Drug safety evaluation of naltrexone/bupropion for the treatment of obesity

Jessica L. Verpeut, Nicholas T. Bello

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Obesity is a known health risk for the development of several preventable diseases. Obesity-related metabolic alterations negatively impact different physiological mechanisms, which supports the rationale for the use of combined drug therapy. Naltrexone is an opioid antagonist for the treatment of opioid and alcohol dependency, whereas bupropion is a norepinephrine/dopamine reuptake inhibitor used to treat depression and smoking cessation. Although not effective as individual monotherapies for obesity, naltrexone and bupropion in combination produce weight loss and a metabolic profile beneficial for the potential treatment of obesity. Areas covered: This review examines the safety and antiobesity effects of naltrexone and bupropion alone and in combination. It reviews the results of four Phase III clinical trials of a novel fixed dose of sustained-released naltrexone/bupropion. Expert opinion: Naltrexone/bupropion has a greater weight loss efficacy than two FDA-approved medications, orlistat and lorcaserin. Although the weight loss produced by phentermine/topiramate is superior to naltrexone/bupropion, the safety profile of naltrexone/bupropion has less severe adverse effects. In addition, naltrexone/bupropion is well tolerated, with nausea being the most reported adverse event. Unlike other centrally acting medications, lorcaserin and phentermine/topiramate, naltrexone/bupropion has no abuse potential.

Original languageEnglish (US)
Pages (from-to)831-841
Number of pages11
JournalExpert Opinion on Drug Safety
Volume13
Issue number6
DOIs
StatePublished - Jun 2014
Externally publishedYes

Keywords

  • Arcuate nucleus
  • Belviq
  • Cardiovascular
  • Contrave
  • Qsymia
  • Xenical
  • β-endorphin

ASJC Scopus subject areas

  • Pharmacology (medical)

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