Mysimba tablets

Mysimba offers a unique solution to getting to a healthier weight by working directly on hunger signals in the brain. Unlike other weight loss treatments, it is available as an oral tablet, and does not work on the gut itself.

Containing two active ingredients, naltrexone and bupropion, Mysimba is licensed for use by eligible patients, and available from our GPhC registered online clinic.

How to Buy Mysimba Tablets Online

As a prescription treatment, to purchase Mysimba you will need to fill out an online consultation, prior to adding to your basket.

Following approval, all medication is packaged securely in plain, discreet packaging and delivered straight to your door with next day delivery options available.

As a GPhC registered pharmacy, at Quick Meds we source all medications from MHRA-accredited suppliers, ensuring all medication is legitimate.

How To Place an Order

To place an order, head to our website, to the weight loss section. Hit the start consultation button, and fill out the whole form accurately.

The form will ask questions about your weight, your general health along with medical history and if you take any other medication. Once complete, you will be able to add Mysimba to your basket and checkout.

Our registered clinicians will review your responses for clinical suitability and safety. Clinicians may also request additional information, by accessing your NHS health record or fully-clothed body images to verify your weight.

Once approved, orders are packaged appropriately and dispatched usually on the same day with delivery options as soon as the next working day.

What is Mysimba and How Does It Work

Mysimba is a prescription-only (POM) weight loss treatment containing the active ingredients naltrexone and bupropion. It works by controlling hunger signals directly in the brain and reducing the pleasure associated with eating food.

Weight loss is not immediately apparent with Mysimba. As it affects nerve centres in the brain, it's essential to gradually increase the dose every week.

Appetite suppression and reduction in food cravings can begin within the first few weeks, but significant weight loss is not expected until the maintenance dose has been reached and continued for several weeks.

Available in 8mg/90mg prolonged release tablets, the dose is titrated up from one tablet daily to the maintenance dose of two tablets, twice daily.

Effectiveness of Mysimba was assessed across four clinical trials (COR-I, COR-II, COR-BMOD, COR-diabetes) evaluating over 4,500 subjects. Trials were randomised and assigned to Mysima or placebo. Primary outcomes were measured over 56 weeks and found:

COR-I - measured the effect of the treatment on weight loss in overweight and obese adults
COR-II - measured the effect on weight loss and weight-related risk factors
COR-BMOD - measured the effect in combination with behaviour modification
COR-Diabetes - measured the effect on both weight and blood sugar levels in diabetic patients.

In all four trials, Mysimba led to a greater weight loss compared to placebo. The most common side effects were:

• Nausea

• Constipation

• Dizziness

• Insomnia

• Dry mouth

• Headache.

In COR-I, 49% of participants dropped out and did not complete the full 56 weeks due to nausea. Data from these trials show, whilst the treatment is effective, it may not suit everyone.

How to Take It

Mysimba is taken as oral tablets, with the dose increasing gradually over 4-weeks as follows:

• Week 1 - One tablet in the morning

• Week 2 - One in the morning and one in the evening

• Week 3 - Two in the morning and one in the evening

• Week 4 - Two in the morning and two in the evening

The maximum recommended dose is four tablets daily. If a dose is missed, an additional dose should not be taken, but take the next dose at the usual time.

The tablets should be swallowed whole with water and should not be cut, chewed, or crushed. Tablets should be taken with meals but avoiding very high-fat meals.

Eligibility

Mysimba is indicated for weight loss, in adults over 18, with an initial Body Mass Index (BMI) of

• 30 or over - Obese

• Between 27 and 30 - overweight, with a weight-related health condition (type 2 diabetes, controlled high blood pressure)

The treatment is indicated for use alongside lifestyle changes such as:

• A reduced calorie diet

• Increased physical activity

Who Cannot take Mysimba

Whilst safe for use by most, Mysimba must not be taken by:

• The elderly - over 75 years

• Children and adolescents - under 18 years

• End stage kidney disease

• Severe liver disease

• A known tumour of the central nervous system

• A history of bipolar disorder

• A current or previous diagnosis of bulimia or anorexia

• A dependence on chronic opioids - such as codeine

• Alcohol dependence

• Allergies to the active ingredients or any of the excipients.

