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DOCTOR TESTIMONIALS

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About a week ago my belviq rep brought in a marketing lady from an
independent group asking me about my opinion on belviq and belviq
xr..... i told them that i have used it on over 1000 patients with
generally good results.....have seen weight loss and few side
effects..... i told them that i often combine belviq with 1/2 pill of
phentermine each morning which gives faster and a larger amount of
weight loss.... i told them that i have seen no problems with
serotonin syndrome when combining belviq with citalopram or escitalopram
( belviq is a mild to moderate inhibitor of cytochrome p450 2d6 and
i dont like to combine belviq with prozac or paxil or zoloft since the
belviq will cause higher levels of prozac and paxil and
zoloft)...(prozac and paxil and zoloft are metabolized by cytochrome
p450 2d6)... (citalopram and escitalopram are not metabolized by
cytochrome p450 2d6)..... i also told the marketing lady that i would
like to see a lower price on belviq..... i think there would be more
sales of belviq at a lower price point and they would make up in volume
what they lose on price.....
i also told her about one of my patients who lost 85 pounds in a year on
belviq plus phentermine.... Not well known is the effect that belviq has
thru the brain on parasympathetic and sympathetic nerves to decrease
gluconeogenesis in the liver and increase insulin release in the
pancreas, which has a direct beneficial effect to lower blood glucose
in type 2 diabetics over and above the weight loss benefit in type 2
diabetics...

steven vig md tucson arizona 11 20 16

NOTE FROM DOCTOR
"I have prescribed it to about 10 people so far, and I've been amazed at how effective it has been, with minimal side effects.....virtually none."   -Dr. Dale Gray is board certified in Obesity Medicine (he is a Diplomate of the American Board of Obesity Medicine
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DOCTOR: "Very safe and effective drug"

Belviq is working for Naomi, Howard, and William. After 3 months, they've lost a combined 73 pounds. They say they feel wonderful and they would recommend it to anybody.

    Howard lost 31 pounds.
    Naomi's lost 10 pounds. Her BMI is now below the obesity level of 30.
    William is down 32 pounds.

"You really see it in the eyes of the patients when they are losing weight. They love to do it. And they love to report back to me and tell me how well they are doing," said Dr. Vig.

Dr Vig said he's only had a few patients reporting side effects of fatigue.

"In my mind, this is a very safe and effective drug," said Dr. Vig.
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NOTE FROM DOCTOR
A doctor’s 14 weeks experience with Belviq:
I am the Dearborn ophthalmologist who started Belviq on June 7, 2013 . My initial weight was 242lbs.  My weight now is 207lbs.  I am 68 years old  and have had diabetes for over ten years, hypertension, and a cardiac stent.  My Hemoglobin a1c was 6.5.   Since I've been on Belviq, and a reduced calorie, higher protein diet, I have lost 35 pounds.  My current hemoglobin  a1c is 5.5.    I previously took over 100 units of insulin daily, I have discontinued insulin and continue to check my sugar five times a day, which has never been under such good control.   My present Hemoglobin  a1c is normal for a non-diabetic.  My endocrinologist said he has never seen anything like this and jokingly asked  if I really did have diabetes in the first place.  He is putting patients on Belviq now. I have recommended  Belviq to five people and all of them have lost twenty to thirty pounds in two months or less. My blood pressure is now 120/70 and was initially 140/90.   Belviq is a MIRACLE.   All the "short bashers" can go to hell with all their misinformation.  The facts are that the drug works… it is a lifesaver.  I will probably live an additional   ten to twenty years because of it. I have no side effects. Even my golf game has improved!!!    As a religious man, this is God's truth.   Thank God for Belviq!    I will report  again in two to three weeks.
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NOTE FROM DOCTOR
Patient lost 5 pounds after being on BELVIQ for a few days
"I saw one patient with United  insurance today who started Belviq a few days ago.  He says he has no side effects from the medicine and simply does not feel like eating so much.  I was surprised to see that he has lost 5 pounds since his last visit with me that happened to be  less than two weeks ago."
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NOTE FROM DOCTOR
This is a great drug
That might be important. Almost everyone is responding, loosing more, faster than the studies.
A patient with a nice response told me today of four of his friends that now have appointments with
their Docs to ask for Belviq.
My first patient came back yesterday to report a 5 pound weight loss in one week.
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NOTE FROM DOCTOR
Tomorrow I start my wife on Belviq---off label usage, I am that confident it the drug.
 
