Phentermine

Today's med: Phentermine (FEN ter meen) 

(brand names: Adipex-P, Suprenza, Lonamin; Index Term: Phentermine Hydrochloride)

Drug Class:  Sympathomimetic Amine Anorexiant, CNS Stimulant

Other Drugs in this class: Phendimetrazine, Amfepramone,Benzphetamine, Phentermine Hydrochloride,Diethylpropion hydrochloride,Phendimetrazine tartrate, Benzphetamine hydrochloride

Action:  Phentermine is a sympathomimetic amine with pharmacologic properties similar to the amphetamines. The mechanism of action in reducing appetite appears to be secondary to CNS effects, including stimulation of the hypothalamus to release norepinephrine.

Indications: Short-term (few weeks) adjunct therapy in obese patients with an initial body

mass index (BMI) ≥30 kg/m² or ≥27 kg/m² in the presence of other risk factors (eg, diabetes, hyperlipidemia, controlled hypertension); therapy should be used in conjunction with a comprehensive weight management program.

Contraindications: Hypersensitivity or idiosyncrasy to phentermine or other sympathomimetic amines or any component of the formulation; history of cardiovascular disease (arrhythmias, congestive heart failure, coronary artery disease, stroke, uncontrolled hypertension); hyperthyroidism, glaucoma, agitated states, history of drug abuse; use during or within 14 days following MAO inhibitor therapy; pregnancy, breast-feeding

Adverse Effects: Frequency not defined. MOST COMMON: Tachycardia and Hypertension

Cardiovascular: Hypertension, ischemic events, palpitation, primary pulmonary hypertension and/or regurgitant cardiac valvular disease, tachycardia

Central nervous system: Dizziness, dysphoria, euphoria, headache, insomnia, overstimulation, psychosis, restlessness

Dermatologic: Urticaria

Endocrine & metabolic: Changes in libido

Gastrointestinal: Constipation, diarrhea, unpleasant taste, xerostomia

Genitourinary: Impotence

Neuromuscular & skeletal: Tremor

Standard Dosing: Note: Dosing is presented in terms of the salt, phentermine hydrochloride (not as phentermine base).

Oral: Children >16 years (OH YAY!) and Adults: Obesity:

Capsule, tablet: 15-37.5 mg/day given in 1-2 divided doses. Individualize to achieve adequate response with lowest effective dose.

Orally disintegrating tablet (ODT): One tablet (15 mg or 30 mg) every morning. Individualize to achieve adequate response with lowest effective dose.

Administration

Avoid late evening administration.

Capsules, tablets: Administer before breakfast or 1-2 hours after breakfast. Tablets may be divided in half and dose may be given in 2 divided doses.

Orally disintegrating tablets (Suprenza™): With dry hands, place tablet on the tongue and allow to dissolve, then swallow with or without water. May administer with or without food.

Dietary Considerations

Capsules, tablets: Should be taken before breakfast or 1-2 hours after breakfast; avoid taking in the late evening. Most effective when combined with a low-calorie diet and behavior modification counseling.

Lab Test Interference: May interfere with urine detection of amphetamines/methamphetamines (false-positive).

Drug interactions: http://www.drugs.com/drug-interactions/phentermine.html

A total of 440 drugs (3259 brand and generic names) are known to interact with phentermine.

• 83 major drug interactions (408 brand and generic names)
• 355 moderate drug interactions (2845 brand and generic names)
• 2 minor drug interactions (6 brand and generic names)

Show all medications in the database that may interact with phentermine.

Avoid: Cardiovascular disease, Glaucoma, Psychosis, Substance Abuse, TIc disorder, Diabetes and Liver disease. Moderate level interaction with food and alcohol. 

Phentermine....like an Amphetamine (increases release of NE)