• Uncontrolled high blood pressure

• During pregnancy or breastfeeding

Drug Interactions

Mysimba can interact with certain medication and must not be taken with:

• Opioids - painkillers containing codeine, morphine, fentanyl or oxycodone

• MAOIs - used for depression or Parkinson’s.

Additionally, Mysimba can affect the levels of the following, making them too strong or too weak:

• Antidepressants - specifically SSRIs, such as sertraline, fluoxetine, citalopram

• Blood pressure & heart medicines - specifically Beta-blockers (bisoprolol, atenolol)

• Tamoxifen - breast cancer medication which may be less effective if taken with Mysimba

• Diabetic medicines - combined with Mysimba may cause hypoglycaemia

Mysimba can lower the seizure threshold. Caution is needed if you take other medications which also have this risk, such as oral steroids, tramadol or quinolone antibiotics.

Whilst not a direct interaction, drinking alcohol with Mysimba can lead to neuropsychotic side effects. It is recommended to avoid alcohol whilst on treatment.

The treatment should always be taken with food. It works best when taken with a meal though avoid high-fat meals to prevent side effects.

Side effects

As with all medicines, Mysimba can cause side effects, though not everyone gets them. These are more likely in the first few weeks of treatment as the body is adjusting to treatment.

Most common

The most common side effects can affect 1 in 10 people who use this medicine and include:

• Nausea

• Constipation

• Diarrhoea

• Headache

• Vomiting

• Dizziness

• Trouble sleeping (insomnia)

• Dry mouth

Lifestyle modifications, such as ensuring adequate hydration and eating plenty of fibre can help manage most of the common side effects whilst also helping with weight loss.

Uncommon

Less common side effects can affect 1 in 100 people and include:

• Anxiety

• Insomnia (difficulty sleeping)

• Tremors (feeling shaky)

• Dysgeusia (a bad or unpleasant taste in the mouth)

• Lethargy (tiredness)

• Somnolence (sleepiness)

• Tinnitus (ringing in the ears)

• Palpitations (irregular heart beat) or a higher-than-usual heart rate

• Flushing or suddenly feeling hot

• Pain or aches in the tummy

• Hyperhidrosis (sweating more than usual)

• Pruritus (itchy skin)

• Alopecia (hair falling out)

The patient information leaflet, included with the treatment includes a comprehensive list of side effects.

Rare/serious Side Effects

Serious side effects are rare, affecting 1 in 1,000 to 10,000 people and include:

• Suicidal thoughts, or thoughts of self harm

• Fits or seizures,

• Loss of consciousness (fainting)

• Stevens-Johnson Syndrome or Erythema Multiforme, e.g. itchy red spots, starting on the arms and legs, severe blisters, bleeding on the lips, eyes, mouth, nose, or genitals

• Rhabdomyolysis, e.g. severe muscle cramps, pain or weakness, affecting any part of the body

• Severe allergic reaction, e.g. difficulty swallowing/breathing, pain in the muscles or joints, itching, hives, a rash that appears red on white skin, dizziness, fever, swelling of the face, tongue, mouth or throat

• Increases in blood pressure or heart rate

• Hepatitis e.g. stomach area pain lasting more than a few days, dark urine, yellowing of the whites of your eyes, or tiredness

• Manic episodes

• Visual problems (symptoms of angle-closure glaucoma include eye pain, changes in vision, swelling, or redness in or around the eye)

• Hypoglycaemia (low blood sugar) in diabetic patients

If you experience any of these side effects, you should seek immediate medical attention, by calling 999 or going to the nearest A&E immediately.