A nurse performing an admission history on a patient learns that the patient is taking orlistat [Xenical], warfarin [Coumadin], and levothyroxine [Synthroid]. What will the nurse do?
a. Contact the provider to discuss increasing the warfarin dose.
b. Give the levothyroxine at least 4 hours before giving the orlistat.
c. Suggest that the patient avoid fatty foods while taking these medications.
d. Tell the patient to take the orlistat on an empty stomach.
B
Orlistat may cause hypothyroidism in patients taking levothyroxine; these two drugs should be administered at least 4 hours apart. The vitamin K deficiency that can occur with orlistat may compound the effects of warfarin, so coagulation should be monitored; it is more likely that the warfarin dose would need to be reduced. The patient may still consume foods containing fat, as long as fat accounts for about 30% of the total intake. Orlistat should be taken with food.
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