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Table 5. Medications Studied for the Long-Term Treatment
of Obesity (cont'd)
Drug Status
Common Side
Effects
Monitoring and
Contraindications
Exenatide
a
Not FDA
approved for
obesity
Nausea, vomiting,
diarrhea, feeling
jittery, dizziness,
headache, dyspepsia
Acute pancreatitis,
including fatal and nonfatal
hemorrhagic or necrotizing
pancreatitis, has been
reported. Observe patients
carefully for signs and
symptoms of pancreatitis.
Discontinue promptly if
pancreatitis is suspected.
Contraindicated in patients
with severe renal impairment.
Drugs Affecting Nutrient Trafficking
Orlistat is drug is
FDA-approved
for treatment
of obesity in
adolescents
≥12 years of age
Oily spotting, flatus
with discharge,
fecal urgency, fatty/
oily stool, increased
defecation, fecal
incontinence
is drug is contraindicated
in chronic malabsorption
syndromes and cholestasis.
Cholelithiasis and, rarely,
severe liver injury, including
hepatocellular necrosis
and acute hepatic failure
leading to death, have
been reported. It decreases
drug concentrations
of cyclosporine and
levothyroxine. Doses should
be temporally separated
from orlistat. Fat-soluble
vitamin absorption is
decreased by orlistat. Use
with caution in those at risk
for renal insufficiency. MVI
supplementation is strongly
recommended. A low- dose
preparation is approved for
over-the-counter sale.
