Phentermine has pharmacologic activity similar to amphetamine (d- and dll-amphetamine) [see Clinical Pharmacology (12.1)]. The patient could have had the prescription for the month of October filled at another pharmacy. Even patients who are overweight and pregnant at the same time are not allowed to use this product. endstream endobj startxref Not only can losing weight harm an unborn baby during pregnancy, but the drug may also cause adverse effects. The natural history of obesity is measured over several years, whereas the studies cited are restricted to a few weeks duration; thus, the total impact of drug-induced weight loss over that of diet alone must be considered clinically limited. It helps patients lose weight by suppressing their appetite and boosting their energy levels, thus leading to a more active lifestyle and greater calorie burn. 1530 0 obj <> endobj The drug is classified under a certain chemical class known as amphetamine as it has a similar pharmacology value to other drugs classified in the class. A doctor is the only person who can determine if phentermine is right for you. hYr ~{L(QdK4^bdsO_d;a BXO--p,!4!,WhfM/@c Rule 4731-11-02 | General provisions. Concomitant use of alcohol with Phentermine may result in an adverse drug reaction. ADIPEX-P (phentermine hydrochloride) tablets, for oral use CIV ADIPEX-P (phentermine hydrochloride) capsules, for oral use CIV Initial U.S. Approval: 1959 This site complies with the HONcode standard for trustworthy health information: verify here. Start with your primary care doctor and schedule an appointment to discuss weight. The plasma protein binding decreases as blood topiramate increases. ): Most people get their phentermine from a family or primary care doctor ( If your primary care physician thinks you are a good candidate for phentermine but does not want to (or cannot) prescribe it, he or she may refer you to a specialist. In a single-dose study comparing the exposures after oral administration of a combination capsule of 15 mg Phentermine and 92 mg topiramate to the exposures after oral administration of a 15 mg Phentermine capsule or a 92 mg topiramate capsule, there is no significant topiramate exposure change in the presence of Phentermine. Special Populations Geriatric Patients Select dosage with caution, starting at lower end of dosage range. In some cases, the use of Phentermine has also led to the development of symptoms that are related to erectile dysfunction. It is advised to stay in strict adherence with the instructions and dosage information a doctor prescribes to the patient in order to avoid dangerous side effects. All rights reserved. A severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia. Review/update the IBM Micromedex. If you are a good candidate for the medication, but your doctor does not prescribe phentermine, ask for a referral. If not, additional education or an additional certification may be needed. Tablets: 37.5 mg phentermine hydrochloride, USP (equivalent to 30 mg phentermine base). Do not keep outdated medicine or medicine no longer needed. Any knowledge would be most appreciated. Use caution in prescribing Phentermine for patients with even mild hypertension (risk of increase in blood pressure). It is a class IV controlled substance because of its serious side effects and addiction potential. 1 Accessed Oct. 11, 2022. They inhibit the activity of an entire enzyme family known as monoamine oxidase. Even after the period that the drug has been prescribed for, the doctor will often recommend to gradually stop using the Phentermine to avoid the withdrawal symptoms. hb```e````a`d`@ f(fcfILLvL~. other information we have about you. potentially hazardous activities such as operating machinery or driving FULL PRESCRIBING INFORMATION in the presence of other risk factors (e.g., controlled hypertension, 333-33-100411 Tasks 35 "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Children 16 years of age and youngerUse is not recommended. Some of these include: As with many other prescription drugs, Phentermine can also interact with certain medications. Late evening medication should be avoided because of the possibility of resulting insomnia. As mentioned above, new mothers should avoid using this medication when breastfeeding. Apart from not combining Phentermine with the MAO inhibitors, a patient should also first ensure they are not allergic to Phentermine before they take it. Losing weight during pregnancy can harm both a mother and her baby. A single copy of these materials may be reprinted for noncommercial personal use only. ). Studies do not permit conclusions as to the relative importance of the drug and non-drug factors on weight loss. Dr. Lazarus, we will discuss combination phentermine therapy later in this roundtable discussion. State Medical Board of Ohio 30 E. Broad Street, 3rd Floor, Columbus, OH 43215-6127 (614) 466-3934 med.ohio.gov Take the disintegrating tablet with or without food. Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Phentermine is a Schedule 4 drug. 100 TABLETS In fact, one study conducted at the Duke University School of Medicine found that apart from the Phentermines ability to effectively reduce body weight, it can also help improve a patients health-related quality of life. A doctor that sees you regularly is in a unique position to assess the pros and cons of a phentermine prescription because he/she is familiar with your medical history, as well as other medications, allergies, and weight trends over time. Phentermine has been linked to many complications; knowing these details will help patients minimize their risk of experiencing such unwanted scenarios. Learn about phentermine and succeed in your weight loss journey. Phentermine is for people with obesity or overweight who haven't been able to lose enough weight with diet and exercise alone to improve their health. Perreault L. Obesity in adults: Drug therapy. Wait, so NPs may prescribe Qsymia, but not phentermine? The usual adult dose is one tablet (37.5 mg) daily, as prescribed by the physician, administered before breakfast or 1 to 2 hours after breakfast. Despite the initial draw of saving time and money by completing your consultation online and receiving weight loss pills in the mail, using these online phentermine doctors is not safe. Unpublished raw data. (5) A treatment plan based upon the clinical information obtained, to include all of the following components: (a) Diagnosis; (b) Objective goals for treatment; (c) Rationale for the medication choice and dosage; and (d) Planned duration of treatment and steps for further assessment and follow-up. x\8zS wU^TM;J`Kc=@y\} Blf\3K|xL?D$aesY"_(ceD!s!@P,?K&Bd8cKS~zq=7'kiw\dqL:A ?O0O@+}y"z[?Os/Kht;[SN4h9c31{8Eh7dPc\BFE(e&9;!PUqK\aD 7) &\1!j-_Y7jD,Sp)AWc/igg?v{5\%a'd9"D0=gRGEZgpbMQJD *k*;1'w24w, d r d?&8xeEj`\2C6xrhq2@-{P5CbBL(/0m8&8Ltnvf};y852q*+I%l=+rwGUv*:!80|>tb?U?L,zG8%K`n]+:,LCE")Xz\^):{~{=vu=Qg`A\6qT=WCZ TcR%mi,OV_RtK1e&:By~i~!nu In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2), limit the dosage of Phentermine to 15 mg daily [see Dosage and Administration (2.2)]. (2019). All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. Primary Pulmonary Hypertension (PPH) a rare, frequently fatal disease of the lungs has been reported to occur in patients receiving a combination of Phentermine with fenfluramine or dexfenfluramine. The strength and dosage of Phentermine depend on the brand that is prescribed and the patients specific condition. Before taking phentermine, tell your doctor and pharmacist if you are allergic to phentermine, any other medications, or any of the ingredients in phentermine tablets. 2021; doi:10.1007/s13679-020-00422-w. Patients should be advised to report immediately any deterioration in exercise tolerance. It is illegal & unsafe to buy phentermine online consider Phen Caps instead! Take this medicine only as directed by your doctor. Phentermine Hydrochloride Tablets are indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index 30 kg/m2, or 27 kg/m2 in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia). Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [see ClinicalPharmacology (12.3)]. These are two schedule- IV medications, phentermine/topiramate (Qsymia), and locaserin (Belviq), as well as non-controlled naltrexone hydrochloride/ buproprion hydrochloride (Contrave). Encourage prescribers to incorporate best clinical practices when prescribing opioids for treating Ohio . Advertising revenue supports our not-for-profit mission. Learn about the most popular weight loss medications. Drug information provided by: IBM Micromedex. Phentermine is not recommended for use in pediatric patients 16 years of age. Tak YJ, et al. https://www.uptodate.com/contents/search. Rule 4731-11-03 | Utilization of anabolic steroids, schedule II controlled substance cocaine hydrochloride, and schedule II controlled substance stimulants. https://fco.factsandcomparisons.com/. (phentermine hydrochloride) orally disintegrating tablet C IV . The Ohio Emergency and Acute Care Facility Opioids and Other Controlled Substances Prescribing Guidelines offer clinical guidance for the acute care environment where there is no established patient-doctor relationship. Overstimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, psychosis. I wonder whose pockets got lined with that one. While suffering from any of these health concerns may be a cause for concern, it does not mean a patient will not be able to use Phentermine at all. We comply with the HONcode standard for trustworthy health information. hbbd``b` @IHpA\> . As a result, they may be more open to the idea of prescribing phentermine. Since 1997, allnurses is trusted by nurses around the globe. