Statins + Orlistat - Drug Interactions

No clinically relevant interaction has been seen between orlistatand atorvastatin,pravastatin or simvastatin.

Clinical evidence,mechanism, importance and management

In a randomised study,32 healthy subjects were given atorvastatin 20mg daily for 6 days, with or without orlistat 120mg three times daily for 6 days. Orlistat had no significant effect on pharmacokinetics of atorvastatin (See reference number 1).

In a placebo-controlled, crossover study in 24 subjects with mild hypercholesterolaemia, orlistat 120mg three times daily was reported to have no effect on pharmacokinetics, or lipid-lowering effects, of pravastatin 40mg daily, when both drugs were given for 6 days (See reference number 2).

A review includes brief details of a comparative study in two groups of healthy subjects given pravastatin,either with orlistat or placebo. After 10 days there was no significant difference in pravastatin AUC between groups, but maximum serum concentration did show a tendency to be higher in orlistat group (See reference number 3).

In a placebo-controlled, randomised study in 29 healthy subjects orlistat 120mg three times daily had no effect on pharmacokinetics of simvastatin 40mg daily (See reference number 4).

Zhi J,Moore R, Kanitra L, Mulligan TE. Pharmacokinetic evaluation of the possible interaction between selected concomitant medications and orlistat at steady state in healthy subjects.J Clin Pharmacol (2002) 42, 1011–19.

Oo CY,Akbari B, Lee S, Nichols G, Hellmann CR. Effect of orlistat, a novel anti-obesityagent, on the pharmacokinetics and pharmacodynamics of pravastatin in patients with mild hypercholesterolaemia. Clin Drug Invest (1999) 17, 217–23.

Guerciolini R. Mode of action of orlistat. Int J Obes (1997) 21 (Suppl 3),S12–S23.

Zhi J,Moore R, Kanitra L, Mulligan TE. Effects of orlistat, a lipase inhibitor, on the pharmacokinetics of three highly lipophilic drugs (amiodarone, fluoxetine, and simvastatin) in healthyvolunteers. J Clin Pharmacol (2003) 43, 428–34.