY
Taking Orlistat 120mg day to day
Take it with the meal
Swallow one capsule with water immediately before a main meal, during it, or up to one hour after it. Most people end up taking it with breakfast, lunch and dinner, so up to three capsules a day.
Skip meals that have no fat
If you miss a meal, or the meal contains no fat, leave that capsule out. Orlistat only acts on fat that is present in the gut, so a capsule taken without fat achieves nothing.
Keep fat near 30% of calories
The SmPC asks for a nutritionally balanced, mildly reduced-calorie diet with about 30% of calories from fat, rich in fruit and vegetables. On a 2,000 kcal day that works out at roughly 67 g of fat.
Spread the fat across three meals
Do not save your fat allowance for one large meal. The SmPC warns that taking orlistat with a meal very high in fat makes the gut side effects both more likely and more intense.
Take any multivitamin at bedtime
Orlistat can reduce absorption of vitamins A, D, E and K and of beta-carotene. If a multivitamin is recommended, take it at bedtime or at least two hours away from an orlistat capsule.
Expect changes within two days
Fat in the stool rises within 24 to 48 hours of the first dose, so oily stools can start quickly. After stopping, stool fat usually returns to its previous level within 48 to 72 hours.
Keep the 12-week review
Attend the review your prescriber arranges. The SmPC says orlistat should be discontinued after 12 weeks if you have not lost at least 5% of the body weight you had when you started.
Tell every prescriber you take it
Orlistat changes how some other medicines are absorbed. Mention it before starting anything new, especially thyroid tablets, anticoagulants, epilepsy medicines, ciclosporin, HIV treatment or contraception, so doses and monitoring can be adjusted.
Safety first
Safety, in full.
Orlistat 120mg is an effective medicine — and like any medicine it carries risks. Your doctor screens for all of this before prescribing. Here's the honest picture, not just reassurance.
Side effects, by how often they happen
Stop and get urgent medical help if
seek medical help immediately
these need urgent attention, whatever the frequency
- Yellowing of the skin or eyes, dark urine, itching or unusual tiredness, which can signal serious liver inflammation
- Severe stomach pain that spreads through to your back, which can signal inflammation of the pancreas
- Rash, hives, swelling of the face, lips or tongue, wheezing or difficulty breathing
- Bleeding from the back passage, or blood in your stool
- Passing much less urine than usual, or new pain in the side or lower back
- Widespread blistering of the skin
- More seizures than usual, or more severe ones, if you take medicine for epilepsy
Very common
very common (≥1/10)
more than 1 in 10 people
- Oily spotting from the back passage, which can mark underwear
- Wind, sometimes passed with a small amount of oily discharge
- A sudden, urgent need to open your bowels
- Fatty or oily stools
- Loose or liquid stools
- Opening your bowels more often than usual
- Stomach pain or discomfort
- Headache
- Colds and other upper respiratory infections, including flu
- Low blood sugar, in people who also have type 2 diabetes
Common
common (≥1/100 to <1/10)
between 1 in 100 and 1 in 10 people
- Pain or discomfort around the back passage
- Soft stools
- Leaking stool, or not reaching the toilet in time
- Chest infections
- Urine infections
- Tiredness
- Irregular periods
- Anxiety
Reported, frequency not known
frequency not known
reported after the medicine was licensed; how often is not established
- Bleeding from the back passage
- Diverticulitis, inflammation of small pouches in the bowel wall
- Pancreatitis, inflammation of the pancreas
- Gallstones
- Hepatitis that may be serious, including fatal cases and cases needing a liver transplant
- Oxalate nephropathy, kidney damage that can lead to kidney failure
- Blistering skin eruptions
- Allergic reactions including itching, rash, hives, swelling, wheeze and anaphylaxis
- Raised liver enzymes on blood tests
- Changes in clotting test results in people taking anticoagulants
Adults with obesity (BMI ≥30), or overweight (BMI ≥28) with risk factors, alongside a mildly reduced-calorie, lower-fat diet.
- One 120 mg capsule with each of the three main meals — during the meal or up to one hour after.
- If you skip a meal, or it contains no fat, skip that capsule.
- Spreading your daily fat intake evenly across meals keeps side effects manageable.
- It supports a diet — it does not replace one.
