FDA Investigating Obesity Drugs Xenical And Alli For Possible Link With Liver Damage

Agency Has Received Case Reports Of Hepatotoxicity For Orlistat, The Active Ingredient For Xenical And Alli

(Posted by Tom Lamb at DrugInjuryWatch.com)

There was only this brief mention in the Memorandum of Meeting Minutes for the FDA's April 16, 2009 Drug Safety Oversight Board Meeting:

The Drug Safety Oversight Board (DSB) discussed two topics: the product orlistat and the potential risk of hepatotoxicity and alcohol-based skin antiseptics and the risk of a fire in the operating room.

Now, about a month later, we have some additional information about the orlistat – hepatotoxicity part of that DSB April 2009 meeting.   

As background, the anti-obesity agent orlistat is the active ingredient in the prescription drug Xenical (Roche) and the over-the-counter drug Alli (GlaxoSmithKline).

Reporter Sue Sutter, in her May 21, 2009 article "US FDA examining reports of liver damage with orlistat", published online by Scrip News (subscription required; free trial available), takes us forward from there:

"Orlistat was discussed in the context of both non-prescription and prescription versions and the potential risk of hepatotoxicity based on several postmarketing reports," the FDA told Scrip.

The agency said it was still reviewing the case reports to determine the extent of orlistat's contribution, if any, to the development of liver damage. The FDA declined to provide the number of postmarketing reports it has received and said any action would depend upon results of its ongoing analysis….

Roche said more than 35 million patients have been exposed to orlistat therapy, and obesity is a high risk factor for hepatic injury. "The available information – postmarketing spontaneous reports, clinical trial data and published literature as well as epidemiology data for drug-induced liver disease – does not suggest that orlistat is causally related to hepatic events."

The current package insert, or label, for Xenical (accessed 5/22/09) mentions rare reports of hepatic, or liver, injury.

Previously, the anti-obesity agent orlistat had been under scrutiny at the FDA for concerns about rectal bleeding.  See: Potential Signals of Serious Risks/New Safety Information Identified from the Adverse Event Reporting System (AERS) between April – June 2008

If you are aware of any cases of drug-induced hepatitis, liver injury, or liver failure involving the use of Xenical or Alli, please let us know by submitting a Comment, below, or you can send me a private email.

P.S.  On August 24, 2009 the FDA issued its "Early Communication about an Ongoing Safety Review Orlistat (marketed as Alli and Xenical)".  (8/25/09)

3 responses to “FDA Investigating Obesity Drugs Xenical And Alli For Possible Link With Liver Damage”

  1. kerri_hutchinson@hotmail.com Avatar
    kerri_hutchinson@hotmail.com

    I have been taking Alli on and off since it first came out in 2007. I was told my liver enzymes were elevated several weeks ago, which were then retested along with an ultra sound. I have some degree of liver damage. I never dreamed this could have a harmful effect until the news this evening, this is really frightening.

  2. Tom Lamb Avatar

    Kerri:
    You should inquire with your treating physician or one of your other doctors about whether your liver damage might be related to your past use of Alli.
    If your liver injury progresses such that you must be hospitalized, please get back in touch with me. Of course, I hope this does not occur.
    I wish you the best in all aspects going forward.
    Tom Lamb

  3. Michele and Phillip Carson Avatar
    Michele and Phillip Carson

    Hello Tom.
    My husband took Orlistat as prescribed by his doctor several yrs ago and because of the side effect of loose and fatty stools stopped taking it.
    He decided to try it again in March of this year and lasted for 12 days on it and stopped it again because of the same side effects and because he was not losing any weight at all in fact was gaining slightly.
    About 10 weeks later he became jaundiced and was sent to the hospital for blood tests and an ultrasound.Although his liver function tests were deranged nothing else was showing up.They then organised for him to have a CT scan and again nothing showed up.After repeat blood tests they organised for him to have an MRI scan.Again nothing was showing.They then did a liver biopsy and that showed nothing significant.3 months since he presented with jaundice and after all these tests he still has constant pruritus,loss of appetite,sometimes nausea etc.
    We were very interested to read an article in our evening paper(we live in London)that the FDA were investigating possible cases of liver problems that may be associated with Orlistat and as there has been no evidence of anything showing on all the blood tests,scans and biopsy we are now wondering if it is possible that he may have had this side effect from this drug.Thought we would let you know to see what you think.

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