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NOTE FROM DOCTOR
One of my patients who has lost 16 lbs. using belviq described the strange ways several of her friends have been starring at her.    Finally, two asked. "Did you have a face lift?"   She responded, "it's not a facelift, it's Belviq!"  She is putting a request for royalties on this forthcoming jingo.   Thanks,  Dr. R.
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NOTE FROM DOCTOR
doctor vig and two patients on 11 7 2013

Two patients who saw me today were doing well on the 3 month checkup on belviq. The first patient is a 68 year old female who lost 27 pounds starting at 216 pounds. She has medicare/tricare for life and is actually paying 205 dollars per month in cash since the savings card does not work on tricare for life. The second patient is a 63 year old male who lost 31 pounds starting at 308 pounds. We decreased the dose of his blood pressure medicine today and I think he will be able to stop it on the next visit if his weight loss continues. Both patients are happy with their weight loss. FYI Steven Vig md internal medicine tucson, arizona 11 7 2013
 
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NOTE FROM DOCTOR
I put one of my belviq patients on phentermine 15mg and he began losing 4 to 5 lbs per week for the past 3 weeks.   He is elated.   Another DM2 patient who is on metformin will be beginning to use 10 mg of Belviq daily at his request.  Metformin can cause B 12 deficiency.  Thanks, Dr. R.
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NOTE FROM DOCTOR
doctor vig final numbers for abc15   tv story
The reporter and her cameraman drove from Phoenix to Tucson today, 9 13 2013, to interview me and do a followup story on the 3 patients who have been on Belviq now for 3 months. Howard G. lost 31 pounds, from 240 pounds to 209 pounds, which was 13 % of his body weight. William C lost 32 pounds, from 387 pounds to 355 pounds, which was 8% of his body weight. Naomi F lost 10 pounds, from 167 to 157 pounds, which was 6% of her body weight. These are very good numbers. The reporter was impressed. She videotaped us and will edit the film and it should appear on the abc15 website , probably the week of September 23, 2013.
Keep in mind from the studies on Belviq that "completers", who took Belviq for a year, lost an average of 8% of the body weight. "Responders", who lost at least 5% of the body weight in the first 3 months, lost about 11% of the body weight in a year. None of the three participants had side effects from the Belviq. All of them met the 5% recommended weight loss in 3 months from the product information. Overall I was amazed by the weight loss, especially from Howard and William, and this should be a great video when it is posted on the abc15 website later this month.
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I had the younger patient today that I had put on Belviq + Phentermine. Weight drop in 10 weeks of 366 to 320. There is a very effective treatment for the #1 problem facing our medical system today. If you know someone that wants a shot at some serious weight loss. "Belphen" is clearly your best option.
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Today I had a diabetic that lost 54 pounds in a year...and diabetic numbers improved a lot. The drug works.
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I saw 3 different overweight/obese patients this morning that have been Belviq at least 18 months. Their Belviq was refilled as we do the other routine medications without a second thought. They are all maintaining a 8-18% weight loss. All the routine parameters are better(lipid, glucose, etc). They are taking it as it was intended with clear benefit.

Await information on Humans and Cocaine addiction. Legitimate chance for off label use because there is no treatment for Cocaine and Meth.
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Did you know Belviq is also used for cocaine and other forms of addiction? A number of trials are ongoing or already done on cocaine, smoking, etc. and Belviq has shown to be effective in pre clinical trials as well on beating addiction. Some doctors have already written prescriptions for addictions. Some smokers quit just by taking Belviq for weight loss. I think in due time FDA approval will be sought for addictions but meanwhile doctors can write prescriptions "off label" which is a very common practice in general.

