Xenical (Thincal 120mg) is prescribed through online consultation.
Starting from 4,000 yen for 14 tablets / Consultations daily from 9:00 to 22:00, fastest same-day shipping.
What is Xenical (Orlistat)?
Xenical (generic name: orlistat) is a medication that inhibits the action of the digestive enzyme lipase, thereby suppressing the absorption of about 30% of dietary fat. Unabsorbed fat is expelled with stool.
While GLP-1 receptor agonists (such as Mounjaro and Ozempic) suppress appetite, Xenical promotes weight loss by "preventing the absorption of consumed fat." This treatment is suitable for those who do not respond well to appetite suppressants or who consume a lot of fatty meals.
Thincal, which we handle at our clinic, is a generic medication with the same active ingredient as Xenical (orlistat 120mg). Ally, marketed by Taisho Pharmaceutical, also contains the same ingredient, but the content is different at 60mg.
Recommended for those who:
- Eat a lot of fried or greasy foods
- Did not respond well to appetite suppressants (such as GLP-1)
- Find dietary restrictions difficult but want medication support
- Want to use it only on days with high-fat meals
- Want to combine it with other diet medications
How much weight can be lost? Efficacy目安
A large-scale 4-year study (XENDOS) on obese individuals reported the following results:
| Condition | Result |
|---|---|
| Orlistat 120mg x 3/day + lifestyle modification (4 years) | Average weight loss of 5.8kg |
| Lifestyle modification alone (4 years) | Average weight loss of 3.0kg |
| Diabetes incidence over 4 years | 37% reduction (45% reduction in those with impaired glucose tolerance at baseline) |
How much is "30% fat cut" in practice?
Looking at the numbers can help visualize the extent of the effect.
- A meal with 20g of fat (approx. one fried dish) → approx. 6g absorption suppressed = approx. 54kcal
- A diet consuming 60g of fat per day → approx. 18g = approx. 162kcal
This means that the more fat in your meal, the greater the effect, and meals with less fat will have little to no effect. Conversely, if you increase your fat intake "because you're taking medication," it will cancel out the effect. The smartest way to use this medication is to target days when you have greasy meals. Individual results may vary.
Only on days with greasy meals, only as needed.
Mechanism of Action of Xenical
Fat Cut by Lipase Inhibition
Dietary fat (triglycerides) is absorbed into the body only after being broken down by the digestive enzyme lipase in the small intestine. Xenical inhibits the action of this lipase, thereby suppressing the breakdown and absorption of fat. Unabsorbed fat is then expelled from the body with stool. A characteristic feature is that it works in the intestines rather than being absorbed into the bloodstream and acting systemically.
Difference from Over-the-Counter Drug "Ally"
| Comparison Item | Thincal 120mg (Our clinic) | Ally (Taisho Pharmaceutical・OTC) |
|---|---|---|
| Ingredient・Dosage | Orlistat 120mg | Orlistat 60mg |
| Category | Doctor's prescription (private practice) | Designated Class 1 OTC (requires in-person consultation with a pharmacist) |
| Estimated Fat Cut | Approx. 30% | Approx. 25% |
| Target Audience | Those deemed appropriate by a physician | Individuals 18 years or older with waist circumference (at navel height) of 85cm or more for men and 90cm or more for women, who are actively engaged in lifestyle modification |
| Efficacy・Purpose | Weight management (private practice) | Reduction of visceral fat and waist circumference |
| Availability | Online consultation complete・Delivery to home | Purchase at pharmacies・drugstores (requires lifestyle record) |
How to Take and Use
Basic Dosing Instructions
Take one tablet (120mg) with water or lukewarm water during or within one hour after a fatty meal. You can take it up to three times a day (with each meal: breakfast, lunch, and dinner).
Tips for Taking
- No need to take it with low-fat meals (e.g., vegetable-focused, Japanese cuisine)
- No need to take it if you skip a meal
- If more than an hour has passed after a meal, skip that dose
- Taking more than 3 times a day will not increase its effectiveness
Common Mistakes
| What people tend to do | Why it's a waste |
|---|---|
| Taking it strictly with every meal | It has little effect with low-fat meals, and you'll just run out of tablets faster |
| Taking it more than an hour after a meal | It won't be effective once fat digestion has already progressed |
| Increasing fried food intake because you're taking the medication | Only about 30% can be cut. If the increased intake exceeds this, it becomes meaningless, and "oil leakage" will be more severe |
| Stopping on your own due to severe side effects | Side effects can be reduced by adjusting fat intake or limiting use to specific meals. Please consult us first |
Choosing between 14 and 28 tablets
| Plan | Who it's for |
|---|---|
| 14 tablets (1 month) | Those who use it only on days with 1-2 greasy meals |
| 28 tablets (1 month) | Those who want to use it with every meal or have fatty meals daily |
Pricing Plans
| Plan | Number of Tablets | Price |
|---|---|---|
| 14 tablets (1 month) | Thincal 120mg x 14 | 4,000 yen |
| 14 tablets x 3 (3 months) | Thincal 120mg x 42 | 11,400 yen |
| 14 tablets x 6 (6 months) | Thincal 120mg x 84 | 21,600 yen |
| 28 tablets (1 month) | Thincal 120mg x 28 | 7,000 yen |
| 28 tablets x 3 (3 months) | Thincal 120mg x 84 | 19,950 yen |
| 28 tablets x 6 (6 months) | Thincal 120mg x 168 | 37,800 yen |
As this is a private medical service, health insurance is not applicable. Prices displayed include tax and consultation fees.
You can start with 14 tablets.
About Side Effects
Most side effects are gastrointestinal symptoms caused by unabsorbed fat remaining in the intestines. These tend to be more pronounced at the beginning of treatment or after fatty meals and can be significantly reduced by being mindful of the fat content in your diet.