WHO SHOULD NOT TAKE IT, AND WHO NEEDS EXTRA CARE
- You are allergic to orlistat or to any of the other ingredients in the capsule
- You have chronic malabsorption syndrome, a long-standing problem absorbing nutrients from food
- You have cholestasis, a condition in which bile cannot flow normally out of the liver
- You are breastfeeding
- You are pregnant: the 60 mg pharmacy product is contraindicated, and the 120 mg label tells prescribers to exercise caution
- You take ciclosporin: contraindicated with the 60 mg product, and not recommended with the 120 mg product
- You take warfarin or another oral anticoagulant: contraindicated with the 60 mg product, and clotting must be monitored on the 120 mg product
- You have chronic kidney disease or are dehydrated, because the risk of oxalate kidney damage is higher
- You are under 18: safety and effectiveness in children have not been established
When to seek urgent care
For severe, sudden or unexpected symptoms, call your local emergency number or go to the nearest emergency department. Then let your doctor know through your account chat.
Medicines and substances that interact
| MEDICINE OR SUBSTANCE | WHAT CAN HAPPEN | WHAT THE DOCTOR DOES |
|---|---|---|
| Ciclosporin, an immune-suppressing medicine | Orlistat lowers ciclosporin blood levels, which can weaken its immune-suppressing effect | The combination is not recommended; if unavoidable, ciclosporin levels are monitored more often |
| Levothyroxine, for an underactive thyroid | Absorption of levothyroxine and iodine salts may fall, so thyroid control can slip | Doses are taken apart and thyroid blood tests are repeated by the prescriber |
| Warfarin and other oral anticoagulants | Less vitamin K is absorbed, so clotting results can shift and bleeding risk changes | INR is monitored; the 60 mg pharmacy product must not be used at all |
| Antiepileptic medicines such as valproate and lamotrigine | Absorption may fall, and convulsions have been reported with the combination | The prescriber watches for any change in seizure frequency or severity |
| Combined oral contraceptives and emergency contraception | Severe diarrhoea can carry the pill through before it is fully absorbed | An additional contraceptive method is recommended while severe diarrhoea lasts |
| Amiodarone, for heart rhythm problems | A slight fall in amiodarone blood levels was seen in healthy volunteers | Clinical review and ECG monitoring are stepped up by the prescriber |
| HIV medicines, antidepressants, antipsychotics including lithium, benzodiazepines | Case reports describe reduced effect after orlistat was started in previously stable patients | Orlistat is only started after the prescriber weighs this risk |
| Fat-soluble vitamins A, D, E, K and beta-carotene | Absorption of these vitamins can fall while orlistat is being taken | A multivitamin is taken at bedtime, or at least two hours from the capsule |
Have a doctor review your caseThis is exactly what the doctor screens for before prescribing anything.
Read the full Orlistat 120mg safety summaryEVIDENCE
What the clinical trials found
Orlistat's weight evidence comes from five 2-year placebo-controlled trials, the 2-year European trial published by Sjostrom in the Lancet, and the 4-year XENDOS trial.
Adults pooled from five placebo-controlled 2-year trials · 1 year
Both groups also followed a reduced-calorie diet.
Source: Xenical 120 mg hard capsules: EU Summary of Product Characteristics (Annex I)Adults pooled from five placebo-controlled 2-year trials · 1 year
Orlistat 120 mg versus placebo, in the pooled trial data reported in the SmPC.
Source: Xenical 120 mg hard capsules: EU Summary of Product Characteristics (Annex I)3,305 adults with obesity · 4 years
Orlistat 120 mg three times daily plus lifestyle change, versus placebo plus lifestyle change.
Source: XENical in the prevention of Diabetes in Obese Subjects (XENDOS): a randomized study of orlistat as an adjunct to lifestyle changes3,305 adults with obesity · 4 years
A 37.3% relative risk reduction. Most cases arose in the 21% who had impaired glucose tolerance at the start.
Source: XENical in the prevention of Diabetes in Obese Subjects (XENDOS): a randomized study of orlistat as an adjunct to lifestyle changesAdults with a BMI of 28 or above, pooled from two placebo-controlled trials · 6 months
Pooled data on the 60 mg pharmacy strength.
Source: alli 60 mg hard capsules: EU Summary of Product Characteristics (Annex I)These are averages, and in every one of these trials the placebo group followed the same reduced-calorie diet, so the figures show what orlistat added on top of dieting rather than the total weight people lost. Individual results vary a lot: in the pooled 2-year data, 37% of people taking orlistat had lost at least 5% of their weight by 12 weeks and the rest had not. That spread is exactly why the label builds in a 12-week checkpoint instead of assuming everyone responds.
