Belviq is a new prescription weight loss drug, one of only two new weight loss drugs approved by the FDA in the last 13 years. Belviq acts in the brain as a serotonin 2C receptor agonist.
Unique features of Belviq
- Belviq is not a stimulant
- Belviq does not cause insomnia
- Belviq can be used for long term
BELVIQ is indicated for chronic weight management in adult patients with an
initial body mass index (BMI) of:
• 30 kg/m2
or greater (obese), or
• 27 kg/m2 or greater (overweight) in the presence of at least
one weight-related comorbid condition (e.g., hypertension,
dyslipidemia, type 2 diabetes)
DOSAGE FORMS AND STRENGTHS
BELVIQ is provided as blue, film-coated, 10 mg tablets. The recommended dose of BELVIQ is 10 mg administered orally twice daily. Dose is unrelated to meal time.
Most common adverse reactions (greater than 5%) in non-diabetic
patients are headache, dizziness, fatigue, nausea, dry mouth, and
constipation, and in diabetic patients are hypoglycemia, headache, back
pain, cough, and fatigue.
What is Qsymia?
Qsymia is the only once daily FDA approved diet pill for long term weight loss. It is unique because it is the first weight loss drug to be approved by FDA in over 15 years due its unique synergistic effect.
It is a unique combination of two well known drugs, phentermine and topiramate, but new formulation.
The main difference is “summation of effect without summation of side effects.”
For that reason at Allergy and weight Loss center and Concord weight loss center we use Qsymia for short and long term weight loss
Qsymia or Qnexa?
Qsymia had been known as Qnexa until its approval. The FDA asked the company to change the name to avoid confusion with another drug on the market, according to the company.
How does Qsymia work?
Phentermine is appetite suppressant. Topiramate acts on the brain neurotransmitters. This medication acts on serotonin , a neurotransmitter that has been implicated
Phentermine is an appetite suppressant. It triggers the release of norepinephrine in the brain, which increases blood concentrations of leptin, an appetite-regulating hormone.
Topiramate, commonly known as Topamax, is prescribed as an anticonvulsant and migraine medication. It can aid in weight loss by increasing the feeling of being full, making foods taste less appealing and increasing calorie expenditure.
Qsymia is indicated for weight loss if
1. If your BMI is over 30 or
2. If your BMI is more than 27 with medical problems such as hypertension, diabetes, high cholesterol, sleep apnea, heart disease, stroke, PCOS etc.
- Must NOT be pregnant, trying to get pregnant, or unable/unwilling to comply with contraceptive guidance
- No glaucoma
- No hyperthyroidism
- Not using monoamine oxidase inhibitors (MAOIs) or have not used within 14 days
- No known hypersensitivity or idiosyncrasy to the sympathomimetic amines
How can you get Qsymia?
- Qsymia is Class IV controlled drug.
- Qualified medical doctor faxes the prescription to central pharmacies like Walgreen, Express Scripts, or CVS
- Medication is shipped to your home address directly
- The first order includes two weeks starter dose, and one additional month’s supply
- Qsymia cannot be filled by local pharmacy or by any online pharmacy.
What doses of Qsymia available?
Qsymia is available as phentermine hydrochloride (as the free base)/topiramate extended-release gelatin capsules in the following strengths and colors:
- 3.75 mg/23 mg [Purple cap imprinted with VIVUS, Purple body imprinted with 3.75/23]
- 7.5 mg/46 mg [Purple cap imprinted with VIVUS, Yellow body imprinted with 7.5/46]
- 11.25 mg/69 mg [Yellow cap imprinted with VIVUS, Yellow body imprinted with 11.25/69]
- 15 mg/92 mg [Yellow cap imprinted with VIVUS, White body imprinted with 15/92]
Side effects of Qsymia
- Qsymia side effects are much less than the individual components of phentermine and topiramate because Dose of phentermine is much less than usually used in weight loss clinics
- Top dose in Qsymia is 15 mg of phentermine as opposed to 37.5 mg Dose of topiramate is much less than used for migraine prevention ro seizure disorder.
- Top dose in Qsymia is 92mg as opposed to 300-400mg Combination of the drugs cancel out the upper/downer side effects
Qysymia starting dose
Qsymia™ is initiated with a starting dose of 3.75 mg/23 mg† that is increased after 14 days of treatment to a recommended dose of 7.5 mg/46 mg. After 30 days on this dose, the patient should be evaluated and the dose titrated based on response.
To begin, your doctor will write 2 prescriptions:
- 14 days on starting dose (3.75 mg/23 mg)
- 30 days on recommended dose (7.5 mg/46 mg)
- Once daily, in the morning, with or without food
Qsymia dose titration
After 12 weeks at recommended dose of 7.5 mg/46 mg
- If weight loss is less than 3%, discontinue Qsymia or escalate the dose
- To escalate dose, prescribe:
- 14 days on titration dose of 11.25 mg/69 mg†
- 30 days on top dose of 15 mg/92 mg
After additional 12 weeks following dose escalation to top dose of 15 mg/92 mg
- If weight loss is less than 5% after 12 weeks, discontinue treatment
- Discontinue top dose (15 mg/92 mg) gradually by taking a dose every other day for at least 1 week prior to stopping altogether, due to the possibility of precipitating a seizure with abrupt cessation of the drug
Qsymia information resources
Contrave, the new prescription weight loss drug to be approved by the FDA in 2014.
Contrave joins Qsymia (phentermine and topiramate) and Belviq (lorcaserin). Both were approved in 2012.
Contrave combines two drugs already on the market:
- Bupropion (Wellbutrin), an antidepressant, (inhibitor of the neuronal reuptake of dopamine and norepinephrine) and
- Naltrexone, an anti-addiction drug (opioid antagonist).
Bupropion, the same active ingredient as some other antidepressant medications ( WELLBUTRIN, WELLBUTRIN SR, WELLBUTRIN XL and APLENZIN)
Naltrexone is is marketed in generic form as naltrexone hydrochloride, and marketed under the trade names Revia and Depade. In some countries including the United States, a once-monthly extended-release injectable formulation is marketed under the trade name Vivitrol. Also in the United States, Methylnaltrexone Bromide, a closely related drug, is marketed as Relistor, for the treatment of opioid induced constipation.
How does Contrave work?
Naltrexone and bupropion have effects on two separate areas of the brain involved in the regulation of food intake:
- Hunger center: Hypothalamus (appetite regulatory center) and
- Craving center: Mesolimbic dopamine circuit (reward system).
What is the usual dosage of Contrave?
More information about Contrave:
- Saxenda is very different from all other weight loss drugs.
- It is a once a day injection instead of a pill. For another,
- it works by mimicking naturally occuring hormone GLP-1 in your intestine secretes when you eat food.
- GLP-1 activates specific areas in the brain that regulate appetite and food intake affecting:
Satiety (satisfaction of a meal)
- The hormone-mimicking drug in Saxenda, Liraglutide, was originally marketed as Victoza, prescribed to treat diabetes.
- It was discovered that a “side effect” of Victoza was weight loss.
- Saxenda is essentially a double dose of Victoza, and after much testing, the FDA approved it for weight loss in December of 2014.
- It can be used effectively long term, for chronic management of obesity.
- It is not like the appetite suppressant weight loss drugs that only work for a while.
- Like other medications used for diabetes, it introduces a hormone that compensates for a deficiency.
At our clinic, Anita Bhat, MD and Jyoti Bhat, MD are board certified endocrinologists with expertise in using Saxenda category of drugs.