Main Side Effects
| Side Effect | Description | Management |
|---|---|---|
| Oily stools・Fatty stools | Unabsorbed fat is expelled with stool | Use panty liners until you get used to it |
| Fecal incontinence・Oily anal leakage | Oil may leak out without your awareness | Common in early treatment. Reduced by decreasing dietary fat intake |
| Frequent bowel movements・Loose stools・Diarrhea | Fat stimulates the intestines, increasing bowel movement frequency | Easily reduced by avoiding high-fat meals |
| Abdominal bloating・Gas | Gas production due to undigested fat in the intestines | Often subsides with continued use |
If symptoms are severe or persistent, please consult us instead of stopping on your own.
Beware of fat-soluble vitamin deficiency
Xenical also suppresses the absorption of fat-soluble vitamins (A, D, E, K) along with fat. If you are taking it long-term, please note the following:
- Take multivitamin supplements at least 2 hours after taking Xenical
- Lack of fat-soluble vitamins can lead to risks such as brittle bones and reduced immunity
- We can also prescribe vitamin supplements. Please consult us via official LINE if you wish
Rare but important side effect: Liver damage
Although very rare, severe liver damage has been reported during orlistat use. While a causal relationship has not been definitively established, regulatory authorities overseas have issued warnings. If you experience any of the following symptoms, stop taking the medication and seek medical attention immediately:
- Itching of the body
- Yellowing of the whites of the eyes or skin (jaundice)
- Dark urine, pale stools
- Loss of appetite, persistent severe fatigue
Differences and Combinations with Other Diet Medications
| Type | How it works | Who it's for |
|---|---|---|
| Xenical (with each meal) | Suppresses fat absorption | Those who eat a lot of fried or greasy foods |
| Metformin (daily) | Suppresses glucose production and improves insulin sensitivity | Those who want to continue slowly and cost-effectively |
| SGLT2 inhibitors (daily) | Expels excess sugar through urine | Those who eat a lot of rice, noodles, or sweets |
| Rybelsus / Mounjaro | Suppresses appetite and prolongs satiety | If you want to suppress your appetite or significantly reduce it |
Concomitant use with Metformin
Metformin works on sugar metabolism, while Xenical works on fat absorption, so their mechanisms of action are different. For those with a diet high in both carbohydrates and fats, they are expected to work synergistically.
Combination with Mounjaro and GLP-1
GLP-1 receptor agonists (such as Mounjaro and Rybelsus) suppress appetite, while Xenical inhibits fat absorption. Because they have different approaches, they may be used in combination. Both can easily cause gastrointestinal symptoms, so the doctor will determine the feasibility of concomitant use and the starting dose during the consultation.
Precautions and Contraindications
Who cannot take this medication
- Pregnant or breastfeeding individuals
- Individuals with chronic malabsorption syndrome
- Individuals with cessation of bile secretion
- Individuals taking warfarin (anticoagulant) (consultation required)
- Individuals taking cyclosporine
Who needs to take this medication with caution
- Individuals with hypothyroidism (caution regarding interaction with thyroid hormones)
- Individuals with diabetes taking hypoglycemic agents (blood sugar levels may drop more easily)
- Individuals taking antiepileptic drugs
- Individuals with a history of eating disorders
Please be sure to inform us during your consultation about any medications or supplements you are taking, and your medical history.
Notes on Unapproved Pharmaceuticals, etc.
- Unapproved pharmaceutical: Syncar (Orlistat 120mg), handled by our clinic, is an unapproved pharmaceutical in Japan for the purpose of obesity treatment.
- Method of acquisition: The physician imports the drug through personal import procedures (obtaining a yakkan shomei from the regional Ministry of Health, Labour and Welfare).
- Availability of approved domestic pharmaceuticals: "Alli" (Orlistat 60mg, a pharmacist-guided drug) from Taisho Pharmaceutical is an approved domestic drug with the same active ingredient. The content, efficacy, and target differ.
- Safety information in other countries: Orlistat is an ingredient approved and used for many years in many countries, including the US and Europe. On the other hand, the US FDA added a warning to the package insert in 2010 about rare reports of severe liver damage (causal relationship has not been established).
- Health damage relief system: Health damage caused by the use of unapproved pharmaceuticals is not covered by the Pharmaceutical Side Effect Relief System.
- Cost/Effect: Since this is an out-of-pocket medical service, health insurance does not apply, and the full amount is self-paid. The degree of effect varies among individuals.
Prescription process at our clinic
| STEP | Content |
|---|---|
| 1. Order & Pre-consultation | Please select your desired plan and place an order. Afterward, you will answer a questionnaire sent via LINE or email. Please accurately provide information about any medications you are taking and your medical history. |
| 2. Online Consultation | A doctor will conduct a consultation via video call and determine whether a prescription is possible. You can receive the consultation with just a smartphone or PC. |
| 3. Shipping | If the video call is completed by 3:00 PM daily, shipping will be on the same day. We will deliver in discreet packaging. |
You can start today.
Frequently Asked Questions
Related Pages
- Metformin (supports sugar metabolism)
- SGLT2 inhibitors (sugar reduction)
- Mounjaro (GLP-1/GIP injection)
- Rybelsus/Ozempic (GLP-1)
- Bofutsushosan (improves bowel movements)
- About Online Consultation / About Fees
References
Torgerson JS, et al. XENical in the prevention of Diabetes in Obese Subjects (XENDOS) study. Diabetes Care. 2004.
U.S. Food and Drug Administration. FDA Drug Safety Communication: Xenical/Alli (orlistat) and severe liver injury. 2010.
