Phentermine

Phentermine is a prescription medication used with a doctor-approved exercise, behavior change, and reduced-calorie diet program for weight loss. It is used by certain overweight people, such as those who are obese or have weight-related medical problems. Losing weight and keeping it off can lessen the many health risks that come with obesity, including heart disease, diabetes, high blood pressure, and a shorter life.

• It is not known how this medication helps people to lose weight. It may work by decreasing your appetite, increasing the amount of energy used by your body, or by affecting certain parts of the brain. This medication is an appetite suppressant and belongs to a class of drugs called sympathomimetic amines.
• Phentermine is available under the following different brand names: Adipex P, and Lomaira.

Adult and Pediatric Dosage Forms & Strengths

Capsule, HCl salt: Schedule IV

• 15mg (generics)
• 30mg (generics)
• 37.5mg (Adipex P, generics)

Tablet, HCl salt: Schedule IV

• 8mg (Lomaira)
• 37.5mg (Adipex P, generics)

Discontinue if weight loss has not occurred with 4 weeks of therapy. Not approved for long-term use.

Discontinue if tolerance develops, and do not exceed recommended dosage to overcome tolerance.

Short-term (few weeks) adjunctive use as part of weight-reduction regimen based on exercise, behavioral modification, and caloric restriction in management of exogenous obesity for patients with initial body mass index (BMI) ≥30 kg/m² or ≥27 kg/m² in presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia).

Adipex P or generic

• 15-37.5 mg/day PO in single daily dose or divided q12hr before breakfast or 1-2 hr after breakfast

Lomaira

• Typical dose is 8mg PO TID 30 minutes before meals

Side effects of phentermine include:

• Heart valve disorder
• Primary pulmonary hypertension
• Psychotic disorder

Other side effects of phentermine include:

• Bad taste in the mouth
• Blurred vision
• Changes in sex drive
• Chills
• Constipation
• Diarrhea
• Drug-induced gastrointestinal (GI) disturbance
• Dry mouth
• Unhappy or anxious mood
• Pain or discomfort when urinating
• Excitement
• Hair loss
• Headache
• High blood pressure (hypertension)
• Impotence
• Insomnia
• Muscle pain
• Nausea
• Nervousness
• Palpitations
• Restlessness
• Fast heart rate
• Tremor
• Hives
• Vomiting

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Severe interactions of phentermine include:
  • iobenguane i 123
  • isocarboxazid
  • linezolid
  • phenelzine
  • procarbazine
  • selegiline transdermal
  • tranylcypromine
• Phentermine has serious interactions with at least 42 different drugs.
• Phentermine has moderate interactions with at least 172 different drugs.
• Mild interactions of phentermine include:
  • amantadine
  • American ginseng
  • desmopressin
  • eucalyptus
  • guarana
  • sage
  • yerba mate

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains phentermine. Do not take Adipex P or Lomaira if you are allergic to phentermine or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Known hypersensitivity or idiosyncratic reaction to sympathomimetic amines
• History of cardiovascular disease (coronary artery disease, uncontrolled hypertension, arrhythmias, stroke, congestive heart failure)
• Glaucoma
• Agitated states
• Hyperthyroidism
• History of drug abuse
• Use of monoamine oxidase inhibitors (MAOIs) within preceding 14 days; concomitant administration of other CNS stimulants
• Pregnancy and breastfeeding

Effects of Drug Abuse

• Phentermine may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as depression, severe tiredness) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions right away.
• Rarely, abnormal drug-seeking behavior (addiction) is possible with this medication. Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed.

Short-Term Effects

• Phentermine may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Long-Term Effects

• Phentermine may rarely cause serious (sometimes fatal) lung or heart problems (pulmonary hypertension, heart valve problems). The risk increases with longer use of this medication and use of this drug along with other appetite-suppressant drugs/herbal products. If you notice any of the following unlikely but very serious side effects, stop taking this medication and consult your doctor or pharmacist right away: chest pain, difficulty breathing with exercise, decreased ability to exercise, fainting, swelling of the legs/ankles/feet.

Cautions

• Primary pulmonary hypertension and valvular disease have been reported with therapy.
• Avoid the use of stimulants in patients with serious heart rhythm disturbances, cardiac abnormalities, cardiomyopathies, or other cardiac problems.
• Caution in hypertension; risk of increase in blood pressure.
• Patients with diabetes mellitus should use caution with antidiabetic agents like insulin or other hypoglycemic agents; dietary restrictions may lower requirements for antidiabetic therapy.
• The drug has not been studied in renal impairment.
• Use caution in patients with seizure disorders or Tourette syndrome.
• May impair the ability to operate heavy machinery.
• Concomitant administration with other weight-loss agents (e.g., selective serotonin reuptake inhibitors [SSRIs], herbal preparations, other over-the-counter products) has not been studied.
• The elderly are at high risk for myocardial infarction, hypertension, angina, or becoming dependent on phentermine with prolonged use.
• Discontinue if weight loss has not occurred with 4 weeks of therapy.
• Not approved for long-term use.
• Discontinue if tolerance develops, and do not exceed the recommended dosage to overcome tolerance.

Pregnancy and Lactation

• Do not use phentermine in pregnancy. The risks involved outweigh the potential benefits. Safer alternatives exist. It is unknown if phentermine is excreted in the milk; the use of phentermine is contraindicated while breastfeeding.