A patient who has hypothyroidism and is obese begins therapy with orlistat. The primary care NP teaches the patient about this drug and then asks the patient to describe its use
Which statement by the patient indicates understanding of the teaching? a. "I may eat a high-fat diet while taking orlistat."
b. "I can expect the most benefit in the first few months."
c. "I should take fat-soluble vitamins each time I take orlistat."
d. "I should take an increased dose of levothyroxine while I am taking orlistat."
B
In long-term studies on the use of orlistat, most of the weight loss occurred during the first months. Patients should not be counseled to eat a high-fat diet; the maximum amount of fat excretion is around 25% to 30%. Patients should take fat-soluble vitamins, but the vitamins should be taken at different times and not with orlistat. Orlistat interferes with levothyroxine absorption, so the two drugs should be taken at different times, and thyroid levels should be monitored with an increase in levothyroxine dose only when indicated by thyroid levels.
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