Drug Interactions & Toxicology

Moderate to high interaction with monoamine oxidase inhibitors

Low interaction with antihypertensive drugs

Toxic effects of anorectics may occur and include hypertension, tachycardia or psychosis

Laws

Anorectic drugs are FDA approved for weight loss: WegovyTM, Saxenda®, Contrave® , Qsymia®

Qsymia® is a C-IV drug due to phentermine

In order to qualify for a Qsymia® Rx, patients must have a BMI >30 kg/m2

References

Colman E. Anorectics on trial: a half century of federal regulation of prescription appetite suppressants. Ann Intern Med. 2005;143(5):380-385. doi:10.7326/00034819-143-5-200509060-00013

Craddock D. Anorectic drugs: use in general practice. Drugs. 1976;11(5):378-393. doi:10.2165/00003495-

197611050-00002

Ehud Grossman, Franz H. Messerli: Chapter 71 - DrugInduced Hypertension. Mosby. 2007,Pages 883-893, 9780323039611, Karam, Nardine. A Review of FDA-Approved Medications for Chronic Weight Management. Drug Topics; 2021.

Monitoring & Drug Screens

WegovyTM: monitor heart rate

Saxenda®: for patients with T2D, monitor blood glucose, monitor depression for mental health disorders

Contrave®: monitor blood pressure, heart rate, and mood

Qsymia®: monitor for hypokalemia; REMS safety required from FDA due to risks of teratogenicity

Anorectics are not normally monitored in standard drug tests; however, phenteramine can cause a false positive for amphetamine

Professional Opinion

If a patient meets the criteria for anorectic drugs, I feel that it can be helpful short-term for appetite suppression. I would stress the importance of a discussed upon diet and exercise regimen as medication is not stand alone treatment.