Phentermine Pills For Weight Loss Near Me – Phentermine is an oral sympathomimetic amine used as an adjunct in the short-term (eg, 8-12 weeks) treatment of obesity. The pharmacological effects of phentermine are similar to those of amphetamines. Phentermine resin complex was approved by the FDA in 1959, but is no longer sold in the US. Phentermine hydrochloride was approved by the FDA in 1973. In the mid-90s, there was renewed interest in phentermine in combination with fenfluramine for the treatment of obesity and substance abuse, however, little scientific data supported this approach. On July 8, 1997, the FDA issued a ‘Dear Health Care Professional’ letter warning physicians about the development of valvular heart disease and pulmonary hypertension in women receiving a combination of fenfluramine and phentermine; Fenfluramine was later withdrawn from the US market in the fall of 1997. The use of phentermine with other anorectic agents for obesity has not been evaluated and is not recommended. In May 2011, the FDA approved phentermine hydrochloride orally disintegrating tablets (Suprenza) for the treatment of exogenous obesity.
Limited data are available in reference texts regarding the mechanism of action of this drug. Phentermine is an analog of methamphetamine. Like amphetamines, phentermine increases the release of norepinephrine and dopamine from nerve terminals and inhibits their reuptake. Thus, phentermine is classified as an indirect sympathomimetic. 2 Other effects include a weak ability to increase serotonin levels in a dose-dependent manner, although the effect on serotonin is less potent than that of methamphetamine. 3 Clinical effects include CNS stimulation and vasodilation. Pressure is believed to suppress appetite through direct stimulation of the satiety center in the hypothalamic and limbic regions.
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Tolerance to the anorectic effects of phentermine usually develops within a few weeks of starting therapy. The mechanism of tolerance appears to be pharmacodynamic in nature; Higher doses of phentermine are required to produce the same response. When tolerance to the anorectic effects develops, it is generally recommended that phentermine be discontinued rather than the dose increased.
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Phentermine is administered orally. The rate and extent of exposure to phentermine in the fasting state are equivalent to when the oral formulation is administered.1
Limited data exist on the pharmacokinetics of phentermine. Phentermine is primarily excreted through the kidneys. The elimination half-life is 19-24 hours and is influenced by urinary pH. Because phentermine has a pKa of 9.84, the elimination half-life decreases to about 7-8 hours under acidic urine conditions.
Oral Route: After oral administration, most of the absorption of phentermine occurs through the small intestine. The duration of action is about 4 hours after taking 8 mg capsules or tablets and 12-14 hours after taking 30 mg capsules or 37.5 mg tablets.
Phentermine oral disintegrating tablet (ODT) reaches its maximum concentration (Cmax) 3-4.4 hours after administration. Drinking water before swallowing ODT does not affect AUC. Although Cmax (approximately 5%) and AUC (approximately 12%) are decreased when phentermine ODT is administered after a high-fat/calorie breakfast, phentermine ODT can be administered with or without food. Cmax and AUC decreased by approximately 7% and 8%, respectively, when ODT was swallowed without prior dissolution.1
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Renal Impairment: Use with caution in patients with renal impairment. The cumulative urinary excretion of phentermine is 62-85% under uncontrolled urinary pH conditions, and exposure is expected to be increased in patients with renal impairment.1
According to the formulation of Phentermine Capsules and Tablets, its products are contraindicated in patients with heart disease, advanced arteriosclerosis, moderate to severe hypertension, excitatory states, or glaucoma. 6 Similarly, orally disintegrating tablets are contraindicated in patients with a history of heart disease. Diseases including coronary artery disease, stroke, cardiac arrhythmias, heart failure, and uncontrolled high blood pressure. 5 Valvular heart disease has been reported in women receiving a combination of fenfluramine and phentermine; The safety and efficacy of combination therapy with phentermine and any other drug products for weight loss with selective serotonin reuptake inhibitors (eg, fluoxetine, sertraline, fluvoxamine, paroxetine) have not been established. Therefore, co-administration of these medicinal products for weight loss is not recommended. Further, primary pulmonary hypertension (PPH) has been reported to occur in patients receiving phentermine in combination with fenfluramine or dexfenfluramine. An association between phentermine use alone and PPH or valvular heart disease cannot be ruled out. The initial symptom of PPH is usually dyspnea. Other early symptoms include: angina pectoris, syncope, or swelling of the lower extremities. Patients should be advised to promptly report any deterioration in exercise tolerance. Treatment should be discontinued in patients who develop new, unexplained symptoms of dyspnea, angina pectoris, syncope, or lower extremity edema.