ALTERNATIVES
How orlistat compares with the injectable weight medicines
| MEDICINE | HOW IT IS TAKEN | HOW OFTEN | TYPICAL DOSE RANGE | EU-AUTHORISED INDICATION | KEY EVIDENCE |
|---|---|---|---|---|---|
| Semaglutide | Injection under the skin | Once weekly | 0.25 mg up to 2.4 mg | Weight management in adults with a BMI of 30 or above, or 27 to under 30 with at least one weight-related condition, alongside a reduced-calorie diet and more physical activity. | STEP 1: mean 15% body-weight loss at 68 weeks versus 2% on placebo |
| Tirzepatide | Injection under the skin | Once weekly | 2.5 mg up to 15 mg | Weight management in adults with a BMI of 30 or above, or 27 to under 30 with at least one weight-related condition, alongside a reduced-calorie diet and more physical activity. | SURMOUNT-1: at least 15% mean weight reduction at 72 weeks versus 3% on placebo |
| Liraglutide | Injection under the skin | Once daily | 0.6 mg up to 3.0 mg | Weight management in adults with a BMI of 30 or above, or 27 or above with a weight-related condition, and in adolescents and children with obesity who meet weight criteria. | SCALE: 7.5% reduction in body weight versus 2.3% on placebo |
Not sure which one fits your case? The doctor reviews your history and tells you.
Start consultation · €25/monthACCESS AND COST
Getting Orlistat 120mg, and what it costs
This table is about how orlistat may legally be supplied in each country and whether the national health system pays for it, not about what it costs. Both strengths are authorised across the whole EU under a single European approval, but which strengths are actually stocked, and who pays, is decided nationally.
What you pay Hi-Doctor
€25/month (billed €25 every 28 days)
Answer a few questions and a licensed EU doctor reviews your case in less than 2 hours on average. Refunded in full if it's not right for you.
What the pharmacy charges
Hi-Doctor does not sell, stock or dispense medicines and does not set their price. The medicine is paid for separately at the pharmacy, and the amount depends on the country, the pack size, whether a generic is available and whether your health system covers it. The official national database linked in the table publishes the current authorised price.
| COUNTRY | HOW IT IS SUPPLIED | COVERED BY THE HEALTH SYSTEM? | OFFICIAL SOURCE |
|---|---|---|---|
| Spain | Prescription-only (120 mg); 60 mg is pharmacy-only | Not financed by the national health system | AEMPS CIMA |
Show the other countries
| Germany | Prescription-only (120 mg); 60 mg is pharmacy-only | Excluded from statutory cover by law | PharmNet.Bund AMIce |
|---|---|---|---|
| France | Prescription-only (120 mg); 60 mg not marketed | Not reimbursed | Base de données publique des médicaments |
| Italy | Prescription-only (120 mg); 60 mg is pharmacy-only | Check national criteria | AIFA Medicinali |
| Netherlands | Prescription-only (120 mg); 60 mg is pharmacy-only | Not reimbursed | CBG-MEB Geneesmiddeleninformatiebank |
| Portugal | Prescription-only (120 mg); 60 mg is pharmacy-only | Check national criteria | INFARMED Infomed |
| Belgium | Prescription-only (120 mg); 60 mg is pharmacy-only | Check national criteria | FAGG-AFMPS medicines database |
| Ireland | Prescription-only (120 mg); 60 mg is pharmacy-only | Check national criteria | HPRA Find a Medicine |
| Austria | Prescription-only (120 mg); 60 mg is pharmacy-only | Check national criteria | BASG Medikamente Info Austria |
| Poland | Prescription-only (120 mg); 60 mg is pharmacy-only | Check national criteria | Rejestr Produktów Leczniczych |
PRICING
You only pay if treatment is approved.
€25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth. €35 one-off is available for sexual health.
Weight loss
ONGOING PLAN
€25/month
Billed €25 every 28 days · cancel anytime
28-day treatment cycle
For ongoing treatment and doctor-reviewed renewals.
