Mysimba

HOW MYSIMBA WORKS

Mysimba is different from Wegovy and Mounjaro. It contains two active ingredients, naltrexone and bupropion. They work in your brain, reducing food addiction and cravings. It results in less weight loss than Wegovy and Mounjaro, but it’s particularly helpful if you have a medical reason why you wouldn’t be able to have those medications, or alternatively because it’s a completely different class of medication, you could take it as well as Wegovy or Mounjaro.

In the UK we only typically prescribe one weight loss medication to patients because frankly, we only have one (hopefully two imminently!) medication approved by the NHS for weight loss, and that’s Wegovy. Mounjaro is approved for diabetes but not weight loss for use in the NHS, but it is licensed for private use in the UK. However, even if it does become available via the NHS in due course, we wouldn’t give Wegovy and Mounjaro to the same patient at the same time because they are so similar.

However, in other parts of the world where more medications are licensed for weight loss, it’s standard practice to have patients on combinations of medications for their weight, and during my time in the USA observing in their clinics, patients were often on Mysimba and Wegovy or Mounjaro at the same time, with great results.

SIDE EFFECTS OF MYSIMBA

Mysimba has the potential to cause some serious side effects including fits, so if you have a history of epilepsy or any other condition affecting your brain then it’s probably best to avoid taking it. Fits occur in about 1:1000 people who take Mysimba, but it if happens to you then you won’t be able to drive for a year, for example, and there are other concerns too. It can also significantly lower your mood, so if you already have depression then it would be best to avoid it.

Other side effects include nausea/vomiting, constipation, headache, anxiety, dizziness, difficulty sleeping, dry mouth, difficulty concentrating, fatigue, tinnitus, fast heart rate, hot flush, increased blood pressure, abdominal pain, rash, itching, excessive sweating, hair loss, irritability. The most common are nausea/vomiting, constipation and headache. Many of these side effects could be managed fairly effectively with over the counter medications.

WHAT DOSE OF MYSIMBA SHOULD I TAKE?

Mysimba has one standard dosing schedule:

• Week 1: One tablet once a day in the morning
• Week 2: Two tablets every day, one in the morning and one in the evening
• Week 3: Three tablets every day, two in the morning and one in the evening
• Week 4 and onward: Four tablets every day, two in the morning and two in the evening

WHAT DO I DO IF I MISS A DOSE OF MYSIMBA?

If you miss a dose, don’t take extra medication to compensate for this. Simply omit that dose and take your next dose as planned.

STORAGE OF MYSIMBA

It can be stored at room temperature like most other medication in tablet form.

IS MYSIMBA SUITABLE FOR ME?

Mysimba is licensed in the UK for people with a body mass index of 30 or more, or 27 or more with at least one weight related health problem.

You shouldn’t take it if you have any conditions that increase your chances of fits, if you have significant depression and if you are currently on any sort of programme for substance misuse. The active ingredients in Mysimba are also used for treatment of alcohol and drug misuse, so if you’re already having treatment for one or both of these then it’s not advisable to take Mysimba alongside it. Also, if you’re legitimately taking strong prescription pain relief for another health problem then you should avoid Mysimba because it can stop the pain relief from being effective.

You should also avoid Mysimba if you have significant heart problems.

HOW MUCH DO YOU LOSE ON MYSIMBA?

Average weight loss with Mysimba is 5%. That may not sound like much, but it is enough to improve your health in many ways, and if (for example) your specialist has advised you that you need to lose up to 5% of your weight to get fertility treatment or get your knee fixed, or gender reassignment surgery, or any one of a number of other procedures, then this could be one way to achieve that. Most people opt for Wegovy or Mounjaro if they can, because the risks are lower and the expected weight loss is more, but Mysimba does have its place.

DOES MYSIMBA BURN FAT?

No, Mysimba works by helping you to eat less by lowering food addiction and craving type feelings. You then burn the fat yourself naturally as a consequence.

SWITCHING BETWEEN WEIGHT LOSS MEDICATIONS

You can change from Mysimba to Wegovy or Mounjaro fairly easily as they are different medication classes, and outside of the UK it’s common practice for some people to be prescribed both simultaneously.

WHAT ARE THE ALTERNATIVES TO MYSIMBA?

The other licensed medications in the UK are Wegovy and Mounjaro. You can find a summary of the differences among Mysimba, Wegovy and Mounjaro here.