Dosing and uses of Adipex P, Lomaira (phentermine)
Adult dosage forms and 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)
Obesity
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 (eg, controlled hypertension, diabetes, hyperlipidemia)
Adjust dosing according to patient's needs to achieve adequate response with lowest effective dosage
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
Pediatric dosage forms and 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)
Obesity
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 BMI ≥30 kg/m² or ≥27 kg/m² in presence of other risk factors (eg, controlled hypertension, diabetes, hyperlipidemia)
<16 years: Safety and efficacy not established
≥16 years
- Adjust dosing according to patient's needs to achieve adequate response with lowest effective dosage
- 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
Adipex P, Lomaira (phentermine) adverse (side) effects
Frequency not defined
Bad taste in mouth
Blurred vision
Changes in libido
Chills
Constipation
Diarrhea
Drug-induced GI disturbance
Dry mouth
Dysphoric mood
Dysuria
Excitement
Hair loss
Headache
Hypertension
Impotence
Insomnia
Myalgia
Nausea
Nervousness
Palpitations
Restlessness
Tachycardia
Tremor
Urticaria
Vomiting
Serious
- Heart valve disorder
- Primary pulmonary hypertension
- Psychotic disorder
Warnings
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
History of drug abuse
Use of monoamine oxidase inhibitors (MAOIs) within preceding 14 days; concomitant administration of other CNS stimulants
Pregnancy and breast feeding
Cautions
Primary pulmonary hypertension and valvular disease have been reported with therapy
Avoid use of stimulants in patients with serious heart rhythm disturbances, cardiac abnormalities, cardiomyopathies, or other cardiac problems (see Contraindications)
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
Drug has not been studied in renal impairment
Use with caution in patients with seizure disorders or Tourette syndrome
May impair ability to operate heavy machinery
Concomitant administration with other weight-loss agents (eg, selective serotonin reuptake inhibitors [SSRIs], herbal preparations, other over-the-counter products) has not been studied
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 recommended dosage to overcome tolerance
Pregnancy and lactation
Pregnancy category: X
Lactation: Unknown if excreted in milk; contraindicated
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Adipex P, Lomaira (phentermine)
Mechanism of action
Amphetamine-related anorexigenic agent; action in reducing appetite may be secondary to CNS effects that may involve stimulation of hypothalamus to release norepinephrine
Absorption
Peak plasma time: 3.0-4.4 hr (orally disintegrating tablet)
Elimination
Excretion: Urine (primarily)
