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• Avoid fatty foods in between meals, e.g. cakes, biscuits, crisps

• DO NOT take Orlistat if a meal is missed or does not contain fat

Reviewing treatment:
It is recommended that Orlistat is monitored regularly, ideally monthly and that diet and lifestyle changes are
reinforced at each review: Continue treatment >3 months ONLY if people achieve at least 5% weight loss from
their initial body weight during the treatment (less strict goals may be considered for those with type 2 diabetes).
Treatment can continue past 12 months for weight maintenance (ONLY after discussing benefits, risks and
limitations with the patient).

Contraindications:
Pregnancy, Breastfeeding, cholestasis & chronic malabsorption syndrome.

It is important the prescribing doctor ensures the patient has no contraindication to commencing this
medication.
HSE guidelines on weight management

http://www.nrh.ie/wp-content/uploads/2015/11/Weight-Management-Treatment-Algorithm-HSE-ICGP.pdf

8) Asthma
Asthma is the most common chronic respiratory disease in the Republic of Ireland affecting people of all ages
and all socio-economic groups. Ireland has the fourth highest prevalence of Asthma worldwide, and current
estimates suggest that there are approximately 450,000 people with doctor-diagnosed asthma in Ireland
(approx. 1 in 10 of population). The prevalence is even higher in children with about 21% of children
affected. Asthma is often under-diagnosed and uncontrolled, creating a substantial burden of ill-health to
individuals, their families and the economy.

While there is no cure for asthma, symptoms can come and go throughout your life. Several treatments can help
control the condition very effectively.
Treatment is based on two important goals:

• relief of symptoms
• preventing future symptoms and attacks from developing

Successful prevention can be achieved through a combination of medicines that are used effectively and lifestyle
advice. The identification of personal triggers and the avoidance of an identified trigger is key to preventing
asthma attacks.
Patients with stable asthma can avail of a repeat prescription for inhaled therapies.

Patients must satisfy certain criteria to be eligible for a repeat prescription without a face to face consultation.

1. Be stable on their current inhaled therapies. No increment in the dose over the preceding year.
2. Have not required oral steroid treatment for an acute exacerbation within the past six months.

3. That they do not have a current exacerbation of their asthma. No current respiratory tract infection.
Once the doctor reviewing the patient safety questionnaire is satisfied that the patient has no contraindication
to the medication or does not have an active current exacerbation of their asthma a prescription for the inhaled
therapies can be issued.
Where a doctor is not satisfied that the patient fulfills these criteria the doctor should direct the patient to have
a face to face consultation with their General practitioner.

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