Quick answer

Ask your pharmacist or doctor before combining. The orlistat label, MedlinePlus and NIH document 2 supplements: vitamin D and vitamin K. Orlistat blocks some fat from being absorbed, and with it some fat-soluble vitamins, so the label advises a daily multivitamin at a separate time. Your pharmacist can plan that around your own products.^1,2,3

Key facts

MedlinePlus says orlistat is used to help people lose and maintain weight, and that it works by stopping some of the fat in food from being absorbed.²
The orlistat label says it reduces the absorption of some fat-soluble vitamins and advises a daily multivitamin with vitamins A, D, E and K taken at a separate time.¹
In the label's first 2 years of trials, low vitamin D values occurred in 12.0% of adults on orlistat who took no vitamins, against 6.6% on placebo.¹
The label says vitamin K absorption may be decreased, and that people on stable warfarin doses who start orlistat should have their clotting tests watched closely.⁴
MedlinePlus also names vitamin E acetate and beta-carotene as nonprescription products that may interact with orlistat.²

What does orlistat do to the vitamins in your food?

Orlistat belongs to a class called lipase inhibitors, and it is sold both by prescription and over the counter. MedlinePlus says it works by preventing some of the fat in the food you eat from being absorbed in the intestines, and the fat that is not absorbed leaves in the stool.²

The label calls vitamins A, D, E and K fat-soluble and says orlistat reduces the absorption of some of them. The concern runs in one direction: the medicine lowers how much of a vitamin the body takes in, and the sources do not describe a vitamin working against the medicine.^1,2

Does orlistat lower vitamin D?

Ask your pharmacist how far apart to take them

Orlistat, a weight-loss medicine, reduces the absorption of fat-soluble vitamins, including vitamin D. Its label advises a daily multivitamin with vitamins A, D, E and K taken at a separate time from orlistat, and in its trials low vitamin D levels were more common on orlistat than on placebo.^1,5,6

On the medicine's label

The strongest part of this card is the trial data printed on the label. Over the first two years, low vitamin D values were recorded in 12.0% of adults who took orlistat and no vitamins, against 6.6% of adults on placebo. The label's response is a multivitamin with vitamins A, D, E and K taken at a separate time from orlistat.¹

Does orlistat matter for vitamin K and warfarin?

Ask your pharmacist how far apart to take them

Orlistat, a weight-loss medicine, can reduce the absorption of vitamin K. Its label says people on warfarin who start orlistat should have their clotting tests watched closely, and advises a daily multivitamin with vitamins A, D, E and K taken at a separate time from orlistat.^3,4,7,8

On the medicine's label

This card has a second layer. NIH's fact sheet lists antibiotics, bile acid sequestrants and orlistat as medicines that lower vitamin K, and the label ties that to warfarin: people on stable doses who start orlistat should have clotting tests watched closely. If you take both medicines, the warfarin page on this site covers the other side of the question.^3,4

Which other vitamins do MedlinePlus and the label name for orlistat?

Vitamin E acetate and beta-carotene appear on MedlinePlus's list of nonprescription products that may interact with orlistat, and the label's multivitamin advice names vitamins A, D, E and K. The documented cards on this page cover D and K only, so the other names come from MedlinePlus and the label wording.^1,2

For a supplement outside these names, the sources checked do not address it. That is not a finding either way, so ask your pharmacist.

What do separate doses and on the label mean for orlistat?

Both cards are tagged separate doses and on the label. The sources frame this as a spacing step, with a daily multivitamin taken at a different time from the medicine, and not as a warning against the vitamins. This page does not give the spacing, so ask your pharmacist.

What to ask your pharmacist about orlistat and vitamins

Should I be taking a multivitamin that contains vitamins A, D, E and K with orlistat, and which kind?¹
If I take warfarin, how often will my clotting tests be checked after I start orlistat?⁴
Does the vitamin D or K in my other supplements count toward that multivitamin?

Questions people ask

What supplements should I avoid with orlistat?

The sources checked do not tell you to avoid a supplement outright. They document vitamin D and vitamin K, because orlistat reduces absorption of fat-soluble vitamins, and the label advises a daily multivitamin at a separate time. Ask your pharmacist how that applies to you.^1,4

Which vitamins should not be taken with orlistat?

The concern on the label is lower absorption of vitamins A, D, E and K, which is a different problem from a vitamin working against the medicine. MedlinePlus also names vitamin E acetate and beta-carotene. Ask your pharmacist about the timing.^1,2

Which supplements interact with orlistat?

Vitamin D and vitamin K are documented on this page, both on the label. MedlinePlus adds vitamin E acetate and beta-carotene as nonprescription products that may interact.^1,2,4

Does orlistat matter if I also take warfarin?

The orlistat label says vitamin K absorption may be decreased, and that people on stable warfarin doses who start orlistat should have their clotting tests watched closely. Tell your pharmacist about both medicines.⁴

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Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.