BELVIQ lorcaserin

Drug Class: Serotonin 2C Receptor Agonist   
Manufacturer: Arena Pharmaceutical
Approval Date: June 2012

What is Belviq and its mechanism of action?

Belviq is a medication used for management of obesity in adults. Belviq’s exact mechanism of action is not known. It reduces the feeling of hunger and need to consume food. Belviq activates serotonin 2C (5HT2C) receptors on pro-opiomelanocortin neurons. Pro-opiomelanocortin neurons are hormone precursors in the hypothalamus, a portion of the brain responsible in many functions including control of hunger. Activating these receptors causes satiety leading to less food consumption and ultimately weight loss. Essentially  Belviq possibly decreases food consumption by making a person feel full even after consuming less food than usual.  

What does Belviq treat?

Belviq is used in conjunction with a low calorie diet and daily exercise for long-term weight management in adults. Belviq is recommended for patients with a BMI of 30 kg/m2 or more and in patients with a BMI of 27 kg/m2 who also have other health related issues such as, high blood pressure, type 2 diabetes and high cholesterol.

Who should not use Belviq?

• Belviq may be execrated in mothers' milk, therefore it is recommended to discontinue its use or not start therapy while nursing.
• Patients who have serotonin syndrome or neuroleptic malignant syndrome.
• Patients who have defected heart valve(s). 
• Patients suffering from severe depression.
• Patients on anti-diabetic medications or those who experience sudden low blood sugar episodes due to anti-diabetic medications.
• Patients who experience priapism, an extended erection in their penis lasting more than 4 hours, must discontinue the use of Belviq.  

Pregnancy: Pregnancy Category X. Belviq should not be used during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. 

Nursing Mothers: It is not known whether Belviq is excreted in human milk. 

How effective is Belviq?

In a clinical trial assessing the efficacy of Belviq, 3182 patients were enrolled and randomly assigned to Belviq or placebo for 2 years. Patients enrolled in the study had either BMI of 30 to 45 kg/m2 or BMI of 27-30 kg/m2 with at least one comorbidity (high blood pressure or cholesterol). At the end of 2 years the results were as follows:

• 47% of patients on Belviq lost 5% or more of their body weight compared to 22.6% of patients on placebo
• 22.4% of patients on Belviq lost 10% or more of their body weight compared to 8.7% of patients on placebo

Interesting facts about Belviq

• One of the first FDA approved weight loss drugs after 13 years
• Weight loss medications that affect serotonin 2B receptors on heart tissue can cause damage to heart valves. They have been removed by the FDA from the market. In laboratory studies Belviq 10 mg twice a day acts on serotonin 2C receptors significantly more than serotonin 2B receptors in heart tissue. 
• There is currently no generic substitution available for Belviq.

• BELVIQ is a schedule IV controlled substances. 

What is the dosage of Belviq?

Belviq is available as a 10 mg tablet.

The recommended dose of Belviq is one 10 mg tablet twice a day by mouth with or without food. If the patient does not lose at least 5% of their initial body weight by week-12 discontinuation of treatment is recommended.

What are the side effects of Belviq?

In non-diabetic patients: Headache, dizziness, fatigue, nausea, dry mouth, and constipation

In diabetic patients: low blood sugar, headache, back pain, cough, and fatigue  

What are Belviq drug interactions?

• Ergot derivatives such as bromocriptine, cabergoline, ergotamine
• Thioridazine
• Antipsychotics, bupropion, and propafenone may increase the level or effect of Belviq in the body resulting in toxicity
• Belviq may decrease the level or effects of codeine and Tamoxifen.

What is the price of Belviq?

A bottle of Belviq 10 mg containing 60 tablets costs $239.40

How to obtain prescription cost assistance for Belviq

To receive a 15-day free trial coupon or a saving card visit Belviq Trial Voucher offering. 

References

Belviq Prescribing Information. Arena Pharmeceuticals, June 2012

US Food and Drug Administration. News and Events. June 27, 2012

by Samar Borhani