Lorcaserin

Lorcaserin is a prescription medication that was used for chronic weight management in adults. It was marketed under the brand names Belviq and Belviq ER and was developed by Arena Pharmaceuticals, with distribution by Eisai. In the United States, it was approved by the Food and Drug Administration in 2012 for adults with a body mass index (BMI) of 30 or greater, or 27 or greater with at least one weight-related condition, as an adjunct to diet and exercise. The standard dosing regimes were 10 mg taken twice daily for the immediate-release form or 20 mg once daily for the extended-release form.

Pharmacology and mechanism of action are centered on the serotonin system. Lorcaserin is a selective serotonin 2C receptor agonist, acting in the hypothalamus to promote satiety and reduce appetite. By favoring 5-HT2C receptor activation, it was designed to minimize stimulation of 5-HT2B receptors, which have been associated with valvular heart disease in other serotonergic weight-loss drugs. Common side effects reported in trials and postmarket use included headache, dizziness, fatigue, nausea, dry mouth, constipation, and upper respiratory symptoms. Clinicians advised monitoring for interactions with other serotonergic medications and caution during pregnancy.

Regulatory history and status changed after safety assessments. In 2019 the FDA indicated concerns about a potential cancer risk associated with lorcaserin and its overall benefit-risk profile. In February 2020 Eisai voluntarily withdrew lorcaserin from the U.S. market at the agency’s request, and it is no longer marketed in the United States. Lorcaserin has not been approved for use in the European Union.