From the Guidelines
The implications of a 4mg dosage are limited to the phentermine/topiramate extended release (Qsymia) medication, which is available in 4 doses, including a 3.75/23 mg and 7.5/46 mg, but not exactly 4mg.
Key Points
- The 4mg dosage is not a standard dose for any of the mentioned weight loss medications, except for the phentermine/topiramate ER, which has a dose of 3.75/23 mg and 7.5/46 mg, with the 3.75mg being close to the 4mg dosage.
- Phentermine/topiramate ER is a combination medication that targets different sites simultaneously to have an additive effect on weight loss, addressing the complexity of obesity.
- The medication should be taken once daily in the morning, with gradual dose escalation to minimize risks and adverse events, starting with 3.75/23 mg daily for 14 days and then increasing to 7.5/46 mg daily, as described in the study 1.
- The medication should be discontinued or the dose should be escalated if 3% weight loss is not achieved after 12 weeks at 7.5/46 mg daily or discontinued if 5% weight loss is not achieved after 12 weeks at 15/92 mg daily.
Dosage and Administration
- The recommended dosage of phentermine/topiramate ER is to be taken once daily in the morning, with a gradual dose escalation.
- The dose escalation should proceed as follows: initially 3.75/23 mg daily for 14 days and then 7.5/46 mg daily, and at 12 weeks the option to increase to 11.25/69 mg daily and then 15/96 mg daily, as mentioned in the study 1.
From the Research
Implications of a 4mg Dosage
- The implications of a 4mg dosage can be understood from various studies, including the use of naloxone nasal spray 4 mg in the community setting 2, the dose-response relationships of retatrutide for obesity 3, and the comparison of dexamethasone 4mg vs 8mg doses in total joint arthroplasty patients 4.
- In the context of naloxone nasal spray, a 4mg dose was found to be effective in reversing opioid overdose in most reported cases, with a success rate of 98.8% 2.
- For retatrutide, a 4mg dose was associated with significant weight loss, with a least-squares mean percentage change in body weight of -12.9% at 24 weeks and -17.1% at 48 weeks 3.
- In the case of dexamethasone, a 4mg dose was found to be effective in preventing postoperative nausea and vomiting (PONV) in patients undergoing total hip arthroplasty and total knee arthroplasty, with no significant differences in outcomes compared to an 8mg dose 4.
- It is worth noting that the implications of a 4mg dosage may vary depending on the specific context and medication being used, and that other studies may have different findings, such as those related to semaglutide 5, 6.