Because phentermine is a sympathomimetic agent, it is contraindicated in patients with hyperthyroidism. It should also be used with caution in patients with thyroid disease.
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Phentermine is contraindicated for use during or within 14 days of using MAOI therapy or other drugs with MAO-inhibitory activity. Monoamine oxidase inhibitors (MAOIs), or drugs with MAO-inhibitory activity such as furazolidone or procarbazine, may prolong and intensify the cardiac stimulation and vasopressor effects of phentermine.4
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Phentermine is contraindicated in patients with an agitated state. These may increase the effects or cause adverse drug reactions. 4 Symptoms of acute intoxication include insomnia, irritability, personality changes, and psychotic symptoms, which may be clinically distinguishable from other psychiatric disorders, such as schirenzoph. Phentermine may exacerbate certain psychiatric conditions, such as in patients who exhibit highly anxious or agitated behavior, including psychosis, mania, or severe anxiety.
Use of phentermine may cause dizziness, signs of fatigue, or the need for rest, or may impair the patient’s ability to participate in activities that require mental alertness. Advise patients to use caution when driving or operating machinery or performing other tasks requiring mental alertness unless they are aware of how therapy may affect their mental and/or motor performance. In general, consuming ethanol may increase these effects or cause an adverse drug reaction. 4 Advise patients to avoid alcohol while taking phentermine.
Use phentermine with caution in patients with diabetes mellitus. Use of phentermine during weight loss and altered dietary regimens may alter the need for insulin or other antidiabetic medications in these patients. Patients should monitor their blood glucose regularly and follow their healthcare provider’s recommendations.5
Use of appetite suppressant therapy is not recommended in patients with a history of anorexia nervosa or other eating disorders. Use of phentermine is contraindicated in patients with a known history of drug or substance abuse. Phentermine is chemically and pharmacologically related to amphetamines which are widely abused. The potential for abuse of phentermine should be kept in mind when evaluating the desirability of including the drug as part of a weight loss program. A minimum reasonable amount should be prescribed or dispensed at a time to limit the potential for overuse or diversion of the drug.5
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Phentermine products are now classified as FDA Pregnancy Risk Category X, as are many anorectants used for weight loss, and are contraindicated during pregnancy. 56 The safe use of phentermine during pregnancy has not been established; There are no known indications for the use of phentermine during pregnancy. Pregnant women or pregnant women should not take phentermine unless, according to the doctor, the potential benefits outweigh the potential risks.
Abrupt discontinuation of phentermine after prolonged high doses may cause severe mental depression or extreme fatigue; Sleep EEG changes have also been reported. A gradual withdrawal of therapy is recommended. If immediate discontinuation is medically necessary, careful monitoring and symptom management are essential.4
Phentermine is contraindicated during breastfeeding. 5 It is not known whether phentermine and its metabolites are excreted in human milk; However, because of the potential for serious adverse effects in nursing infants, breastfeeding while taking phentermine is not recommended.76
The safety and efficacy of phentermine in children have not been established. Phentermine is not recommended for children or adolescents 16 years of age and younger. There is no established use of phentermine in infants or neonates.45
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Debilitated or elderly patients may be more susceptible to the CNS and sympathomimetic side effects of phentermine; Use with caution in elderly patients. Patients with renal impairment may also be more susceptible to side effects. Increased exposure can be expected in patients with renal impairment or renal failure. Use caution when administering phentermine to patients with renal impairment.4
The use of inhalational anesthetics during surgery can sensitize the myocardium to the effects of sympathomimetic drugs. Because of this, and its effect on blood pressure, phentermine should generally be discontinued several days prior to surgery. Avoid sudden shutdown.
Phentermine products are now classified as FDA Pregnancy Risk Category X, as are many anorexics used for weight loss, and are contraindicated during pregnancy. 55 The safe use of phentermine during pregnancy has not been established; There are no known indications for the use of phentermine during pregnancy. Pregnant women or pregnant women should not take phentermine unless, according to the doctor, the potential benefits outweigh the potential risks.5
The safety of phentermine when used with other anorexic agents such as amphetamine, benzamphetamine, dexphenfluramine, dextroamphetamine, diethylpropion, ephedrine, fenfluramine and sibutramine 8 is controversial and concomitant use should be avoided. The role of phentermine in production
