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Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on December 02, 2022.
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Alli vs Xenical: What is the difference between Orlistat 60mg and 120mg?

So, why are there different doses of Orlistat? Well, the 60mg dose is more commonly known as Alli and the 120mg dose is often better known under the brand name, Xenical. Both of these branded medications are made by GlaxoSmithKline.

Orlistat is the name of the active ingredient in both Alli and Xenical, and it’s also the name of the generic 120mg medication.

Orlistat is what’s known as a lipase inhibitor. Lipase is an enzyme that breaks down the dietary fat that you consume. It turns it into energy, which your body then stores. Lipase inhibitors block lipase from working, so if you take them regularly, and with the right diet, you should lose weight.

You’ll only need a prescription for Orlistat if you want to take the 120mg dose. The 60mg dose, known as Alli, can be picked up over-the-counter, either in pharmacies or online. Though you’ll still need to have a chat with the pharmacist when you buy it so they can make sure that it’s safe for you to use.

To get 120 mg of Orlistat you’ll need to have a chat with a prescribing clinician. This is to make sure it’s the right medication for you to take, depending on any other health conditions you’ve got and other treatments you’re taking.

However, if you already have menstrual migraines, the combined contraceptive pill can balance your oestrogen levels during your menstrual cycle and help prevent headaches.

Headaches are one of the most common side effects of contraceptive pills. But if you’re getting birth control headaches everyday or they have worsened, get in touch with your prescriber and let them know. They’ll be able to suggest an alternative that might be more suitable for you.

It might seem tempting to want to take the highest dose to get the best results, but the higher dose of Orlistat at 120 mg isn’t right for everyone. This dose should only be prescribed to people with a BMI of over 30 that puts them in the obese category, or to people who are overweight and have related health conditions that put them at risk.

You also shouldn’t take more than 360mg per day (so a maximum of three 120mg doses). If you’re taking 60mg of orlistat, then you should take a maximum of 180mg a day.

The best way to take it is three times a day, with each of your main meals. You can take the tablet just before you eat, with your food or take it up to one hour after you’ve finished eating.

Sometimes, when life gets in the way, you might be too busy and skip a meal. In these cases you shouldn’t take a tablet, and simply carry on as normal until the next time you eat or have a meal. Similarly, if you eat a meal that has no fat in it at all, then you shouldn’t take your tablet. This is because it won’t work properly on these occasions.

You may feel like racing to your weight loss goal is the best route, but taking it slowly and steadily can produce the best long term results.

Does a lower dose mean Orlistat is less effective?

Taking the 60mg dose of orlistat will often mean that your weight loss is slower than if you take the 120 mg dose. But this can be the best course of action for some people to lose weight in a more sustainable way.

If you take the 60mg orlistat dosage for fat loss, it’s been shown to often facilitate better eating habits over time and offer longer term weight loss benefits, which can be healthier for you in the long run.

Opting to take the 60mg dose of Orlistat can offer a range of benefits. Your weight loss might be a little slower, but you can get more tablets over the counter if you run out. The lower dosage may allow you to take your time with your weight loss goals and build foundations for good long term eating and exercise habits.

Many people also get fewer side effects from the 60mg dose than from the 120mg dose, such as stomach issues. Any stomach issues that you might experience are usually only short-term whilst you adjust to taking your treatment, and should pass pretty quickly.

Both the 60 mg and 120 mg doses of orlistat are most effective when they’re taken with a low-calorie, low-fat diet.

The 60mg dose will absorb less of the fat in your diet so your weight loss will likely be slightly slower. This is due to the fact you’ll be taking less of the active ingredient.

Where can I get more advice about Orlistat?

If you’d like to get some more advice on whether Orlistat can be right for you, talk to us about your health. Our experts will offer you helpful and impartial advice on which dose of Orlistat can be the best one for you.

Once you’ve got your treatment, we’ll check in with you to see how you’re doing and answer any questions that you might have.

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How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on December 02, 2022. Next review due on December 02, 2024.

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