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Had two gals from work stop me in hallway Friday. They had noticed my weight loss. They asked how I was doing it. Told them about Belviq. Both requested information, discount card info, and my doctors name. Both had BMI's in excess of 30+. Told them they still needed to eat right, and not all were responders. Also told them the side effects listed were normal for most drugs. I have had no consistent side effects. Have noticed dry mouth on occasion and lower legs cramps every once in awhile. Not sure if they're Belviq related.
As for my weight loss.... now wearing 40 inch waist for my blue jeans. Got on more notch on the belt before I have to buy new. (on my second belt). Started with 46 inch, tight. Now also able to wear my XXL shirts easily. I thought I had hit a small plateau but the belt and jeans convinced me that I must still be making progress. I don't own a scale.

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some details on the patient who lost a lot of weight.....86 pounds since 8 2014.... i dont want to use his name due to patient privacy....

patient weighed 285 pounds on 8 18 14 with bmi 39.7 and started belviq alone at that time.... he was down to 269 pounds on 1 8 15 and added phentermine to belviq on 2 1 15.... weight was 225 by 4 15 15 and was 199 pounds by 7 16 15....

thus, 285 pounds in 8 2014 minus 86 pounds of weight loss equals current weight of 199 pounds in 7 2015 .

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I saw a patient yesterday (7 /15/ 2015) who has been on Belviq plus phentermine for a year and he has lost 75 pounds. Today, i saw another patient who has been on Belviq plus phentermine for a year and he has lost 86 pounds. Both patients are very happy with the weight loss. I start my patients on Belviq 10mg twice a day, and often use phentermine 37.5mg 1/2 pill each morning along with the Belviq for faster weight loss. I sometimes will increase the phentermine to 37.5mg, one full pill each morning, along with the Belviq . Steven Vig md

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Doctor: " I saw a lady today who started 18 mo ago. Now 200 lbs. as compared 265 lbs. Has taken it twice daily for 18 mo. "

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Please check with your doctor before trying any medicine, but Belviq is the only new drug for obesity with the best safety profile and for many very good results. I lost 45 lbs in 6 months on Belviq with no side effects. It also has a new once a day pill which has been approved by the FDA Belviq XL coming in the Fall. Obesity killed my parents. I treated over a thousand patients over 40 years in health care as a wound care specialist that had complications from their obesity. Good luck to all trying to have a better life with better health.

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NOTE FROM DOCTOR
Today is Friday, 6 14 2013, before my clinic starts. From monday through thursday this week I gave prescriptions of Belviq to 19 patients, which is over 4 patients per day. I have handed out a number of Vouchers for the free 15 day supply of Belviq, which is accompanied by a prescription for the 15 day supply of Belviq. I am also giving the patient a monthly prescription of Belviq, which can be refilled 5 times. Both prescriptions are printed on our blue tamper proof paper. I am giving each patient a handout on diet tips, and a second handout about Belviq. I have filled out some prior authorization forms and faxed them to the insurances. A couple of patients who were on medicare and did not have insurance coverage of Belviq were going to use the Voucher, followed by cash payment for Belviq using the Savings Card from the Belviq web site. Cash price of Belviq at CVS across the street is about 209 dollars per month, and the Savings Card will decrease this by 75 dollars per month to 134 dollars per month, and can be used monthly for up to 12 months. I sent a group email to our Carondelet doctors here in Tucson about Belviq. I also send an email to a doctor at Arizona Community Physicians, another large group here in Tucson, and the doctor offered to send the email to those doctors. My patients are excited about trying Belviq for weight loss. I have given Belviq prescriptions to a total of 178 patients so far over the last few weeks.
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NOTE FROM DOCTOR
I see 20-25 patients per day in my office. The day Belviq was in the pharmacies, I Rx'd eight people. These are patients who have BMI's over 30. They have tried everything else under the sun to lose wt. Their family members confirm that compliance has been observed in terms of not cheating with diet, exercising regularly and in general trying to maintain as healthy a life style as possible. They are suffering varying degrees of comorbid problems and were absolutely giddy when they learned that this NEW medication was available. The fact that they could take something that would not keep them up at night or cause palpitations was key for them. To date, I have Rx'd 28 patients in my small practice.
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NOTE FROM DOCTOR
Medical Assistant Misses Lunch by Doctor Vig
A medical assistant at my office has been on Belviq for several days.
On Wednesday, I noticed that she was still working on her computer at
lunch time. The other medical assistants had gone to lunch, so I
asked her if she was going to lunch. She said that she just “wasn’t
hungry” and she had decided to “skip lunch”. I have NEVER seen this
medical assistant miss lunch before! She also said that she had
decreased her food intake in the evenings. She “felt full” and did
not feel like eating very much food at night. She said that she was
already beginning to lose weight. She has a history of headaches, and
I asked her if she was having any headache problems, but she said that
she was not having increased headaches. She said she felt “just
fine”. Time to maximum concentration after a single pill of Belviq is
about 2 hours. The half life of Belviq is 11 hours, and steady state
concentration is reached after 3 days of dosing when given at 10 mg
orally twice a day, with or without food. Patients should feel
maximum effect of Belviq after 3 days of dosing. Risk of headache is
about 16% compared to 10 % on placebo, so it was encouraging that the
medical assistant was not experiencing headaches. We know that Belviq
works according to the clinical studies. It is encouraging to see
positive effects of Belviq first hand.
Steven Vig md internal medicine Tucson, Arizona 6 21 2013


