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Long-term use may require intake of fat-soluble vitamins to be taken at least 2 hours before or after orlistat dose. This product should not be given to patients with known allergy to orlistat or to any of its components. Patients taking immunosuppressants like cyclosporine and those with chronic malabsorption syndrome or cholestasis should not take this product. Not recommended for use in pregnant or breastfeeding women. A few weeks ago, a middle-age patient who has been taking orlistat regularly for weight loss asked about the increased risk of developing cancer, especially colon cancer, with prolonged intake of the product. Orlistat, which is available locally under different brand names, is the only anti-obesity drug approved for over-the-counter sale. When a drug is approved as such, that means there’s no significant risk for people to take it even without a doctor’s prescription. 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