Table 1.
Prescription Weight Loss Medications Analyzed
| Generic name | Trade name | Special prior authorization requirements |
|---|---|---|
| Phentermine HCL | Lomaira - 8mg (non-formulary) | --- |
| Adipex-P - 37.5mg (formulary) | --- | |
| Benzphetamine HCL | Didrex (brand name discontinued) | --- |
| Regimex (brand name discontinued) | --- | |
| Diethylpropion HCL | Tenuate (brand name discontinued) | --- |
| Dospan | --- | |
| Phendimetrazine Tartrate | Phendiet | --- |
| Melfiat | --- | |
| Anorex-SR | --- | |
| Pleine | --- | |
| Bontril | --- | |
| Lorcaserin | Belviq | --- |
| Belviq XR | --- | |
| Naltrexone / Bupropion SR | Contrave | Failure to lose weight on phentermine or has a contraindication its use. |
| Orlistat | Xenical | Failure to lose weight or contraindication to use phentermine or Contrave. |
| Phentermine / Topiramate ER | Qsymia | Failure to lose 5% of baseline weight with 12 weeks of phentermine use. |
| Liraglutide | Saxenda | Tried and failed or has a contraindication to ALL of the following: phentermine, Qsymia, and Contrave. |
| Semaglutide | Wegovy | Tried and failed or has a contraindication to ALL of the following: phentermine, Qsymia, and Contrave. |
| Ozempic |
Note: Italicized trade names are non-formulary within the Military Health System.