Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
lorcaserin
Selective serotonin 5-HT2C receptor agonist (anti-obesity; WITHDRAWN) · Weight management (historical use)
START
Use discouraged (withdrawn — cancer signal)
TYPICAL MAX
20 mg/day (historical ceiling)
STOP IF
Any signal of malignancy, serotonin syndrome, or depression
WATCH
Discontinue if <5% weight loss at 12 weeks; mood; not for use
CDSCO approvedATC A08AA11
KDIGO 2024 + manufacturer label
- ONSET
- 1h · absorption
- PEAK
- 1.8h · Tmax
- t½
- 11h · t½
- DURATION
- 12h · twice-daily
EXCRETION
Renal — mainly metabolites; ~3% unchanged
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Contraindicated.
FDA category + note
Top interactionssee all 12 →
- AlfentanilSevereDatabaseDDInter
- AlmotriptanSevereDatabaseDDInter
- AmitriptylineSevereDatabaseDDInter
- AmoxapineSevereDatabaseDDInter
Mechanism
Selective 5-HT2C receptor agonist on hypothalamic POMC neurons, reducing appetite and food intake; was used as adjunct to diet/exercise for weight loss until withdrawal.
Indications
Historical: chronic weight management (BMI ≥30, or ≥27 with comorbidity). WITHDRAWN from market (cancer signal in CAMELLIA-TIMI 61).
Dosing
- Adult
- Historical: 10 mg PO twice daily (or 20 mg ER once daily). Use discouraged/not available in most markets.
- Pediatric
- Not established.
- Renal adjustment
- Severe impairment: not recommended.
- Hepatic adjustment
- No specific adjustment for mild–moderate.
- Geriatric
- Limited data.
- Max dose
- 20 mg/day (historical)
Pharmacokinetics
Onset
Appetite suppression within days
Peak effect
~1.5–2 h (Tmax)
Duration
~12 h (twice-daily)
Half-life
~11 h
Bioavailability
High
Protein binding
~70%
Metabolism
Hepatic (multiple pathways)
Excretion
Renal (mainly metabolites; ~3% unchanged)
Contraindications
- Pregnancy
- Hypersensitivity
- Use generally not recommended (withdrawn)
Side effects
Common
HeadacheDizzinessNauseaDry mouthConstipationFatigue
Serious
- Increased malignancy risk (cancer signal — withdrawal basis)
- Serotonin syndrome (with serotonergic drugs)
- Valvulopathy / pulmonary hypertension (theoretical, class)
- Psychiatric (depression/suicidal ideation)
- Hypoglycaemia (with diabetics)
Pregnancy & lactation
Pregnancy
Contraindicated.
Lactation
Avoid.
Drug interactions
Almotriptan
Severe
Database
Clinical effect not specified
Source: DDInter
Amitriptyline
Severe
Database
Drug interaction classified as: synergy, metabolism
Source: DDInter
Amoxapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Benzphetamine
Severe
Database
Clinical effect not specified
Source: DDInter
Brexpiprazole
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Bromocriptine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Buspirone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cabergoline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Citalopram
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clomipramine
Severe
Database
Drug interaction classified as: synergy, metabolism
Source: DDInter
Desipramine
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
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Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20