Name: Obesity Treatments - Optometry Advisor
Published: 2021-09-29T14:35:00+00:00

OBESITY TREATMENTS
Generic	Brand		Strength	Form	Adult Dose
CNS STIMULANT
amphetamine sulfate	Evekeo	CII	5mg, 10mg	tabs	Take 30−60mins before meals. Usually up to 30mg/day in divided doses of 5−10mg.
methamphe– tamine HCl	Desoxyn	CII	5mg	tabs	≥12yrs: 1 tab 30mins before each meal.
GLUCAGON RECEPTOR-1 AGONIST
liraglutide	Saxenda	Rx	6mg/mL	SC inj	Give by SC inj into abdomen, thigh, or upper arm once daily. Escalate dose gradually. Week 1: 0.6mg daily; Week 2: 1.2mg daily; Week 3: 1.8mg daily; Week 4: 2.4mg daily; Week 5 and onward: 3mg daily. Delay dose escalation 1wk if increased dose not tolerated; discontinue if 3mg not tolerated. If >3 days elapsed since last dose, reinitiate at 0.6mg/day, then escalate dose as above. Evaluate response after 16wks. Discontinue if ≥4% weight loss is not achieved.
LIPASE INHIBITOR
orlistat	Alli	OTC	60mg	caps	≥18yrs: 1 cap with each fat-containing meal; max 180mg/day. Take multivitamin once daily at bedtime.
orlistat	Xenical	Rx	120mg	caps	≥12yrs: Use with a reduced calorie diet with about 30% of calories from fat; spread fat intake over 3 main meals. 120mg three times daily during or up to 1hr after each fat-containing meal. If a meal is missed or has no fat, skip dose. Take multivitamin once daily 2hrs before or after Xenical.
OPIOID ANTAGONIST + AMINOKETONE
naltrexone HCl/ bupropion HCl	Contrave	Rx	8mg/ 90mg	ext-rel tabs	Avoid high-fat meals. Escalate dose gradually. ≥18yrs: Week 1: 1 tab daily in the AM; Week 2: 1 tab daily in the AM and 1 tab daily in the PM; Week 3: 2 tabs in the AM and 1 tab in the PM; Week 4 and thereafter: 2 tabs in the AM and 2 tabs in the PM. Max 32mg/360mg per day. Evaluate response after 12wks. Discontinue if ≥5% weight loss is not achieved.
SYMPATHOMIMETIC
benzphet– amine HCl	—	CIII	50mg	scored tabs	≥12yrs: Initially 25−50mg once daily in mid-morning or mid-afternoon. Increase if needed to 25−50mg 1−3 times daily.
diethylpro– pion HCl	—	CIV	25mg	tabs	≥16yrs: 25mg 3 times daily 1hr before meals and in midevening for night hunger or one 75mg sust‑rel tab daily in midmorning.
diethylpro– pion HCl	—	CIV	75mg	sust-rel tabs
phendime– trazine – tartrate	—	CIII	105mg	ext-rel caps	≥17yrs: 1 cap in AM, 30−60mins before morning meal.
phendime– trazine – tartrate	—	CIII	35mg	scored tabs	Individualize. 1 tab 2−3 times daily, 1hr before meals. May reduce to 17.5mg/dose. Max 75mg 3 times daily.
phentermine HCl	—	CIV	15mg, 30mg	powder-filled or pellet-filled caps	Avoid late evening dosing. ≥16yrs: Individualize. 15−30mg at approx. 2hrs after breakfast.
	Adipex-P		37.5mg	caps, scored tabs	Avoid late evening dosing. ≥16yrs: 1 tab once daily before or 1−2hrs after breakfast, or 18.75mg 1−2 times daily.
	Lomaira		8mg	scored tabs	Avoid late evening dosing. ≥16yrs: Individualize; usually 1 tab 3 times daily at approx. 30mins before meals.
SYMPATHOMIMETIC + ANTIEPILEPTIC
phentermine HCl/ topiramate extended-release	Qsymia	CIV	3.75mg/ 23mg, 7.5mg/ 46mg, 11.25mg/ 69mg, 15mg/ 92mg	caps	Take once daily in AM. Initially 3.75mg/23mg for 14 days; then increase to 7.5mg/46mg. Evaluate weight loss after 12wks on this dose. Discontinue or escalate dose if patient has not lost ≥3% baseline body weight. To escalate dose: increase to 11.25mg/69mg for 14 days, then increase to 15mg/92mg and evaluate weight loss after additional 12wks at this dose. If patient has not lost ≥5% baseline body weight, discontinue by taking a dose every other day for at least 1wk prior to stopping altogether. Qsymia 3.75mg/23mg and 11.25mg/69mg strengths are for titration purposes only.
NOTES
Not an inclusive list of medications or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 5/2020)

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