Side Effects of Obesity Drugs

1. CONTRAVE-  oNE OF THE MOST POPULAR OBESITY DRUGS

How it works: CONTRAVE is a combination of naltrexone, an opioid antagonist, and bupropion, an antidepressant, and is offered in extended release tablets. Naltrexone is used to treat alcohol and opioid dependence while bupropion is approved to address depression and seasonal affective disorder and serves as an aid to smoking cessation treatment.

Approved Use: Contrave is used in conjunction with a reduced-calorie diet and increased physical activity for chronic weight management in adults with a body mass index (BMI) of 30 or greater (obese) or 27 or greater (overweight) in the presence of at least one weight-related medical problem such as high blood pressure, high cholesterol, or type 2 diabetes. Contrave has not been tested on and is not approved for use in children under the age of 18. Patients begin with 1 tablet in the morning and graduate to 4 tablets per day by week 4, taking 2 tablets in the morning and 2 tablets in the evening.

Patents should swallow Contrave tablets whole and not cut, chew or crush the tablets. They should avoid high-fat meals and excessive alcohol consumption while taking Contrave. If a patient misses a dose of Contrave, he or should wait until the next regular time to take it. Patients should not take more than 1 dose of Contrave at a time.

Contrave has strict dosing requirements and warnings so check the Medication Guide for more information. There are many drug interactions and counter indications for a significant number of populations so patients are advised to check the drug’s Medication Guide before taking this medicine.

CONTRAVE Side Effects

If any of the following symptoms of overdose occur while taking bupropion / naltrexone, get emergency help immediately:

• symptoms of overdose
• blue lips, fingernails, or skin
• change in consciousness
• confusion
• decreased awareness or responsiveness
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fainting
• loss of consciousness
• muscle cramps or spasms
• severe sleepiness
• sweating

Some of the side effects that occur with this obesity drugs  combination may not need medical attention. As your body adjusts to the medicine during treatment these side effects may lessen or go away completely. Your health care professional may also be able to guide you regarding ways to reduce or prevent some of these side effects.

Effectiveness: The effectiveness of Contrave was evaluated in several clinical trials that included approximately 4,500 obese and overweight patients with and without other weight-related medical problems. In one trial of patients without diabetes, those taking Contrave lost 5.4% of their body weight compared to 1.3% taking a placebo after 56 weeks. 42% of the patients in the trial taking Contrave lost 5% or more of their body weight compared to 17% of those not on Contrave. All patients followed a diet and exercise regimen.

Other Considerations:
Black Box Warning: In its release about the approval of Contrave, the FDA makes this note: “Because it contains bupropion, Contrave has a boxed warning to alert health care professionals and patients to the increased risk of suicidal thoughts and behaviors associated with antidepressant drugs. The warning also notes that serious neuropsychiatric events have been reported in patients taking bupropion for smoking cessation.”

Contrave can also cause seizures and should not be used in patients who have seizure disorders. Contrave can also raise blood pressure and heart rate and should not be used in patients with uncontrolled high blood pressure. Blood pressure and pulse should be measured prior to starting the drug and monitored at regular intervals. Other products containing bupropion, such as Wellbutrin and Aplenzin, should not be taken in conjunction with Contrave. The medication can also cause liver and vision problems.

Other groups who should not take Contrave including those who:

• have or have had an eating disorder called anorexia (eating very little) or bulimia (eating too much and vomiting to avoid gaining weight)
• are dependent on opioid pain medicines or use medicines to help stop taking opioids such as methadone or buprenorphine, or are in opiate withdrawal
• drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines and you stop using them all of a sudden
• are taking medicines called monoamine oxidase inhibitors (MAOIs). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including linezolid. Do not start Contrave until you have stopped taking your MAOI for at least 14 days.
• are allergic to naltrexone or bupropion or any of the ingredients in Contrave.
• are pregnant or planning to become pregnant. Tell your healthcare provider right away if you become pregnant while taking Contrave.

2. SAXENDA

How it works: This drug (generic name: liraglutide), which is administered through daily injection, mimics a hormone made in the intestines called GLP-1 (glucagon-like peptide) that tells the brain the stomach is full. It may also help stabilize blood sugar which is why it is also used in diabetes treatment.
Approved Use: People who meet the CDC’s criteria for obesity drugs , e.g., anyone with a BMI of 30 or greater. People with a BMI greater than 27 who have a known weight-related health
condition such as diabetes or heart disease.

Saxenda should not be used by patients with a personal or family history of Medullary thyroid cancer (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

SAXENDA Side Effects

Effectiveness: The safety and effectiveness of Saxenda were evaluated in three clinical trials that included approximately 4,800 obese and overweight patients. Patients without diabetes had an average weight loss of 4.5% from baseline compared to a placebo treatment, and in in the most successful trial, 62% lost at least 5 percent of their body weight using the drug compared with 34% of patients treated with placebo.
Other Considerations
If a patient has not lost at least 4% of body weight at 16 weeks, the drug should be discontinued as it unlikely to offer any meaningful clinical results for weight loss after that point. In rodent studies, the drug caused thyroid gland tumors but it is not known if it will do the same in humans;
for this reason Saxenda has a boxed warning.

3. BELVIQ

How it works: Works by activating the brain’s response to the “feel good” chemical serotonin
which has the effect of suppressing appetite.
Approved Use:
People who meet the CDC’s criteria for obesity, e.g., anyone with a BMI of 30 or
greater.

People with a BMI greater than 27 who have a known weight-related health
condition such as diabetes or heart disease.

The drug is NOT approved for pregnant or nursing women; People taking cabergoline (Dostinex) or other obesity drugs linked to valvular heart disease; people who take medication for depression, migraine headaches, mood and anxiety disorders or the common cold; men with a deformed penis or with sickle cell anemia, multiple myeloma, leukemia or any other condition that predisposed them to prolonged erections.

BELVIQ Side Effects

4. QYSMIA

How it works: Medication, and phentermine, the “safe” ingredient in phen-fen, this drug. It appears to suppress appetite by triggering the release of the chemical norepinephrine in the brain, which increases blood concentrations of the hunger-regulating hormone, leptin. The topiramate side of this example of obesity drug acts to increase feelings of fullness, makes food less appealing, and increases calorie-burning capabilities.