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"not expected to cause heart valve problems like fenfluramine..."

From: http://pharmacistsletter.therapeuticresearch.com/pl/Newsletter.aspx?nidchk=1&cs=CP&s=PL

Belviq "is usually well tolerated. And it's not expected to cause heart valve problems like fenfluramine...they work at different receptors."

Qsymia... "more side effects...dizziness, insomnia, tingling in the hands and feet, impaired cognition, and taste perversion.  Qsymia will have a REMS program because it can cause birth defects.  Counsel women of childbearing age about the need for contraception and monthly pregnancy tests. Be sure to give ALL patients the Qsymia MedGuide and the Risk of Birth Defects patient brochure with every Rx."
   
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NOTE FROM DOCTOR
So far, William C lost about 30 pounds, starting at 387 pounds, which is about 7.7 % of his initial weight. Howard G lost about 30 pounds, starting at 240 pounds, which is about 12.5% of his initial weight. Naomi F lost about 10 pounds from her initial weight of 166.8 pounds, which is about 6% of her initial weight. All three participants met the FDA suggested weight loss goal of at least 5% weight loss in the first 12 weeks of Belviq therapy. All three participants feel fine. An unexpected development was an improvement in asthma in William C. , who is a moderate asthmatic.
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NOTE FROM DOCTOR
Just got an email from Howard G, one of my patients who was featured on the abc15 tv news story earlier in 2013 on Belviq ..... since starting Belviq in summer 2013, he has lost 48 pounds....he continues to exercise and feels well... he just turned 80 years old in september 2013....
steven vig md internal medicine tucson, arizona, 12 20 2013 happy holidays to all... looking forward to 2014....
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NOTE FROM DOCTOR
Belviq WORKS !!! Saw a patient back today for a follow-up visit. She is morbidly obese with a BMI of 39. She smokes 1 1/2 pack of cigarette a day. She has Type 2 DM. Started her on Belviq 10 mg BID two weeks ago. She has lost 9 pounds(260 to 251). Her post-prandial blood sugars have dropped by 50 points. She feels great, has tremendous energy, sleeps well and is extremely happy. The bonus is, she is down to three cigarettes a day. She can't believe it. She has been trying to quit smoking all her life. She is beyond ecstatic and gave a big hug befor she left !!! She received the 15 day trial and is going to fill her Rx. Her co-pay is 77/month which she says she will happily pay as she is saving money from less food and cigarette costs. Her husband is also morbidly obese and she sent him in to his MD to get some Belviq STATt!!! She reported no side effects such as headache, GI symptoms or fatigue. This stuff is AMAZING and seeing this type of response first hand is very rewarding.

