Indications for: LOMAIRA
A short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index ≥30kg/m2, or ≥27kg/m2 in the presence of other risk factors (eg, hypertension, diabetes, hyperlipidemia).
In relatively short-term clinical trials, adult obese patients instructed in dietary management and treated with anorectic drugs lost more weight on the average than those treated with placebo and diet.
The magnitude of increased weight loss of drug-treated patients over patients given placebo is only a fraction of a pound a week. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo patients and tends to decrease in succeeding weeks.
The natural history of obesity is measured over several years, whereas the studies cited are restricted to a few weeks’ duration; thus, the total impact of drug-induced weight loss over that of diet alone must be considered clinically limited.
>16yrs: Individualize. Use lowest effective dose. Usual dose: 1 tab 3 times daily at approx. 30mins before meals. Avoid late PM dose.
≤16yrs: not recommended.
Cardiovascular disease (eg, coronary artery disease, stroke, arrhythmias, CHF, uncontrolled hypertension). During or within 14 days of MAOIs. Hyperthyroidism. Glaucoma. Agitated states. History of drug abuse. Pregnancy. Nursing mothers.
Increased risk of primary pulmonary hypertension (PPH), valvular heart disease. Discontinue if new, unexplained dyspnea, angina, syncope, or lower extremity edema develops. Discontinue if tolerance to the anorectant effect develops. Mild hypertension. Diabetes. Renal impairment: monitor. Prescribe minimal supply to avoid overdose. Elderly.
See Contraindications. Hypertensive crisis possible with MAOIs. Concomitant other weight loss drugs, OTC preps, herbals, including SSRIs (eg, fluoxetine, sertraline, fluvoxamine, paroxetine): not recommended. Caution with alcohol. Insulin or oral hypoglycemics: requirements may be altered. May decrease hypotensive effect of adrenergic neuron blockers.
Cardiovascular (eg, PPH, regurgitant cardiac valvular disease, palpitation, tachycardia, elevated blood pressure, ischemic events, CNS (eg, overstimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, psychosis), dry mouth, unpleasant taste, GI upset, constipation, urticaria, impotence, changes in libido.
Generic Drug Availability:
Tabs—30, 60, 90, 250, 500, 1000