How to Take Orlistat: 120mg and 60mg (alli) Doses, Timing and Missed Doses

Short answer: Orlistat is taken the same way at both strengths. Take one capsule immediately before, during, or up to one hour after each main meal, up to three times a day. If you miss a meal, or a meal contains no fat, skip that dose. Swallow the capsule with water. Never take more than three capsules in 24 hours (alli SmPC, section 4.2): doses above 120mg three times a day have not been shown to give any extra benefit (Xenical SmPC, section 4.2). If you forget a capsule, take it if it is within an hour of the meal, otherwise skip it, and never take two at once (NHS website; both leaflets, section 3). Take a daily multivitamin containing vitamin D, at least 2 hours after a dose of orlistat, or at bedtime.

This guide sets out what the UK product information for orlistat 120mg (Xenical) and orlistat 60mg (alli) and the NHS say, as of October 2026: the dose at each strength, the best time to take it, once-a-day and two-at-once questions, missed doses and skipped meals, other medicines, the pill, pregnancy, how long you can take it and how to store it. A GPhC-registered pharmacist reviews every orlistat consultation before anything is supplied.

How do you take orlistat?

Take one capsule immediately before, during, or up to one hour after each main meal, up to three times a day. If you miss a meal, or a meal contains no fat, skip that dose. That is the rule our pharmacist works to, and it is the same for orlistat 120mg and orlistat 60mg. The NHS advises trying to take it the same way every mealtime, so it becomes part of the meal.

1. With a main meal. Immediately before, during or up to one hour after it.

2. Swallow it with water. One capsule, whole.

3. One capsule per meal. Up to three a day, never more than three in 24 hours.

4. Skip it for a meal with no fat, or a missed meal. Orlistat has nothing to act on without fat in the meal.

5. A multivitamin at bedtime. Take a daily multivitamin containing vitamin D, at least 2 hours after a dose of orlistat, or at bedtime.

Orlistat works on the fat in the meal you take it with, which is explained in how does orlistat work. What to eat alongside it is in our orlistat diet plan.

What is the dose of orlistat 120mg and 60mg?

The dose is one capsule with each main meal, up to three a day, at either strength. Xenical is a brand of orlistat 120mg and alli a brand of orlistat 60mg; the two strengths side by side, as of October 2026:

Not sure of your BMI? Use our BMI calculator. The other weight-loss medicines taken by mouth are set out on our weight-loss tablets page.

When is the best time to take orlistat?

There is no single best time: immediately before, during or up to an hour after the meal all work (Xenical SmPC, section 4.2), so pick one and keep to it, as the NHS advises. For most people that means a capsule at breakfast, lunch and dinner, the three main meals the leaflets describe (Xenical and alli leaflets, section 3).

Can you take orlistat once a day?

One capsule is taken with each main meal that contains fat, up to three a day, so a day with only one such meal means one capsule. Each capsule works on the fat in the meal it is taken with: "Xenical only works in the presence of dietary fat" (Xenical leaflet, section 3). So one capsule does not cover your other meals, and a capsule taken once a day at a set time, away from a meal, has no fat to act on.

What happens if you take orlistat without eating?

It has nothing to act on, which is why you skip the capsule when you miss a meal or eat a meal with no fat. The Xenical leaflet says that "if you miss a main meal or if you have a meal containing no fat, Xenical need not be taken", and the alli leaflet that "alli does not work unless there is some fat in the meal" (section 3 of each). Why each main meal still needs some fat is in our orlistat diet plan.

What if you forget to take orlistat?

Take it if it is within an hour of your last main meal; if more than an hour has passed, skip it and take the next capsule with your next main meal (NHS website; alli and Xenical leaflets, section 3). Never take two doses to make up for a missed one. If you have missed several doses, the Xenical leaflet asks you to tell your doctor (section 3); you can also message our pharmacist through your account.

Can you take 2 orlistat at once?