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Phentermine is pregnancy category X, so it should never be taken while pregnant or nursing ( (2019, May 03). Store at 20 to 25C (68 to 77F) [See USP Controlled Room Temperature]. Or it can help you feel full longer. 6 Medically reviewed by Drugs.com. Below we explain how to get phentermine, including why you need a prescription, who can take this medication, and how to get your doctor to prescribe phentermine. Each tablet contains the following inactive ingredients: starch, lactose anhydrous, microcrystalline cellulose, colloidal silicon dioxide, stearic acid, magnesium stearate and blue sugar spheres. The limited usefulness of agents of this class, including Phentermine, [see Clinical Pharmacology (12.1, 12.2)] should be measured against possible risk factors inherent in their use such as those described below. The most common brand of Phentermine is a product known as Adipex, but officially called Adipex-P. Phentermine is a Schedule IV controlled substance. What to offer the 99% of patients with severe obesity who do not undergo bariatric surgery? This is a label given to drugs that can be misused. If your dose is different, do not change it unless your doctor tells you to do so. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. information submitted for this request. 138 0 obj <>stream However, if it is almost time for your next dose, skip the missed dose and go back to your . The goal of the drug is to help patients lose weight and increase energy since the withdrawal symptoms of include fatigue and weight gain through an increase in appetite, the product is rendered a waste of the patients time and money. Accessed Oct. 11, 2022. Gastrointestinal symptoms include nausea, vomiting, diarrhea and abdominal cramps. In relatively short-term clinical trials, adult obese subjects instructed in dietary management and treated with anorectic drugs lost more weight on the average than those treated with placebo and diet. United States of America, Drug Enforcement Administration, Federal Register. https://www.micromedexsolutions.com. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. Ohio Administrative Code 4731-11-04 and 4731-11-04.1. It is important to follow these instructions religiously. How Is Phentermine Dosed? The doctor may advise the patient to complete the remaining period of the program or help him/her end the program safely. Long-term efficacy and safety of anti-obesity treatment: Where do we stand? But regarding phentermine monotherapy, phentermine hydrochloride (HCl) is a sympathomimetic Drug Enforcement Agency (DEA) scheduled IV drug approved as an anti-obesity medication and marketed in the US since 1959 (See Table 1).The reported weight reduction efficacy of phentermine [10] derived from . Available for Android and iOS devices. When tolerance to the anorectant effect develops, the recommended dose should not be exceeded in an attempt to increase the effect; rather, the drug should be discontinued. The use of Topamax and Phentermine is actually an FDA-approved combination. A weight loss doctor will be more familiar with the research on phentermine for weight loss and, in many cases, more likely to prescribe it. The drug is always accompanied by increased physical activity and a diet that includes a lower amount of calories. The combined drug is approved for long-term use. Especially considering Ohios ability to track the prescribing and dispensing of the drug in Ohios drug database, OARRS. At January's meeting, the board discussed the rules and elected to investigate what other states are doing to regulate weight loss medication. health information, we will treat all of that information as protected health Although phentermine is the agent-of-choice among physicians specializing in obesity treatment, the use of this drug for obesity treatment by other physicians has long been curtailed because misapprehensions regarding phentermine safety. If we combine this information with your protected OSMA is actively following this issue and we are hopeful that the medical board will make changes to Ohios rules that will enable physicians to utilize their training and professional judgment, instead of restrictive time limits, when treating some of Ohios most vulnerable patients. the unsubscribe link in the e-mail. Portions of this document last updated: Feb. 01, 2023. Obesity has been linked to many different diseases, including type 2 diabetes and cardiovascular disease. It is not uncommon for patients to experience a change in their sexual interest. When breastfeeding, the drug may enter the breast milk and travel into the nursing babys body, which may cause harm to them. These are both major barriers to optimal medical care. Concomitant use of alcohol with phentermine may result in an adverse drug reaction. 