Lomaira-  4 hr Phentermine Appetite Suppressor with “New Uses”

Lomaira is a 4 hr phentermine  appetite suppressant. It is a  low-dose, fast-acting version of phentermine approved by the FDA in 2016. Although its a “phentermine” its a much lower dose (8 mg instead of 30 or 37.5 mg) than what has been available over the past 50 years! It similar to a 85 mg baby aspirin vs a 325 mg adult aspirin!

Lomaira vs. 37.5 mg  phentermine: Doctors have been prescribing phentermine for over 60 years. It is the most commonly prescribed weight loss medication. In fact, doctors wrote over 7 million prescriptions for it in 2016 alone. To date, over 125,000 healthcare professionals have prescribed this medication, including obesity specialists, family practitioners, endocrinologists, internists, and cardiologists. Lomaira stands out as the first new preparation of  phentermine in over 30 years! The problem has been that for some people the dose is too low to have much efficacy. However, there is role taken alone or even as a booster to a higher dose phentermine that may provide weight loss benefits for millions of people.

Lomaria as Post GLP-1 Weight Maintenance Aid

Preventing GLP-1 Rebound Weight Gain-New/Off-label Strategy 

The rationale for using Lamaira as a weight gain preventative is strong.  After stopping semaglutide or tirzepatide, many patients experience return of hunger, cravings, “food noise,” larger portions, and gradual weight regain.This does not happen immediately, but gradually appears 4-6 weeks  after stopping   GLP-1 medications. In the STEP 1 extension trial, patients who stopped semaglutide regained a substantial amount of lost weight over the following year, showing that obesity behaves like a chronic relapsing disease rather than a short-term cosmetic problem.

In a recent report from the British Medical Journal, researchers found that individuals going through post GLP-1 weight loss, a return to prior weight at an averge of  1.5 years after stopping the GLP-1 treament.  In practical terms, it may help replace part of the appetite control that disappears when a GLP-1 is reduced or stopped.

Lomaira to Prevent Phentermine Tolerance

Phentermine in the form of  15, 30 and 37.5 mg doses have been on the market for more than 40 years.  Twenty years ago, it was felt that the development of tolerance could be avoided by taking   “tolerance breaks.”  This was accomplished by stopping the drug for 2-3 weeks after a 6-8 week treatment period. However, recent research from the NIH has found little benefit and minimal increased weight loss by taking tolerance breaks. A large long term study from Mexico found similar results. Yet tolerance still limits weight loss. Some researchers believe reducing Phentermine dose for a short period with drugs like Lomaria might be useful.

Lomaira as  Low Dose Appetite Control-Few Side Effects

Lomaira is different from the usual form of phentermine in its  immediate release dose of only 8 mg and almost immediate action to diminish hunger and cravings. Side effects of Lomaira  are limited because it acts with a few minutes and is  gone from the brain in only 4 hours.When side effects occurr  there is a little bit of anxiety, dry mouth and possibly a mild headache. These are very short term and usually disappear in one or two hours. After a week or two of side effects they disappear.

Lomaria vs. Long Acting Phentermine:

Regular phentermine is long acting. Therefore, its taken at breakfast or in the mid-morning. Typical doses are 15mg, 30mg, or 37.5 mg (Adipex). It is effective for about 8-10 hours and gradually wears off in the early evening. Because of its long acting effects, patients only take a single dose. As a result, much less medication remains in the blood after 5 pm than before 5 pm. Since there is less medication in the evening, hunger is not as well controlled, latter in the day.

Adipex (a brand of phentermine 37.5mg) is manufactured as a time release tablet and  is the only long active form of phentermine  that enables patients to split the pill into half doses. The dieter takes 1/2 of the dose in the morning (lasts about 6 hours) and 1/2 in the later afternoon. Phentermine long acting is often hard to control due to variation in absorption and length of action leading to some side effects.

Lomaira Dosage for Weight Loss

Lomaira dosage is 8 mg per pill. It can be taken up to 3 times a day since each pill has a duration of only 4 hours. Its an immediate acting medication. Lomaira dosage is very flexible and can be adjusted for each individual.

Lomaira is Best for Evening Eating and Cravings

Lomaira is the lowest dose appetite suppressant in the phentermine group. Patients can take it up to three times a day before meals. Unlike the higher doses, you can take Lomaira before each meal and in the late afternoon or early evening. Therefore, it’s ideal for dieters with hunger at dinner and in the evening when the longer acting versions would be wearing off. Because phentermine has stimulant effects, taking higher doses of the long-acting versions or taking them later in the day often interferes with sleep.

