Weight Loss Medications
Use with reduced-calorie
diet and increased physical activity
Contrave
(naltrexone/bupropion)
·
Naltrexone is an opiod
antagonist
·
BMI
o 30 kg/m2 or greater (obese) or
o 27 kg/m2 or greater (overweight) + comorbidity
§ Hypertension
§ Type 2 diabetes mellitus
§ Dyslipidemia
·
4-week dose titration
schedule
·
ADR – suicidality,
neuropsychiatric reactions
·
Administration
o NOT cut, chew, or crush Contrave tablets
o NOT take Contrave with high-fat meals à seizures
Belviq (lorcaserin)
·
Serotonin 2C receptor
agonist
·
ADR - serotonin
syndrome, neuroleptic malignant syndrome
·
Administration
o with or without food
Qsymia (phentermine/topiramate)
·
Phentermine - sympathomimetic
amine anorectic
·
Topiramate - antiepileptic
medication
·
ADR - concentration,
memory, and speech difficulties
·
Administration
o With or without food
o Avoid in evening à insomnia
o Avoid alcohol à dizziness and sleepiness
o NOT stop suddenly à seizures
Alli (orlistat)
·
Inhibits gastrointestinal
lipases
·
Administration
o 3 times a day with each main meal containing fat
o Take multivitamin with A,D,E,K
·
ADR – GI effects, gas
Evaluate response after
12 weeks
If 5% weight loss not
seen à stop drug
Weight Loss Bariatric Surgery
- BMI > 35 + comorbidity (hypertension, dyslipidemia, type 2 diabtes)
- BMI > 40
Weight Gain Medications
- Anticonvulsants (carbamazepine, gabapentin, pregabalin, valproic acid, lithium)
- Antidepressants (phenelzine, mirtazapine, paroxetine, amitriptyline, nortriptyline)
- Antihistamines (H1 blockers - cetirizine)
- Antihypertensives (atenolol, propanolol)
- Vasodilators (minoxidil)
- Antipsychotics (chlorpromazine, clozapine, iloperidone, olanzapine, quetiapine, risperidone)
- Corticosteroids
- Hormonals (medroxyprogesterone, megestrol)
- Hypoglycemic (insulin, sulfonylureas, meglitinides, thiazolidinediones)
Source:
http://www.pharmacytimes.com/contributor/anyssa-garza/2015/03/weight-loss-medications-on-the-market