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NOTE FROM DOCTOR

I saw a patient today who lost 30 pounds in the last three months on Belviq, from 342 to 312 pounds, which is over 8% of his body weight. He is on aetna and express scripts and I faxed a prior authorization request to express scripts in order to continue Belviq. I expect it to be approved, since he lost at over 5% of his body weight in three months. He said that his craving for sweets was gone. He says he only has to pay a 5 dollar copay per month for the Belviq, which is the lowest copay I have heard of on Belviq. This is just one of many success stories I have seen here in the clinic on Belviq. Steven Vig md internal medicine tucson, arizona 10 2 2013
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NOTE FROM DOCTOR
Today one of my pt on Belviq came in to pick up her rx, as I saw her, her eyes lightened up, happy face in full bloom, I asked her how are you doing on Belviq? She replied "great, I have lost 30lb since August, that is why I am back for my refill" She gave me a five, and mentioned that her HbA1C has dropped too, but it was not too high to start off with anyway. Her MD is going to reduce her metformin dose in next visit if she is at HbA1C goal. She seemed very happy and excited about her progress. Please note that she was not overly obese anyway, but definitely needed to lose weight!! Belviq works and it work very well.
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NOTE FROM DOCTOR
I had a patient in this week who lost 25 pounds in the first 3 months on belviq.... he was a "responder"...he was very happy...
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BELVIQ doesn't have this problem that Qsymia has:
Topiramate: Effects on Cognition
MORE NOTES FROM DOCTORS
First four patients today on Belviq. All lost at least 10% of their body
Weight. I am impressed by a 31 year old lady who is gone from 215 pounds to 165. She works at Captain D's. Yet she has no interest in stopping the medication. She is happy to pay $160 per month with the coupon.
Patient this a.m
After 12 mo. of B+P : 259 to 179 lbs.
She is still loosing weight every month.
Hard to justify not continuing the combo longer than 3 mo.?
They all continue weight loss for more than 3 mo.
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THE ONLY THINK A SCIENTIST WOULD CONCLUDE AT THIS POINT: BELVIQ APPEARS TO WORK TWICE AS WELL AS CHANTIX WITH NO SIGNIFICANT ADVERSE EVENTS OR WEIGHT GAIN.
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Patients
Getting lots like one this a.m. On Belviq x one yr. 12% drop and no drift upward. (Some do drift upward. e.g. 11% to 8%.)
This lady adding phentermine x 3 mo.
The study and the new. A.C.E. guidelines remove any hesitation.
BTW, the patient above had abnormal liver function test from NASH. Now normal. It does not take much weight to change this. It is about metabolism and not necessarily about the number of lbs.
Great drug.
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As a primary care physician the next time I see an overweight/obese patient with non-alcoholic steatohepatitis I WON'T refer them to a hepatologist at the university. I'll just give them Belviq!
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Looking through EHR at lab results coming back. Great case with only 4 lbs. Weight loss. A patient in her Late 50's with diabetes, truncal obesity, type IV hyperlipidemia. On statin and fenofibrate. On Metformin and Tradjenta for diabetes.. These patients have refractory obesity with a large abdominal girth and relative absence of excess adipose tissue elsewhere. They are very resistant to treatment and diet
Baseline 12 weeks ago: Triglycerides- 1077, Hemoglobin A1C- 8.6, Weight 152.
 
