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Lorcaserin

A medically-prescribed weight loss pill sold as Belviq was approved June 2012.

BACKGROUND Start the Diet Now Advertisement

Lorcaserin is a new prescription weight loss drug manufactured by Arena Pharmaceuticals, Inc. In June 2012 it became the first weight loss drug to receive FDA approval since Alli in 1999. The drug name Lorcaserin will be sold to consumers as Belviq and will require a prescription from a doctor.

Belviq is indicated as an adjunct to a reduced-calorie diet and increased physical activity for adults with BMI > 30 or > 27 with at least 1 co-morbid condition (high blood pressure, diabetes, high cholesterol).

Lorcaserin is a new class of selective serotonin 2C receptor agonists. The serotonin 2C receptor is expressed in the areas of the brain that are involved in the control of appetite and metabolism. Stimulation of this receptor is strongly associated with reducing hunger and increasing satiety.

In a large-scale study, patients who took Lorcaserin lost five percent of their body weight in comparison to a placebo group. Lorcaserin patients also achieved greater improvements in total cholesterol, triglycerides, HDL cholesterol and insulin resistance compared to placebo across all subgroups. Greater improvements were also seen in fasting insulin, fasting glucose and blood pressure for Lorcaserin patients compared to placebo overall and in most subgroups.

In clinical trials of at least 1 year, 6888 patients participated where 3451 patients received Belviq and 3437 received placebo. Ages ranged from 18 to 66 years old and almost 80% of patients were women, 66.6% were caucasian, 19.2% African American, 11.8% Hispanic, 2.4% other races and 7.4% were type 2 diabetic. 426 patients took Belviq for two years.

Three trials were conducted, two without patients who had diabetes and one with patients with diabetes. All patients received one-on-one counseling about a reduced calorie diet and exercise at first dose of medication and every four weeks after. At one year, 47.1% of patients had lost greater than or equal to five percent of their body weight in the Belviq group and 22.4% of patients had lost greater than 10% of their body weight. While in the placebo group which is those who did not receive the study drug, 22.6 % had lost greater than or equal to 5% of their body weight and 8.7% had lost 10 or greater percent of their weight.

As part of the FDA approval, Belviq (Lorcaserin) will have to undergo six post-market studies to monitor the drug's effects on heart health.

PRO
  • May help those who are obese or very overweight gain control over their health
  • FDA-approved
  • Prescription only
  • Produces minimal side effects in comparison to other medically-prescribed weight loss drugs
  • Does recommend following a healthy diet and regular fitness regimen
CON
  • Long-term health effects are still unknown even after FDA approval
  • Does not address real issues of overeating
  • Can be mistakenly used as a quick fix for weight loss
  • Very modest weight loss in comparison to other prescription weight loss pills and diet and exercise alone
PHARMACIST NOTES

Dr. Sarah G. Khan, contributing pharmacist for DietsInReview.com

  • Belviq (lorcaserin) should NOT be taken in pregnancy.

  • Patients should discontinue if they do not lose 5% of the body weight in the first twelve weeks of use. Duration of therapy and whether it should be weeks or 1 to 2 years has not been determined.

  • Use caution with other drugs that effect serotonin levels such as antidepressants (Paxil, Zoloft, Cymbalta, Effexor etc.). There is a risk of Serotonin Syndrome, which is a rare condition that can lead to seizures. Symptoms of serotonin syndrome include increased heart rate, fluctuating blood pressure, lack of coordination, nausea, vomiting and diarrhea. If someone seems to have altered mental status they need to stop taking Belviq immediately.

  • Male patients may also experience priapism, which is an erection lasting longer than 6 hours. If patient experiences an erection longer than 4 hours they should discontinue Belviq and go to the emergency room.

  • Belviq increased prolactin levels which could lead to breast development in males or lactation in females. If you begin to experience these effects your prolactin levels should be monitored.

  • Belviq can also have an effect on white and red blood cell count. Bloodwork may be necessary.

  • If patients develop any valvular heart disease they should discontinue use. This was seen in another serotonin receptor medication that activated the 2B receptor, Belviq activates the 2C receptor.

  • Belviq may cause memory and attention problems so caution should be used when operating a vehicle or machinery.

  • When used along with diabetes medications, patients may experience low blood sugar. More frequent monitoring of blood sugar may be appropriate and patients should carry a small carbohydrate snack at all times to avoid this.

  • It is also not advised that patients take other weight loss products along with Belviq as we do not know how they will react together.

  • Safety has not been established in patients under 18 years old.

DIET and NUTRITION

Lorcaserin patients will be advised to use the pill in conjunction with a healthy, reduced-calorie diet.

The dosage for Lorcaserin is 10 mg twice daily and can be administered with or without food. Make sure to store it in an area that is room temperature and can avoid heat and moisture (avoid medicine cabinets in the bathroom!).

EXERCISE

It is recommended that for best results while taking Lorcaserin that patients adhere to a regular fitness regimen.

CONCLUSION

One of a trio of prescription weight loss pills that has been undergoing FDA trials and review in 2010, Lorcaserin works to suppress appetite by increasing the amount of the feel-good hormone, serotonin, in the brain. While this medication has the least amount of side effects in comparison to other medically-prescribed pills, its weight loss results are not that stellar.

Common Misspellings

lorcasrin, lorcserin, lorsacerin, lorsarin, lorserin, loriserin, belviq, belvick, belvic


Related Diets: Alli, Contrave, Qnexa


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