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Expert Opin Drug Saf. 2017 Jan;16(1):27-39. Epub 2016 Oct 24.

Safety assessment of combination therapies in the treatment of obesity: focus on naltrexone/bupropion extended release and phentermine-topiramate extended release.

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a Obesity Unit, Department of Endocrinology, Hospital das Clínicas , University of São Paulo (USP) , São Paulo , Brazil.


Few studies on combination therapies for the treatment of obesity had been conducted until recently, when two fixed-dose combinations, bupropion-naltrexone ER fixed-dose combination and phentermine-topiramate ER titrated-dose combinations were evaluated in clinical studies that ultimately led to FDA approval. Areas covered: In this review, we discuss safety concerns about both combinations, the rationale and history of combination therapies for obesity (including phentermine plus fenfluramine), and possible future new combinations. Expert opinion: Combination therapies are a promising new area in obesity treatment, similar to what occurs with diabetes and hypertension. Safety assessment is highly important due to the high number of potential users on a chronic basis.


Obesity pharmacotherapy; bupropion/naltrexone; cardiovascular safety; combination therapy; nephrolithiasis; phentermine/topiramate; psychiatric safety; seizures

[Indexed for MEDLINE]

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