Which anti-obesity medications should be avoided in patients with severe liver impairment or cirrhosis?

The reasoning for avoiding certain anti-obesity medications in patients with severe liver impairment or cirrhosis stems from the pharmacokinetics and safety profiles of each medication.

When considering Qsymia and Contrave, both combinations of medications can pose significant risks for patients with liver issues. Qsymia contains phentermine and topiramate. In those with hepatic impairment, there is a potential for altered metabolism which can lead to increased levels of topiramate, raising the risks of side effects or toxicity. Contrave, which combines naltrexone and bupropion, also has concerns with liver health; both components require careful management due to their metabolic pathways and the potential for liver-related side effects.

Understanding the implications of liver impairment is critical when prescribing medications, as the liver is essential for drug metabolism. In the case of patients with severe liver impairment, many medications can accumulate to toxic levels or lead to increased adverse effects, thus necessitating caution or avoidance altogether.

While phentermine and orlistat may have some considerations for patients with liver issues, they are typically not as contraindicated as the combinations found in Qsymia and Contrave. Liraglutide, a GLP-1 receptor agonist, can also