I have prescribed Lomaira in my Miami office since its release in 2016. Patients have experienced good results. Most importantly, we individualize dosages to obtain the best response with the lowest necessary dose. It is especially helpful for those “dangerous” early evening cravings. Because it is a short-acting appetite suppressant, it’s ideal for people who overeat at dinner and throughout the evening. It was especially helpful in groups of obese individuals with high chances of Covid that could not take any other medications. 

Lomaira Advantages and Disadvantages

Lomaira Advantages over long acting phentermine

• 4-hour appetite Control
• Minimal side effects
• Easy to control dosing
• Long history of safety
• Minimal interference with sleep (people can take it as late as 6 PM without affecting sleep)
• Possible less development of tolerance–only in brain for few hours
• Inexpensive compared to new medications-less than $1/day
• Ideal for evening over-eaters

Lomaira Disadvantages compared to phentermine

• Very low dose( 8 mg vs 37.5 mg)
• If used alone, need to take 2 or 3 doses a day so its easy to forget the 2nd and 3rd dosing. Usual phentermine is taken once or at most twice a day.
• We may need to combine it with a second medication to achieve full day appetite control

How Does Lomaira Work?

After taking Lomaira, it quickly dissolves in the stomach and then is rapidly absorbed into the blood. After that, it passes into the brain. It stimulates the release of the neurotransmitter norepinephrine in neurons. To a lesser extent, it also releases dopamine and serotonin into synapses. This acts on the appetite center in the hypothalamus to reduce appetite so you feel full and eat less.

Outside of the brain, it releases norepinephrine and epinephrine. This causes fat cells to break down stored fat. It also minimizes your calorie intake by reducing the absorption of starch and fat by the body.

How Effective is Lomaira ?

Phentermine is the active ingredient in Lomaira. Its appetite suppressant properties have been widely studied and produce consistent outcomes. As a result, it is the most commonly prescribed weight loss medication in the world. I prescribe Lomaira as one of the medication options in my Miami Diet Plan. Patients report less desire to eat and snack, especially later in the evening. Weight loss of around 2 lbs./week is common. Lomaira has been successful https://lomaira.com/testimonials/ for people all over the world since it was first approved. Watch a video of success with Lomaira.

What are the Side Effects of Lomaira?

Some reported side effects of Lomaira include those common to all phentermine medications: pulmonary hypertension, valvular heart disease, palpitations, increased heart rate or blood pressure, insomnia, restlessness, dry mouth, diarrhea, constipation and changes in sexual drive. These are not all of the potential side effects of Lomaira.

Tell your doctor if you have high blood pressure, even if it’s mild. If you are taking medicines for type 2 diabetes, your doctor may have to adjust these medicines while taking Lomaira.

The drug manufacturer advises caution when engaging in potentially hazardous activity such as driving or operating machinery while taking Lomaira. This medication has the potential to be abused. Keep it in a safe place to prevent theft, accidental overdose, misuse or abuse. Using alcohol with this medication may result in an adverse reaction.

Who Can Take Lomaira?

Lomaira is for adults with an initial BMI of 30 or more (obese) or 27 or more (overweight) with at least one weight-related medical condition such as controlled high blood pressure, diabetes, or high cholesterol. It is intended for short term use of up to 12 weeks. It is not recommended for use in pediatric patients 16 years of age or younger.

Who Should NOT take Lomaira

Don’t take Lomaira if you have a history of cardiovascular disease. You shouldn’t take this medication if you are taking or have taken a monoamine oxidase inhibitor drug (MAOI) within the past 14 days. Don’t take this medication if you have an overactive thyroid, glaucoma, agitation, a history of drug abuse, are pregnant, nursing, or allergic to the sympathomimetic amines such as phentermine or any of the ingredients in Lomaira.

What the Experts Say

“Lomaira can help patients who meet appropriate guidelines (no history of heart diseases, not pregnant or nursing, controlled blood pressure, etc.) and who are undertaking a dietary program. Patients can take Lomaira for a few weeks or months to lose weight and then switch to weight loss maintenance approaches. The chief advantages of Lomaira are that the medication improves the safety and efficacy profile of Phentermine by allowing physicians to tailor treatment to an individual patient’s needs, thus giving them the minimum dose needed for efficacy and timing that dose to the patient’s hunger profile.” – Weight Expert Dr. Donna Ryan, Editor of the Journal Obesity and Endocrinology Professor at LSU

Each individual needs to discuss the use of these medications with their personal physician to see which medications will be safe and effective.