II. Background

  1. Released in U.S. in 2013

III. Efficacy

  1. Weight loss is 7 pounds more than Placebo in one year
  2. Weight loss of at least 5% in up to 47% of patients at one year

IV. Mechanism

  1. Serotonin 2C (5HT-2C) agonist that increases satiety
  2. Active at pro-opiomelanocortin (POMC) Neurons of the Hypothalamus
  3. POMC is cleaved into a-Melanocyte stimulating hormone (MSH)
  4. MSH binds Hypothalamus melanocortin 4 receptors, resulting in decreased food intake
  5. Thomsen (2008) J Pharmacol Exp Ther 325(2): 577-87 [PubMed]

V. Dosing

  1. Lorcaserin (Belviq) 10 mg orally twice daily
  2. Belviq XR preparation available for once daily use in 2017
  3. Stop medication if 5% weight loss is not achieved at 12 weeks

VI. Adverse Effects

  1. No associated valvulopathy
    1. Lorcaserin has 100 fold greater neurologic 5HT-2C affinity over cardiac valve 5HT-2B affinity
  2. Well tolerated
  3. More specific, and does not appear to carry same valvular heart disease risks as with fenfluramine
  4. Constipation
  5. Cough
  6. Dry Mouth
  7. Fatigue
  8. Nausea
  9. Hypoglycemia

VII. Drug Interactions

  1. Serotonergic medications (e.g. SSRI, Dextromethorphan)
    1. Serotonin Syndrome risk

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Cost: Medications

belviq (on 9/8/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
BELVIQ 10 MG TABLET $3.89 each
BELVIQ XR 20 MG TABLET $7.73 each

Ontology: lorcaserin (C2350948)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C506658
English Lorcaserin, (1R)-8-chloro-1-methyl-2,3,4,5-tetrahydro-1H-3-benzazepine, lorcaserin, LORCASERIN

Ontology: Belviq (C3485407)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C506658
English Belviq