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Alternatives to Phentermine Topiramate for Obesity Management Orlistat (available over-the-counter at 60 mg and on prescription at 120 mg) remains the most established option, working through gastrointestinal lipase inhibition to reduce dietary fat absorption by approximately 30%

If a dose is missed, follow the instructions provided for the specific medication and take the missed dose within the recommended time frame

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In particular, tell your provider if you have or had a past history of: Type 1 or type 2 diabetes Thyroid cancer Gastrointestinal disease Pancreatitis Kidney disease Diabetic retinopathy Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding