Korean J Obes.  2015 Mar;24(1):17-27. 10.7570/kjo.2015.24.1.17.

Safety of Anti-Obesity Drugs Approved for Long-Term Use

Affiliations
  • 1Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea. zaduplum@aim.com

Abstract

Because of the widespread use of ant-obesity medications, bariatricians need to be aware not only of common adverse events but also uncommon serious events in the pharmacotherapy of obesity. Safety and tolerability must be considered in selecting the drug, titrating the dosage, and monitoring patients. In Korea, orlistat and lorcaserine are the two anti-obesity drugs that can be used for long-term treatment, and in the US, liraglutide, phentermine/topiramate, and naltrexone/bupropion have been recently approved. In general, all of these drugs have very good safety and tolerability profiles. Common adverse events of these drugs are well understood, and they can be coped with or prevented by adjusting the dosage properly. In addition, patients can recover from serious events by stopping the medication. However, there are other serious side effects that need to be monitored for. These include liver injury, acute kidney injury, and pancreatitis for orlistat; valvulopathy for lorcaserine; thyroid C-cell pathology and pancreatitis for liraglutide; metabolic acidosis, urolithiasis, acute angle closure glaucoma, and teratogenic effects for phentermine/topiramate; and severe nausea and heart disease for naltrexone/bupropion.

Keyword

Safety; Adverse event; Orlistat; Lorcaserine; Liraglutide; Phentermine/topiramate; Naltrexone/bupropion

MeSH Terms

Acidosis
Acute Kidney Injury
Anti-Obesity Agents*
Drug Therapy
Glaucoma, Angle-Closure
Heart Diseases
Humans
Korea
Liver
Liraglutide
Nausea
Obesity
Pancreatitis
Pathology
Thyroid Gland
Urolithiasis
Anti-Obesity Agents
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