Weight loss
Orlistat
Lipase inhibitor
Other names: Alli, Xenical
Wait
48 hours
observation when starting
Examiner
The examiner can issue when the document's criteria are met
FAA label
ACCEPTABLE
The FAA lists orlistat as acceptable weight loss medication when the certification criteria are met, with a 48-hour initial observation; it may also be combined with metformin or with a GLP-1 agonist, with only one diabetic medication in the combination.
Track your medicationsCompare FAA documents: orlistatWhat each of the three FAA documents says, in plain wordsOpen
For diabetic medications used for weight loss, the same sheet says the A1C must be 6.4 or less with no diagnosis of diabetes and there must be no history of hypoglycemia requiring intervention; for metformin, a GLP-1 agonist and these combinations it lists an observation of one week after starting for weight loss and 48 hours with each dose increase, medication or formulation change, and points to the Prediabetes or Weight Loss Management disposition tables.
The FAA's weight loss management table says that for treatment with one diabetic medication (non-insulin) component it points to the CACI – Weight Loss Management Worksheet, which requires a current, detailed clinical progress note from the treating physician and an A1C lab no more than 90 days before the exam, or to the Weight Loss Management Status Report, and that the examiner issues if the pilot meets all the CACI worksheet criteria and is otherwise qualified.
The FAA's MedGuide names orlistat (Alli, Xenical) as allowed, for weight loss, with a wait of 48 hours after the first dose and none after later doses or after the final dose, used per label directions. The MedGuide defines allowed as acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.
- 48 hours after starting: ground observation
Show the FAA's words: orlistatThe official FAA wording: five passages, each with its document and dateOpen
ACCEPTABLE Weight Loss Medications When certification criteria are met.
Lipase inhibitors – e.g., orlistat [Alli; Xenical] - OTC, 48 hours
Combination of the following (only one diabetic medication): orlistat + metformin, orlistat + GLP-1 agonist
DIABETIC MEDICATIONS USED FOR WEIGHT LOSS: A1C must be 6.4 or less with no diagnosis of diabetes AND No history of hypoglycemia requiring intervention.
Treated with a single diabetic medication component: metformin, GLP-1 agonist
Combination of the following (only one diabetic medication): orlistat + metformin, orlistat + GLP-1 agonist
One (1) week after starting for weight loss. 48-hour observation with each dose increase, medication, or formulation change.
See either the Prediabetes or Weight Loss Management disposition tables
B.
Treated with ONE diabetic medication (non-insulin) component
See the CACI – Weight Loss Management Worksheet
This requires a current, detailed Clinical Progress Note from the treating physician and Hemoglobin A1c lab performed no more than 90 days before the AME exam.
OR
Weight Loss Management Status Report
If the pilot meets all CACI worksheet criteria and is otherwise qualified:
ISSUE
Generic: orlistat
Brand Name: Alli; Xenical
Drug Class: Lipase Inhibitor
Underlying Condition: Weight loss (Obesity)
Use: ALLOW
INITIAL Wait Time (after first dose): 48 hours
SUBSEQUENT Dose Wait Time (after each dose): None
DISCONTINUATION Wait Time (after final dose): None
Frequency Use Limit: Per label directions
ALLOWED: The medication is acceptable for use while performing flight or safety-related duties, provided the condition is stable/aeromedically acceptable and no adverse side effects are present.