Prab at 17:54, 14 December 2023

2023-12-14T17:54:33Z

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[[File:Fentermina.svg|Phentermine structure|thumb]]

Phentermine is controlled substance and an appetite suppressant [[weight loss]] medication or [[diet pill]] used as [[weight loss]] prescription that has been on the market for over 50 years in the United States.

==FDA approval==
Approved by the US FDA in 1959, Phentermine has been on the market for a long time with proven safety record. Phentermine is used for a limited period of time to speed weight loss in overweight people who are exercising and eating a low-calorie diet. Phentermine is in a class of medications called anorectics. It works by decreasing appetite. Phentermine comes as tablets and extended-release capsules. It usually is taken as a single daily dose in the morning or three times a day 30 minutes before meals.

==Indications for Phentermine==
ADIPEX-P® is a [[sympathomimetic amine]] anorectic [[weight loss medication]] indicated as a short-term adjunct in a regimen of weight decrease based on exercise, behavioral modification and caloric limit in the management of exogenous obesity for patients with:

[[File:Adipex 37.5mg pills.jpg|alt=Adipex P 37.5 mg|thumb|Adipex P 37.5 mg]]


* a primary body mass index ≥ 30 kg/m2, or
* ≥ 27 kg/m2 along with other risk factors such as controlled [[hypertension]], [[metabolic syndrome]], [[diabetes]], [[hyperlipidemia]] etc.

==Adverse effects of Phentermine== 
Phentermine is generally well tolerated and most people may not experience any major side effects.


Treatment should be discontinued inpatients who develop new, unexplained symptoms of [[dyspnea]], [[angina pectoris]], syncope or smaller extremity [[edema]], and patients should be evaluated for the possible occurrence of [[pulmonary hypertension]].

'''Common (1% or more in incidence) adverse effects include:'''
* [[Xerostomia]] ([[dry mouth]])
* [[Restlessness]]
* [[Nervousness]]
* [[Euphoria]]
* [[Agitation]]
* [[Arrhythmia]]
* [[Tachycardia]]
* [[Hypertension]]
* [[Diarrhea]]
* [[Vomiting]]
* [[Headache]]
* [[Rash]]
* [[Urinary frequency]]
* [[Facial edema]]
* [[Unpleasant taste]]
* [[Urticaria]]
* [[Impotence]]
* Changes in [[libido]]
[[File:Phentermine.jpg|alt=Phentermine|thumb|Phentermine]]

'''Rare (1% or less incidence) adverse effects include:'''
* Primary pulmonary hypertension
* Valvular heart disease (in combination with dexfenfluramine and fenfluramine; causal relationship unclear)
* Increased seizure activity in people with epilepsy
* [[Psychosis]]
* Withdrawal symptoms on stopping are rare
* [[Dysphoria]]
* Ischaemic events are rare
==Cautions and interactions== 
Phentermine use is contraindicated in those who are:
* Known hypersensitivity or idiosyncratic reaction to sympathomimetic amines
* Taking amphetamine (i.e., Adderall, Dexedrine, Vyvanse), dexfenfluramine, fenfluramine, furazolidone, guanadrel, guanethidine, or have taken a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine) in the last 14 days
* Hyperthyroidism
* Glaucoma
* Peptic ulcer
* Prostatic hypertrophy
* Epilepsy
* Simultaneous treatment with drugs that increase blood pressure
* Contraindicated in cardiac disease (e.g. advanced arteriosclerosis, pulmonary hypertension, uncontrolled hypertension, arrhythmias) and cerebrovascular disease (stroke)
* Pregnant, planning to become pregnant, or are breast-feeding
* Those receiving serotonergic medications such as the selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitor, tricyclic antidepressant, due to the potential for serotonin syndrome to be precipitated by the treatment.
{{qsymia}}
==Mechanism of action== 
It is believed to suppress the appetite and increases the metabolism by its actions on the [[appetite center]]

==Dosing and administration== 
It is available in 15 mg, 30 mg and 37.5 mg in tablet and capsule form.

==Brand names available== 

*'''Adipex P''' (immediate release)
*'''Anoxine-AM'''
*'''Ionamin''' (slow-release resin, Australia, discontinued in the US)
*'''Mirapront'''
*'''Obephen'''
*'''Obermine'''
*'''Obestin-30'''
*'''Phentermaxx'''
*'''Phentrol'''
*'''Phenterex'''
*'''Phentromin'''
*'''Pro-Fast SA'''
*'''[[Qsymia]]''' (with [[topiramate]])
*'''Redusa'''
*'''Panbesy'''
*'''Phentermine Trenker'''
*'''Obenix'''
*'''Oby-Trim'''
*'''Teramine'''
*'''Zantryl'''
*'''Suprenza''' (disintegrates orally)

==Phentermine and Topiramate== 
Phentermine is often combined with Topiramate like in the brand name [[Qsymia]] for better [[weight loss]] results, mitigate some of the side effects, and increase effectiveness. In fact, in a large 30,000 patient [https://jamanetwork.com/journals/jama/fullarticle/2528211 diet pill comparison study] published in JAMA that compared new prescription weight loss medications or [[diet pills]], [[Phentermine Topiramate|Qsymia]] was considered the most effective weight loss prescription medication.

{{weight-loss-clinic-map-us}}
{{Amphetamine|state=expanded}}
{{Anorectics}}
{{Monoamine releasing agents}}
{{TAAR ligands}}
{{Phenethylamines}}
[[Category:Amphetamine]]
[[Category:Anorectics]]
[[Category:Anti-obesity drugs]]
[[Category:Carbonic anhydrase activators]]
[[Category:Norepinephrine releasing agents]]
[[Category:Phenethylamines]]
[[Category:Substituted amphetamines]]
[[Category:TAAR1 agonists]]
[[Category:Withdrawn drugs]]
{{w8md}}

Phentermine - Revision history

Prab at 17:54, 14 December 2023