Cardiovascular effects of phentermine and topiramate: a new drug combination for the treatment of obesity

• Published in: Journal of hypertension Vol. 32; no. 6; pp. 1178 - 1188
• Main Authors: Jordan, Jens, Astrup, Arne, Engeli, Stefan, Narkiewicz, Krzysztof, Day, Wesley W, Finer, Nick
• Format: Journal Article
• Language: English
• Published: England Wolters Kluwer Health | Lippincott Williams & Wilkins 01-06-2014; Lippincott Williams & Wilkins
• Subjects: Aged; Anti-Obesity Agents - administration & dosage; Appetite Depressants - administration & dosage; Cardiovascular Diseases - complications; Clinical Trials, Phase III as Topic; Comorbidity; Drug Combinations; Female; Fructose - administration & dosage; Fructose - analogs & derivatives; Humans; Male; Middle Aged; Obesity - complications; Obesity - drug therapy; Overweight - complications; Overweight - drug therapy; Phentermine - administration & dosage; Randomized Controlled Trials as Topic; Reviews; Risk Factors; Treatment Outcome; Weight Loss
• ISSN: 0263-6352; 1473-5598
• DOI: 10.1097/HJH.0000000000000145

Weight loss can reduce the increased cardiovascular risk associated with obesity. Pharmacotherapy is a recognized weight loss treatment option; however, cardiovascular safety issues with some previous weight loss drugs raise concerns for newly approved pharmacotherapies. Phentermine is approved for short-term obesity treatment in conjunction with lifestyle modifications, but is commonly used chronically. Topiramate, approved for treating epilepsy and preventing migraines, also induces weight loss. A single-dose combination of low-dose phentermine and topiramate extended-release was recently approved by the United States Food and Drug Administration as an adjunct to lifestyle intervention for the chronic treatment of overweight/obese adults. This review summarizes and evaluates the cardiovascular risk/benefit profile associated with phentermine and topiramate, individually and in combination. Cardiovascular data associated with long-term use of phentermine and topiramate extended-release indicate that this combination may be a safe and effective option for reducing weight in overweight/obese patients at low-to-intermediate cardiovascular risk.