Lomaira, selective serotonin (5-hydroxytryptamine [5HT])-2C receptor agonist, was approved by the FDA in 2012 as a long-term treatment of obesity.
Lorcaserin reduces appetite and increases satiety by binding to the 5HT-2C receptors anorexigenic pro-opiomelanocortin (POMC) neurons in the hypothalamus.
Because of its selective agonism of the serotonin 2C receptor, lorcaserin was designed to avoid cardiac valvular effects mediated through the 5HT-2B receptor. The development program has not observed an increased incidence of valvulopathy over2 years, and long-term data are being collected in a 5-year cardiovascular outcome study.
The recommended dosage of lorcaserin is 10 mg twice daily with or without food. 25 There is also a new 20-mg extended-release tablet, which can be taken once daily. 26 The medication should be discontinued if 5% or less weight loss is achieved after 12 weeks. Lorcaserin is a schedule IV controlled substance.
Lomaira is the only strength of phentermine hydrochloride that can be taken up to three times a day before meals. The limited usefulness of agents of this drug class (anorectics), including Lomaira, should be measured against possible risk factors inherent in their use.
INDICATIONS FOR USE
Don’t take Lomaira if you have a history of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive heart failure or uncontrolled high blood pressure); are taking or have taken a monoamine oxidase inhibitor drug (MAOI) within the past 14 days; have an overactive thyroid, glaucoma (increased pressure in the eyes), agitation or a history of drug abuse; are pregnant, nursing, or allergic to the sympathomimetic amines such as phentermine or any of the ingredients in Lomaira.
Taking phentermine with other drugs for weight loss is not recommended. Primary pulmonary hypertension (PPH), a rare fatal lung disease, has been reported in patients who had taken a combination of phentermine and fenfluramine or dexfenfluramine for weight loss. The possible association between phentermine use alone and PPH cannot be ruled out. Patients should report immediately if they experience any decrease in the amount of exercise that they can normally tolerate, shortness of breath, chest or heart pain, fainting or swelling in the lower legs.