Add Belviq 10 mg BID. No phentermine.
Yesterday weight 148. Triglycerides down to 724. Hemoglobin A1C-6.9. Only lost 4 pounds, but these patient have a great benefit from any weight loss. Feels great. No problems. Continue Belviq? absolutely.
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Clinic today. Young couple. In 30s. Both 12 weeks on B+P. Combined weight loss of 103 lbs. The feedback was that their mattress would last much longer. They said that, not me
However, I do think that could be a fine commercial.
If a course of treatment produces a life-changing event, others will find out about it and pursue the same treatment.
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Saw patient today with repeat lab in hand. 48-year-old female weight 252. Also had "fatty liver". This is non alcoholic steatohepatitis. Common problem among overweight people. It will be the leading cause of cirrhosis. Look at what happened to ICPT when they had positive trial results on a drug that works by another pathway. The primary treatment for steatohepatitis is weight loss. First line. Best treatment.
The above patient had an inflamed liver related to steatohepatitis. Common. After one month the Belviq. Weight loss 12 pounds. Liver test returned to normal. It doesn't take much weight loss to turn this around. It is all about being catabolic versus anabolic.
ICPT gets a 5 billion dollar market primarily related to a drug that can do this. Their drug has some safety issues and is not on the market yet.
This patient will take Belviq indefinitely. Her federal Blue Cross will start paying for it in January. She is happy to pay herself until then.


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Another patient.
5'8" 235 lb. female. Developed DM, type II of course. Was on no treatment and had A1c of 9.3 3 m0. ago. Metformin along usually well not get a 9.3 to goal. MetFormin is the first drug of choice for type II diabetes. Started Metformin 500mg BID and Belviq 10 mg BID. Lost only 11 lbs. to 224, but a1C is 6.4. That is an incredible drop. I have tried this combo a couple of times with good results but nothing like that. If EISAI would get going, "BELFORMIN" could become the drug of choice in type II DM.
A1c control, weight loss, without the risk of Hypoglycemia. I hope they know what they got or I hope someone figures it out and buys EISAI. ARNA does not have the money to bring these drugs to market. It looks like they are stuck with EISAI on Lorcaserin.
OFF LABEL
This is another real patient of mine. 31 years old. She has Ehlers Danlos. This a Connective Tissue Disease with lots of chronic pain among other things. At no fault of her on, came back to me on large doses of narcotics. I had treated for a decade in the past 2000-2010. Two years ago moved back after being treated at a large referral academic center.
Her weight 130 lbs. Lyrica great drug for chronic pain. IMO, Lyrica the only non narcotic drug of value for chronic pain. If she takes it, needs less narcotics. Side effect is hunger. Her weight increased 10 lbs. to 140 on Lyrica. This was very important to her. She discontinued Lyrica. Weight went back to 130. However, again needed much higher doses of narcotics. Had some depression. Depression is common in chronic pain. So, three months ago I restarted the Lyrica back and also gave her Belviq. As of last week: weight 129, on Lyrica, on Belviq, Narcotic dose cut by one half, now off SSRI as well, feels the best she has in years. As I have said, Belviq is a remarkable new compound.
This is a great example of "Off Label" use of a drug. The FDA provides guidelines. They are not rules. 1 out of 5 of all scripts written by physician are "Off Label". What is my risk as a physician? None, as long as I explain to patient the potential risks. What the drug is used for normally, and why we should consider using it for a given problem. In this case, there may be a small risk of increased CNS seritonin effects. The truth is there is likely no risk at all. Regardless, are potential small risks worth taking 1/2 the narcotics and feeling well. For this case, yes it is. It is the Practice of Medicine. This Practice of Medecine is why I can't be replaced by a well written computer program. At least, not yet.
I see this mistake all the time: Using Belviq and Phentermine is not "Off Label."
They are two drugs approved to treat Obesity/Overweight syndrome. As with Hypertension, a physician can use two drugs to treat a disease. Using the combination as two scripts would be usual and expected practice. As with ANY two drugs used at the same time, there are always potential interactions. EISAI/ARENA has taken an extraordinary step to protect patients. They are doing a safety study because they know that these drugs will be commonly prescribed to the same patient. A safety study of this kind is almost never done. It is knowing the safety study is coming, that has delayed wide spread use of the combination.
On the other hand, using Belviq to treat tobacco addiction before the FDA approves a label change would be "Off Label." The only addiction Belviq is approved for is food so far. As with my example above in which I used Belviq to prevent weight gain caused by Lyrica, a brief discussion of risk/benefits is required. If Belviq shows any efficacy, are the benefits worth the small potential risks? That is an easy one.
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OFF LABEL
This is another real patient of mine. 31 years old. She has Ehlers Danlos. This a Connective Tissue Disease with lots of chronic pain among other things. At no fault of her on, came back to me on large doses of narcotics. I had treated for a decade in the past 2000-2010. Two years ago moved back after being treated at a large referral academic center.
Her weight 130 lbs. Lyrica great drug for chronic pain. IMO, Lyrica the only non narcotic drug of value for chronic pain. If she takes it, needs less narcotics. Side effect is hunger. Her weight increased 10 lbs. to 140 on Lyrica. This was very important to her. She discontinued Lyrica. Weight went back to 130. However, again needed much higher doses of narcotics. Had some depression. Depression is common in chronic pain. So, three months ago I restarted the Lyrica back and also gave her Belviq. As of last week: weight 129, on Lyrica, on Belviq, Narcotic dose cut by one half, now off SSRI as well, feels the best she has in years. As I have said, Belviq is a remarkable new compound.
This is a great example of "Off Label" use of a drug. The FDA provides guidelines. They are not rules. 1 out of 5 of all scripts written by physician are "Off Label". What is my risk as a physician? None, as long as I explain to patient the potential risks. What the drug is used for normally, and why we should consider using it for a given problem. In this case, there may be a small risk of increased CNS seritonin effects. The truth is there is likely no risk at all. Regardless, are potential small risks worth taking 1/2 the narcotics and feeling well. For this case, yes it is. It is the Practice of Medicine. This Practice of Medecine is why I can't be replaced by a well written computer program. At least, not yet.
I see this mistake all the time: Using Belviq and Phentermine is not "Off Label."
They are two drugs approved to treat Obesity/Overweight syndrome. As with Hypertension, a physician can use two drugs to treat a disease. Using the combination as two scripts would be usual and expected practice. As with ANY two drugs used at the same time, there are always potential interactions. EISAI/ARENA has taken an extraordinary step to protect patients. They are doing a safety study because they know that these drugs will be commonly prescribed to the same patient. A safety study of this kind is almost never done. It is knowing the safety study is coming, that has delayed wide spread use of the combination.
 
