Table 1.

Oral agents for potential combination therapy in obesity management

Name	Medication class	Mode of action for weight management	Side effects/ safety profile concerns	FDA approval status	Combinatorial trials	Typical net weight loss (kg)
Orlistat	Lipase inhibitor	Reducing bowel based fat absorption	+	Approved for obesity rx, available OTC	With Sibutramine, metformin and phentermine	~2.3
Sibutramine	B-phenethylamine	Appetite suppressant and increased energy expenditure	++++	Pulled from the US market; 2010	With orlistat	~3.5
Phentermine	Sympathomimetic	Appetite suppressant	++	Approved for short term obesity rx	With orlistat and topiramate	~4
Diethylpropion	Sympathomimetic	Appetite suppressant	++	Approved for short term obesity rx	–	~3
Benzphetamine	Sympathomimetic	Appetite suppressant	++	Approved for short term obesity rx	–	~2.5
Phendimetrazine	Sympathomimetic	Appetite suppressant	++	Approved for short term obesity rx	–	~2.5
Naltrexone	Partial opioid antagonist	? altered satiety perception	++	Approved for alcohol dependence	With bupropion	~1.6
Buproprion	Antidepressant	? altered satiety perception	++	Approved for smoking cessation	With naltrexone and zonisamide	~3.2
Rimonabant	Cannabinoid antagonist	? altered satiety perception	+++	Pulled from the market in Europe; 2007	–	~6.5
Topiramate	Antiepileptic	? appetite suppressant ? altered satiety perception	+++	Approved for epilepsy and migraine rx	With phentermine and rimonabant	~2.8
Zonisamide	Antiepileptic	? appetite suppressant ? altered satiety perception	+++	Approved for epilepsy rx	With bupropion	~7.5
Metformin	Biguanide antidiabetic	Unclear? Mild anorexiant	+	Approved for diabetes and PCOS rx	With orlistat and rimonabant	~2
Lorcaserin	Sympathomimetic	Appetite suppressant; serotonin 2c agonist	+++	Approved for monotherapy of obesity	–	~3.7

Abbreviations: OTC, over-the-counter; PCOS, polycystic ovary syndrome.