From the Guidelines
The most effective alternative to phentermine for weight management is Saxenda (liraglutide), a GLP-1 receptor agonist that reduces appetite and slows gastric emptying, with a recommended dose of 3.0 mg daily as a subcutaneous injection 1. When considering alternatives to phentermine, it's essential to evaluate the various options based on their mechanisms of action, efficacy, and safety profiles.
- Phentermine/topiramate extended release (Qsymia) is another option, which targets different sites simultaneously to have an additive effect on weight loss 1.
- Lorcaserin (Belviq) is a serotonin receptor agonist that reduces food intake and increases satiety, with a recommended dose of 10 mg twice daily 1.
- Bupropion/naltrexone sustained release (Contrave) is a combination medication that activates POMC neurons in the arcuate nucleus, with a recommended dose of 8 mg naltrexone and 90 mg bupropion, increasing to a maximum dose of 2 tablets in the morning and 2 tablets in the evening (32/360 mg) 1.
- Orlistat (Xenical/Alli) works by blocking fat absorption, with a recommended dose of one 120-mg capsule (Xenical) or one 60-mg capsule (Alli) 3 times a day with each main meal containing fat 1. It's crucial to note that any weight loss medication should be used alongside lifestyle modifications, including diet and exercise, and under the guidance of a healthcare provider to determine the most appropriate option based on individual medical history, current medications, and weight loss goals 1.
From the Research
Alternative Options to Phentermine
There are several alternative options to phentermine for weight loss, including:
- Orlistat: a medication that works by reducing fat absorption in the gut 2, 3, 4, 5
- Liraglutide 3.0 mg: a glucagon-like peptide-1 (GLP-1) receptor analog that helps reduce hunger and increase feelings of fullness 2, 3, 4, 5
- Naltrexone/bupropion: a combination medication that works by reducing hunger and increasing feelings of fullness 2, 3, 4, 5
- Phentermine/topiramate: a combination medication that works by reducing hunger and increasing feelings of fullness 2, 3, 4, 5
- Semaglutide 2.4 mg: a GLP-1 receptor analog that has been shown to produce significant weight loss, with an average of 15% weight loss at 1 year 6
- Tirzepatide and cagrilintide/semaglutide combination: new medications that are currently in phase 3 trials and have shown promise for even greater weight loss efficacy 6
- Setmelanotide: a medication that is approved for the treatment of certain rare genetic diseases characterized by severe, early-onset obesity 6
Considerations for Choosing an Alternative
When choosing an alternative to phentermine, it's essential to consider individual factors such as:
- Contraindications: certain medications may not be suitable for individuals with specific health conditions 3
- Comorbidities: certain medications may be more effective for individuals with specific health conditions, such as diabetes or depression 3
- Patient preferences: individuals may have preferences for certain medications based on factors such as administration route, frequency of dosing, and safety profile 3
- Cost: the cost of the medication may be a factor in the decision-making process 3