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.