Lipase Inhibitor : Causes And Adverse Effects

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Lipase inhibitor In humans, the first step in dietary fat digestion starts in the stomach with mechanical emulsification and partial TAG hydrolysis by gastric lipase, resulting in the lipolytic products DAG and free fatty acids. (CREY, Carey, Borgstrom) The remaining part of TAG digestion is brought about in the duodenal lumen by pancreatic lipase, which acts mainly on the sn-1 and sn-3 position of TAG molecules, releasing 2-MAG and free fatty acids. (Borgstrom, Mattson) Thus, inhibition of gastric and pancreatic lipases leads to substantial decrease in the absorption of dietary fats. One lipase inhibitor already approved in 1999 by FDA was Orlistat, which was later made available as an over-the-counter drug in 2007 as a weight loss aid for overweight adults under the name Alli to be used along with a reduced-calorie, low-fat diet, and exercise program. It is to be taken in the dose of 60 mg up to three times a day with each fat-containing meal. (fda) It is known to cause undesirable GI-related adverse events such as oily evacuation, flatus with discharge, oily spotting and faecal incontinence, which leads to poor patient compliance. (Finer, Sjostrom, Davidson) Although considered relatively safe, a US consumer advocacy group namely Public Citizen differed strongly in its opinion of Xenical (Orlistat 120 mg dose under prescription) and in Alli (Orlistat 60 mg dose over the counter). Dr Sidney Wolfe, Director of Public Citizen 's Health Research Group, declared to the press
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