ATC Group: A08AA Centrally acting antiobesity products

The World Health Organization's ATC classification organizes medical drugs based on therapeutic properties, chemical composition, and anatomy. It helps make essential medicines readily available globally and is widely used in the pharmaceutical industry.

Position of A08AA in the ATC hierarchy

Level Code Title
1 A Alimentary tract and metabolism
2 A08 Antiobesity preparations, excl. diet products
3 A08A Antiobesity preparations, excl. diet products
4 A08AA Centrally acting antiobesity products

Group A08AA contents

Code Title
A08AA01 Phentermine
A08AA02 Fenfluramine
A08AA03 Amfepramone
A08AA04 Dexfenfluramine
A08AA05 Mazindol
A08AA06 Etilamfetamine
A08AA07 Cathine
A08AA08 Clobenzorex
A08AA09 Mefenorex
A08AA10 Sibutramine
A08AA11
A08AA12
A08AA51
A08AA56 Ephedrine, combinations
A08AA62

Active ingredients in A08AA

Active Ingredient Description
Amfepramone

Amfepramone is a sympathomimetic amine with some pharmacologic activity similar to that of the prototype drugs of this class used in obesity, the amphetamines. Actions include some central nervous system stimulation and elevation of blood pressure. It has not been established, however, that the action of such drugs in treating obesity is primarily one of appetite suppression. For example, other central nervous system actions or metabolic effects may be involved.

Bupropion and Naltrexone

The exact neurochemical appetite suppressant effects of naltrexone/bupropion are not fully understood. Naltrexone is a mu-opioid antagonist and bupropion, a weak inhibitor of neuronal dopamine and norepinephrine reuptake. These components affect two principal areas of the brain, specifically the arcuate nucleus of the hypothalamus and the mesolimbic dopaminergic reward system.

Cathine
Clobenzorex

Clobenzorex is an N-substituted amphetamine analog that is converted to d-amphetamine soon after ingestion. Clobenzorex is a stimulant drug of the phenethylamine and amphetamine chemical classes used as an appetite suppressant.

Dexfenfluramine

Dexfenfluramine is the d-enantiomer of fenfluramine (structurally similar to amphetamine) and acts as a serotonergic anorectic drug that reduces appetite by increasing the amount of extracellular serotonin in the brain.

Fenfluramine

Fenfluramine is a serotonin releasing agent, and thereby stimulates multiple 5-HT receptor sub-types through the release of serotonin. Fenfluramine may reduce seizures by acting as an agonist at specific serotonin receptors in the brain, including the 5-HT1D, 5-HT2A, and 5-HT2C receptors, and also by acting on the sigma-1 receptor. The precise mode of action of fenfluramine in Dravet syndrome and Lennox-Gastaut syndrome is not known.

Lorcaserin

Lorcaserin is believed to decrease food consumption and promote satiety by selectively activating 5-HT2C receptors on anorexigenic pro-opiomelanocortin neurons located in the hypothalamus. The exact mechanism of action is not known. It is used as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients.

Mazindol

Mazindol is a sympathomimetic amine for the treatment of obesity and Duchenne muscular dystrophy. Like other sympathomimetic appetite suppressants, mazindol is thought to act as a reuptake inhibitor of norepinephrine. In addition, it inhibits dopamine and serotonin reuptake. It stimulates the central nervous system, which increases heart rate and blood pressure, and decreases appetite.

Mefenorex

Mefenorex is an amphetamine derivative which was used as an appetite suppressant.

Phentermine
Setmelanotide

Setmelanotide is a selective MC4 receptor agonist. MC4 receptors in the brain are involved in regulation of hunger, satiety, and energy expenditure. In genetic forms of obesity associated with insufficient activation of the MC4 receptor, setmelanotide is believed to re-establish MC4 receptor pathway activity to reduce hunger and promote weight loss through decreased caloric intake and increased energy expenditure.

Sibutramine

Subitramine is a potent inhibitor of monoamines (serotonin, dopamine, noradrenaline) reuptake for the treatmen of obesity. Sibutramine is metabolized to metabolites M1 and M2 which are more active toward the monoamine transporters.

Related product monographs

Title Information Source Document Type  
BELVIQ / BELVIQ XR Film-coated tablet / Extended-release tablet FDA, National Drug Code (US) MPI, US: SPL/PLR
CONTRAVE Extended-release tablet FDA, National Drug Code (US) MPI, US: SPL/PLR
IMCIVREE Solution for injection European Medicines Agency (EU) MPI, EU: SmPC
MYSIMBA Prolonged-release tablet European Medicines Agency (EU) MPI, EU: SmPC