Obesity PCT dosing/info (final)

phentermine (Adipex-P) dose

15 to 37.5 mg PO QD (1 or 2 divided doses)

phentermine is for long-term or short-term (3 months) use?

short-term

phentermine IR dose

25 mg IR PO TID

phentermine SR dose

75 mg PO QD

Adipex-P MOA

sympathomimetic; increases norepinephrine; suppresses appetite

phentermine MOA (Qsymia)

sympathomimetic; increases norepinephrine; suppresses appetite

topiramte MOA (Qsymia)

effects neurotransmitters/ion channels; suppresses appetite; enchances satiety

phentermine + topiramate (Qsymia) initial dose

3.75/25 mg PO QAM x 14 days; then 7.5/46 mg x 12 weeks

phentermine + topiramate (Qsymia) max dose

15/92 mg

if using Qsymia as PCT, and 3% of baseline body weight has not been achieved, increase dose from 7.5/46 mg to?

11.25/69 mg PO QAM x 14 days; then 15/92 mg x 12 weeks

Qsymia has which significant adverse effect?

paresthesias

bupropion MOA (Contrave)

reduces appetite

naltrexone MOA (Contrave)

reduces food cravings and enhances bupropion

bupropion + naltrexone (Contrave) dose

90/8 mg PO QAM x 7 days; then titrated weekly to 180/16 mg PO BID with non-fatty meals

Contraves end titration goal resuslts in how many total pills per day?

4

liraglutide MOA (Saxenda)

GLP-1 agonist; delays gastric emptying; promotes satiety

liraglutide (Saxenda) initial dose

0.6 mg SC QD x 1 week

liraglutide (Saxenda) titration increments

0.6 mg

liraglutide (Saxenda) max dose

3 mg QD

liraglutide (Saxenda) titration schedule?

weekly

semaglutide MOA (Wegovy)

GLP-1 agonist; delays gastric emptying; promotes satiety

semaglutide (Wegovy) initial dose

0.25 mg SC Q week x 4 weeks

Wegovy titration schedule

monthly

Wegovy max dose

2.4 mg

wegovy month 1 dose

0.25 mg

wegovy month 2 dose

0.5 mg

wegovy month 3 dose

1 mg

wegovy month 4 dose

1.7 mg

wegovy month 5 dose

2.4 mg

wegovy maintenance dose

1.7 or 2.4 mg

tirzepatide MOA (Zepbound)

GLP-1/GIP agonist; delays gastric empting; promotes satiety

tirzepatide (Zepbound) initial dose

2.5 mg SC Q week x 4 weeks

tirzepatide titration schedule?

monthly

tirzepatide max dose

15 mg

tirzepatide maintenance dose

5, 10, or 15 mg

Zepbound month 1 dose

2.5 mg

Zepbound month 2 dose

5 mg

Zepbound month 3 dose

7.5 mg

Zepbound month 4 dose

10 mg

Zepbound month 5 dose

12.5 mg

Zepbound month 6 dose

15 mg

liraglutide, semaglutide, and tirzepatide all share what common significant adverse effect?

dose-dependent nausea

tirzepatide has which significant DDI

oral contraceptives

semaglutide and tirzepatide have high efficacy on?

A1c; weight

tirzepatide has a benefit on which comorbidity?

OSA

semaglutide has a benefit on which 2 comorbidities?

MASH; CV reduction

of semaglutide and tirzepatide which is more efficacious?

tirzepatide