4 0 obj Rule 4731-11-04.1 Controlled substances: utilization for chronic weight management. Phentermine is most commonly prescribed to patients who experience negative health effects to excessive amounts of body weight. Typical actions of amphetamines include central nervous system stimulation and elevation of blood pressure. Ideally, patients should take it on an empty stomach. Along with Ohio's telehealth law in Sub. He or she may prescribe the medication him/herself if you are an appropriate candidate, or he/she may choose to refer you to a specialist for further evaluation and follow-up. The medication has been classified as a controlled substance in most countries and is also classified as a schedule IV prescription drug. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Please consult with your physician before you make any decisions regarding your health. These are all promoted as weight loss pills that assist obese individuals. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. Carefully follow your doctor's instructions for a reduced-calorie diet plan and regular exercise. More specifically, this medication is an option for people with a body mass index (BMI): Weight-related conditions that may qualify a lower-BMI patient for phentermine include: type 2 diabetes, high cholesterol (hyperlipidemia), and controlled high blood pressure (hypertension) ( Yes, you need a prescription for phentermine. Drugs of this class used in obesity are commonly known as anorectics or anorexigenics. It has not been established that the primary action of such drugs in treating obesity is one of appetite suppression since other central nervous system actions, or metabolic effects, may also be involved. National Association of Boards of Pharmacy. \ Detailed Phentermine dosage information Related/similar drugs Use of Phentermine is contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors because of the risk of hypertensive crisis. Yes, phentermine is a federally controlled substance because it may be abused or lead to Ohio has some of the strictest rules in the country and. Acidification of the urine increases Phentermine excretion. Get the best fitness, food, and weight loss tips to succeed on your journey! A minimum weight gain, and no weight loss, is currently recommended for all pregnant women, including those who are already overweight or obese, due to obligatory weight gain that occurs in maternal tissues during pregnancy. Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. In most cases, the drug is prescribed to users in periods of 12 weeks. Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic and/or tricuspid valves, has been reported in otherwise healthy persons who had taken a combination of Phentermine with fenfluramine or dexfenfluramine for weight loss. It can help weight loss by making you less hungry. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. The dosage may be adjusted to the patients need. Copyright 2023 IBM Watson Health. The weight loss experts who OSMA has consulted with have indicated that misuse of phentermine is unlikely. In some cases, the doctor may prescribe Phentermine in smaller doses and advise the patient to take it up to three times in a single day. What could be the cause? This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Patients are advised to report any symptoms or diseases they may have before the doctor prescribes the drug this may include high blood pressure and kidney problems, as well as any type of diabetes and thyroid disorders. This website is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. endstream endobj 1531 0 obj <>/Metadata 26 0 R/Pages 1528 0 R/StructTreeRoot 41 0 R/Type/Catalog>> endobj 1532 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/TrimBox[0.0 0.0 630.0 702.0]/Type/Page>> endobj 1533 0 obj <>stream The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. Contraindications History of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive heart failure, uncontrolled hypertension) During or within 14 days following the administration of monoamine oxidase inhibitors Hyperthyroidism Phentermine doctors network. Phentermine is 17.5% plasma protein-bound, while topiramate is 15 - 41% plasma protein-bound when the blood concentration range is 0.5 to 250 g/mL. BMI is calculated by taking the patients weight, in kilograms (kg), divided by the patients height, in meters (m), squared. However, weight loss clinics are not the perfect solution. If we combine this information with your protected Cardiovascular effects include arrhythmia, hypertension or hypotension, and circulatory collapse. Our members represent more than 60 professional nursing specialties. In some cases, the side effects were life-threatening and led to the death of a patient. The board expressed concerns that removing the prescribing restrictions could lead to misuse of weight loss drugs such as phentermine. There is a problem with The CPG determination is specific to Qsymin, Belviq and Contrave only. The possible role of Phentermine in the etiology of these valvulopathies has not been established and their course in individuals after the drugs are stopped is not known. N;d0)zQ|,]8EtXy(En"GX omjU3Y3>kfkYHYi]-zhm{= o`i$G1BK%?9Z+(dm`mKt,?;6K@Q 7}}*Tw>7BkKsJ;E|Viexb T-3j%5QB%wI5'$5oB :h*C"Q7yjTzLO%6QS/u>HX 4DGz*A!1*p"7$-joX2YF8ht@\l[&LS$FU=udM&y.l_ Many people live far away from their nearest weight loss clinic, which can make follow-ups complicated. