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).
Individualize. Use lowest effective dose. Allow tablet to dissolve on tongue, then swallow. >16yrs: usually one tab daily in the AM. Avoid late PM dose.
≤16yrs: not recommended.
Cardiovascular disease (eg, coronary artery disease, stroke, arrhythmias, CHF, uncontrolled hypertension). Hyperthyroidism. Glaucoma. Agitated states. History of drug abuse. During or within 14 days of MAOIs. Pregnancy (Cat.X). Nursing mothers.
Increased risk of primary pulmonary hypertension (PPH), valvular heart disease. Discontinue if unexplained dyspnea, angina pectoris, syncope, or lower extremity edema develops. Discontinue if tolerance to anorectant effect occurs. Mild hypertension. Diabetes. Renal impairment. Prescribe minimal supply to avoid overdose. Elderly.
See Contraindications. Hypertensive crisis possible with MAOIs. Concomitant other weight loss drugs, including SSRIs (fluoxetine, sertraline, fluvoxamine, paroxetine): not recommended. Caution with alcohol. Insulin and oral hypoglycemics: requirements may be altered. May decrease hypotensive effect of adrenergic neuron blocking drugs.
Cardiovascular (eg, PPH, regurgitant cardiac valvular disease, palpitations, 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.