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Many of my patients are healthy, active women in their 40s or 50s who want to maintain the tone and lift of their younger years, while others have lost significant weight through lifestyle changes, pregnancy, or GLP-1 medications and want to celebrate their achievement

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a multivitamin supplement is recommended, taken at bedtime or at least 2 hours before or after an orlistat dose Orlistat should be skipped if a meal is fat-free or a meal is missed Important interactions with orlistat include: Ciclosporin : avoid concomitant use (reduced ciclosporin absorption) Warfarin and other anticoagulants : monitor INR closely, as orlistat may affect vitamin K absorption Levothyroxine : separate doses by at least 4 hours and monitor thyroid function Antiepileptics (e.g., valproate, lamotrigine) and some antiretrovirals : reduced absorption possible

Under ordinary circumstances, its not especially contentious when drugs come off a shortage list