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Phentermine is a popular prescription drug that is often used to treat obesity. Existing health conditions that may act as a problem include diabetes, thyroid disorders, hypertension and kidney disease. Is Phentermine a Controlled Substance? This medication has been linked to physical dependence, which means a patient may become addicted to it. In 1968, three years after its release, Aminorex was withdrawn. It is important not to perform activities that require a patient to be alert while experiencing mental impairment as an adverse effect. Phentermine hydrochloride (phentermine HCL) is the active ingredient in phentermine weight loss pills. The amount of weight loss associated with the use of an anorectic drug varies from trial to trial, and the increased weight loss appears to be related in part to variables other than the drugs prescribed, such as the physician-investigator, the population treated and the diet prescribed. LZ(6&JQKU5@5_M.~#p = yLgzP"Z90* v~1iu0pV (s:J&Q,. } }& 8}q>u@y)dO|fRmknw huA0@6-%&k-1qI6fSt4#>=sHMk>8fztq9_ nw:>NxHfib Lx.c QEWg\@y@ ~[*+-Dze~Ej+%.E`|IdW#o~#` MM ). "@Hw4`tqCA\+ q [AF]` b L ! In order to use Phentermine, the doctor needs to prescribe the drug for a specific patient. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This website is a resource which lists doctors and clinics who may offer phentermine or appetite suppressants for patients they deem qualified. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Nationwide Efforts to Combat the Problem Questions To Discuss At the completion of this block of instruction you will be able to answer the following questions: 1. The medical board would like to work with the pharmacy board to make OARRS reports more available and helpful to physicians. stream You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Some of the most common withdrawal symptoms include weight gain, fatigue, insomnia and a bad mood. Dosage form: tablet Ohio has some of the strictest rules in the country andthe current rules place time limitations on prescriptions that, many times, force physicians to stop a medication that is showing positive weight loss results. While discussing the use of Phentermine with the doctor, a patient is provided a list of lifestyle changes to implement while using this product. Overdosage of pharmacologically similar compounds has resulted in fatal poisoning usually terminates in convulsions and coma. Facts & Comparisons eAnswers. Phentermine. Primary Pulmonary Hypertension (PPH) a rare, frequently fatal disease of the lungs has been reported to occur in patients receiving a combination of Phentermine with fenfluramine or dexfenfluramine. The possible origins of the increased weight loss due to the various drug effects are not established. Swallow the tablet whole. Therefore, coadministration of Phentermine and these drug products is not recommended. Duromine is not funded by Pharmac, so patients pay $160-$200 per month when they present a standard prescription of 30mg daily - in addition to the GP consultation fee. Six years after the approval, a similar drug, called Aminorex, were released in Europe with the same purpose of helping obese individuals. If the drug is taken too late in the day, it may also cause insomnia. 0 The most common side effects that patients experience include tremors, headaches, dizziness, dry mouth, diarrhea, constipation, upset stomach, feeling restless and being hyperactive. The medical board is currently reviewing its long-standing rules regarding prescribing controlled substances for the treatment of obesity. Rx only. I hold a DEA cert. If a patient would like to take other supplements, they should consult their doctor first. Following the administration of Phentermine, Phentermine reaches peak concentrations (Cmax) after 3 to 4.4 hours. other information we have about you. Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. Like other weight-loss medicines ordered by providers, phentermine is meant to be only part of a weight-loss plan. The possibility of an association between PPH and the use of Phentermine alone cannot be ruled out; there have been rare cases of PPH in patients who reportedly have taken Phentermine alone.