No. Take one capsule per main meal and never more than three in 24 hours (alli SmPC, section 4.2), even after a high-fat meal: "If you eat a high-fat meal, do not take more than the recommended dose" (alli leaflet, section 2). More capsules have not been shown to help: "Doses of orlistat above 120 mg three times daily have not been shown to provide additional benefit" (Xenical SmPC, section 4.2). If you have taken more than you should, the NHS advises contacting NHS 111. For urgent medical concerns, call NHS 111 or 999.

Can you take orlistat with other medicines?

Often yes, but some medicines need checking and some rule orlistat out, so our pharmacist reviews your medicine list. Some medications interact with orlistat. Our pharmacist will review your medication list during the consultation. Tell us if you take ciclosporin, amiodarone, lithium, acarbose, warfarin or another blood thinner, levothyroxine, an epilepsy medicine, an HIV medicine, a diabetes medicine, another weight-loss medicine or a GLP-1 medicine, or the contraceptive pill. Orlistat is not suitable alongside some of them, such as warfarin, epilepsy medicines and HIV medicines.

Can you take orlistat with antidepressants?

Often, after a pharmacist review. The alli SmPC reports "some case reports of reduced efficacy of antidepressants, antipsychotics (including lithium) and benzodiazepines" around the time orlistat was started, in people whose condition had been well controlled, and says orlistat should only be started "after careful consideration of the possible impact" (section 4.5). The Xenical SmPC says the same, and also names HIV medicines (section 4.5). So tell us everything you take, and keep taking your medicines as prescribed.

Vitamins

Orlistat reduces how much of the fat-soluble vitamins A, D, E and K you absorb from food. Take a daily multivitamin containing vitamin D, at least 2 hours after a dose of orlistat, or at bedtime.

GLP-1 medicines

We do not supply orlistat together with Mounjaro, Wegovy or any other GLP-1 medicine. Our pharmacist confirms with you that one has stopped before the other is supplied. How they differ is in orlistat vs Mounjaro and Wegovy.

Does orlistat stop the contraceptive pill working?

Not directly: interaction studies found no effect on the pill, but orlistat may indirectly make it less reliable, so an extra method of contraception is advised if you have severe diarrhoea (Xenical and alli SmPCs, section 4.5). For the combined pill, the NHS describes this as "severe diarrhoea, or diarrhoea that lasts for more than 24 hours", and advises a barrier method such as condoms.

Can you take orlistat when pregnant, breastfeeding or trying to conceive?

No, we do not supply orlistat if you are pregnant, planning a pregnancy or breastfeeding. Orlistat is not suitable if you are pregnant, planning a pregnancy or breastfeeding, have chronic malabsorption syndrome, cholestasis, or liver or kidney problems, or your weight gain is caused by a hormone condition or a medicine. alli must not be taken in pregnancy or while breastfeeding (alli SmPC, section 4.3), and Xenical must not be taken while breastfeeding (Xenical SmPC, section 4.3); for pregnancy, the Xenical SmPC advises caution (section 4.6), and the NHS says orlistat is not used during pregnancy. If you become pregnant while taking orlistat, the NHS advises telling your doctor.

How long can you take orlistat for?

Orlistat 120mg is reviewed at 12 weeks: Orlistat is reviewed at 12 weeks and only continued if you have lost at least 5% of your starting weight. After that, our pharmacist reviews it at every order. For orlistat 60mg: Orlistat 60mg should not be taken for more than 6 months. If you have not lost weight after 12 weeks on orlistat 60mg, the alli leaflet says to see your doctor or pharmacist (section 3). How to tell if it is working is in how does orlistat work.

How should you store orlistat, and does it expire?

Do not store it above 25°C, and keep it in its original pack, away from moisture (Xenical SmPC, section 6.4, for blister packs; alli leaflet, section 5). Always follow the storage line in the leaflet in your own pack. alli bottles contain sealed silica gel canisters that keep the capsules dry: leave them in the bottle and do not swallow them. Do not use orlistat after the expiry date on the pack (alli leaflet, section 5).

Side effects in the gut, such as oily stools, are covered in orlistat side effects. If you are unsure whether your GP should know you are taking orlistat, see whether we tell your GP.