On the other hand, using Belviq to treat tobacco addiction before the FDA approves a label change would be "Off Label." The only addiction Belviq is approved for is food so far. As with my example above in which I used Belviq to prevent weight gain caused by Lyrica, a brief discussion of risk/benefits is required. If Belviq shows any efficacy, are the benefits worth the small potential risks? That is an easy one.
P.S. You may remember that a study is being done(not EISAI or ARENA) to evaluate if Belviq will prevent weight gain by antipsychotics. Another anecdotal observation that by itself has little value, but I think it worth noting the improvement in my patients depression.
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 It definitely works to stop smoking. Earlier this year, I had a patient who was morbidly obese, BMI 40+ who was a lifelong smoker 1 1/2 packs a day, equivalent to 30 cig/day. After 2 months of therapy, she was down to 1-2 cig day and 30 pounds weight loss. I recently saw her at her 6 months and she is no longer smoking. I think she is more excited about the smoking cessation than the weight loss. She has has lost about 45 pounds thus far as well.
Her mother and husband are also on Belviq now.
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On B+P patient down 265 to 227 lbs. in 14 weeks. B+P.
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7 lbs in 10 days.
Last pt. In for unrelated problem. Belviq 10 mg qd + 1/2 (phentermine 37.5 mg) qd.
DOCTOR
Turns out one of the nurses that started on Belviq smokes. She told me today "I don't want to smoke anymore." I didn't know she smoked.
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"I have used citalopram (celexa) 20mg per day with belviq and escitalopram (lexapro), 10mg with belviq"
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Just saw pt. Female. I have left her own her combo treatment for 6 mo. now: Belviq 10 mg gd + Phentermine 1/2(37.5 mg tab) qd. In 6 mo. 240 lbs. to 183.
She looks good. Lab good. I am going to let her keep going. When she hits her low, will maintain on B alone. Phentermine does not do this. Phentermine 3 mo. event. B can but less likely. However, this is not unusual result for the Combo.
Locaserin a unique chemical compound. Blocks "craving" center.




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