Safety assessment of combination therapies in the treatment of obesity: focus on naltrexone/bupropion extended release and phentermine-topiramate extended release |
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Authors: | Bruno Halpern Marcio C. Mancini |
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Affiliation: | 1. Obesity Unit, Department of Endocrinology, Hospital das Clínicas, University of S?o Paulo (USP), S?o Paulo, Brazilbrunohalpern@hotmail.com;3. Obesity Unit, Department of Endocrinology, Hospital das Clínicas, University of S?o Paulo (USP), S?o Paulo, Brazil |
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Abstract: | Introduction: Few studies on combination therapies for the treatment of obesity had been conducted until recently, when two fixed-dose combinations, bupropion-naltrexone ER fixed-dose combination and phentermine-topiramate ER titrated-dose combinations were evaluated in clinical studies that ultimately led to FDA approval. Areas covered: In this review, we discuss safety concerns about both combinations, the rationale and history of combination therapies for obesity (including phentermine plus fenfluramine), and possible future new combinations. Expert opinion: Combination therapies are a promising new area in obesity treatment, similar to what occurs with diabetes and hypertension. Safety assessment is highly important due to the high number of potential users on a chronic basis. |
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Keywords: | Obesity pharmacotherapy phentermine/topiramate bupropion/naltrexone combination therapy cardiovascular safety nephrolithiasis seizures psychiatric safety |
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