Much recent work has documented the safety and efficacy of appetite suppressants in weight control.[7-46] Appetite suppressants that have been studied and found to be safe, effective, and of low abuse potential include diethylpropion hydrochloride (75 mg daily), mazindol (1 mg daily), phentermine
hydrochloride, fenfluramine hydrochloride (d-fenfluramine and the racemic dl-fenfluramine), fluoxetine hydrochloride (60 to 80 mg daily), and phenylpropanolamine hydrochloride (75 mg daily, available over the counter)[7-46] (Table).
Long term weight control study (weeks 0 to 34); The enhancement of behavior modification, caloric restriction, and exercise by fenfluramine plus phentermine
and fenfluramine were both approved by the FDA, the agency never approved their combined use.
, which acts on another brain chemical, dopamine, increases the body's metabolism and is thought to have a role in reducing minor side effects caused by fenfluramine, such as drowsiness.
As of September 30, FDA had received 144 individual, provider-initiated (i.e., "spontaneous") reports involving fenfluramine or dexfenfluramine, with or without phentermine
, in association with valvulopathy (this total included the 24 publicly reported cases ).
Off-label use of fenfluramine and phentermine
soared after 1992 reports suggested that the combo helps people lose significant amounts of weight.
And anybody who has hypertension, atherosclerosis, or other cardiovascular disease (as many obese people do) should not take phentermine
. Thus a few subjects who developed hypertension in the course of the study had to drop out.
In RCTs, 37%-48% of patients taking phentermine
/topiramate-ER had a total body weight loss of at least 10%, similar to the Mayo Clinic's figure of 49%.
* Comorbid obstructive sleep apnea: Although not indicated for obstructive sleep apnea, patients with obesity and moderate to severe obstructive sleep apnea who were not receiving positive airway pressure treatment received phentermine
15 mg/topiramate 92 mg extended-release or placebo in combination with lifestyle modification counseling.
(Adipex-P, Suprenza and Lonamin) is a psychostimulant, pharmacologically similar to amphetamine, and is available in the U.S.
As part of the amended agreement, Eisai and Arena plan to investigate the potential of BELVIQ in new areas, including smoking cessation, a once-daily formulation, a fixed-dose combination with phentermine
, as well as explore BELVIQ's impact on diabetes and cardiovascular outcomes.
Qnexa is actually a combination of two older drugs that have long been available: the amphetamine phentermine
, which is approved for short-term weight loss, and topiramate, an antiseizure drug sold by Johnson & Johnson as Topamax.