Renewals reviewed by your doctor
Start consultation
Full refund if a review is not approved
WHAT'S INCLUDED
- First consultation included
- Renewals reviewed by your doctor
- Ongoing care with your doctor
- Cancel anytime
Full refund if a review is not approved
If a review is not approved, we refund that period's €25 fee and cancel the plan.
Note: The medication, if the doctor prescribes it, is paid separately at the pharmacy at the price it sets. Hi-Doctor does not sell medications.
HOW THE DOCTOR DECIDES
A licensed doctor reviews your case, not an algorithm
An EU-licensed doctor reads your questionnaire and answers in less than 2 hours on average.
If the doctor decides it is not safe to prescribe, the consultation fee is refunded in full.
Follow-up happens in the private chat inside your account, under GDPR. No WhatsApp, no SMS.
FREQUENTLY ASKED QUESTIONS
Questions about Orlistat 120mg.
OTHER WEIGHT LOSS TREATMENTS
Explore related treatments.
SOURCES
Where this information comes from
- 01
Xenical 120 mg hard capsules: EU Summary of Product Characteristics (Annex I) — European Medicines Agency, 2023
- 02
Xenical: EPAR medicine overview — European Medicines Agency, 2026
- 03
alli 60 mg hard capsules: EU Summary of Product Characteristics (Annex I) — European Medicines Agency, 2024
- 04
Alli: EPAR medicine overview — European Medicines Agency, 2026
- 05
XENical in the prevention of Diabetes in Obese Subjects (XENDOS): a randomized study of orlistat as an adjunct to lifestyle changes — Diabetes Care (via PubMed), 2004
- 06
Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients — The Lancet (via PubMed), 1998
- 07
Orlistat: NHS medicines A to Z — National Health Service (UK), 2026
- 08
Xenical 120 mg hard capsules: Summary of Product Characteristics — electronic medicines compendium (emc), 2026
- 09
alli 60 mg hard capsules: Summary of Product Characteristics — electronic medicines compendium (emc), 2026
- 10
Arzneimittelverschreibungsverordnung (AMVV), Anlage 1: entry for orlistat — Bundesministerium der Justiz (gesetze-im-internet.de), 2026
- 11
Section 34 SGB V: medicines excluded from statutory health insurance, including weight-reduction medicines — Bundesministerium der Justiz (gesetze-im-internet.de), 2026
- 12
CIMA: Spanish medicines information centre, orlistat and Xenical records — Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), 2026
- 13
Nomenclátor de Facturación, July 2026: products included in national health service pharmaceutical provision — Ministerio de Sanidad (Spain), 2026
- 14
Base de données publique des médicaments: Xenical and Orlistat EG records, liste I — ANSM / HAS / Ministère de la Santé (France), 2026
- 15
Medicijnkosten.nl: orlistat, Xenical and alli entries with reimbursement status — Zorginstituut Nederland, 2026
- 16
Lista de Medicamentos Não Sujeitos a Receita Médica: alli, Orlistato Beacita and Sthen 60 mg — INFARMED (Portugal), 2026
- 17
AIFA Medicinali: Xenical, alli and Beacita orlistat records — Agenzia Italiana del Farmaco, 2026
- 18
Répertoire Commenté des Médicaments: orlistat, Belgian products — CBIP / BCFI (Belgium), 2026
- 19
Xenical 120 mg hard capsules: authorised medicines list — Health Products Regulatory Authority (Ireland), 2026
- 20
Xenical, Alli (Orlistat): official notice on authorised orlistat products in Austria — BASG / AGES (Austria), 2011
- 21
Rejestr Produktów Leczniczych: Xenical (Rp) and Alli (OTC) orlistat records — Ministry of Health / Centrum e-Zdrowia (Poland), 2026
- 22
Wegovy: EPAR medicine overview and product information — European Medicines Agency, 2026
- 23
Mounjaro: EPAR medicine overview and product information — European Medicines Agency, 2026
- 24
Saxenda: EPAR medicine overview and product information — European Medicines Agency, 2026
Reviewed by Hi-Doctor's medical team · Last reviewed 2026-07-27 · Next review due 2027-07-27
This page is educational information about a medicine, not a recommendation to take it and not a substitute for a medical consultation. Only a licensed doctor who has reviewed your history can decide whether a treatment is appropriate for you.
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See if Orlistat 120mg is appropriate for you.
Answer a few questions and a licensed EU doctor reviews your case in less than 2 hours on average. Refunded in full if it's not right for you.