Name of drug/dosage | Drug Class/ Mechanism of action | Adverse effects | Precautions/ Contraindications | Notes |
Orlistat (Xenical 120 mg TID, Alli 60 mg TID, OTC) | Gastrointestinal lipase inhibitor, alters fat absorption and fecal fat excretion increased | Oily, fecal incontinence, GI complaints | May alter fat soluble vitamin absorption; diet intake of fat < 30% | May be used safely long-term. Does not interfere with any other medication. |
Lorcaserin (Belviq) 10 mg QID | Centrally acting 2C/serotonin agonist | Mild, headache, nausea: hypoglycemia in diabetics | Efficacy similar to Orlistat. Contraindicated with other SSRIs. Caution in patients with valvular heart disease, cognitive impairment, psychiatric disorders, pulmonary HTN. | |
Phentirmine (Adipex) Diethylpropion (Tenuate) | Sympathomimetic, appetite suppressant. Induce early satiety. | CNS stimulation: Hypertension, tachycardia, irritability, palpitations, insomnia, nervousness etc. | Approved for only up to 12 weeks of therapy. Contraindicated in patients with hypertension, hyperthyroidism, and glaucoma. | Schedule IV drugs with low potential for abuse. |
Phentirmine/ Topiramate (Qsymia) | Centrally acting 2C/serotonin agonist appetite suppressant and anti-seizure medicine | Same as above, with additional paresthesia, dizziness, dysgeusia, insomnia, constipation, dry mouth. | Consider in post-menopausal women and men without cardiovascular disease; increased risk of suicide and seizures with abrupt withdrawal. |