Phentermine

What is Phentermine?
Oral Phentermine Hydrochloride (HCL) is sold for weight loss. It is in the Sympathomimetic family of appetite suppressants (used for the short-term management of exogenous obesity.) When used in conjunction with diet, exercise, and behavior therapy, Phentermine may help you to lose weight while you are learning new ways to eat and to exercise.

Three forms of Phentermine are available:

TABLETS

CAPSULES

RESIN CAPSULES

How does Phentermine work?
Phentermine works by stimulating the hypothalamus gland and affecting certain neurotransmitters to decrease appetite. The hypothalamus is the region of the brain that controls the autonomic nervous system, regulating sleep cycles, body temperature, appetite, etc.

Proper Use of Phentermine
Phentermine should be taken on an empty stomach, once daily, prior to breakfast. If in tablet form, the tablet may be broken or cut in half. Do NOT break, crush, or chew tablets.

As Phentermine may disrupt normal sleep patterns, avoid taking a dose late in the day. If taking more than one dose a day, take the last dose approx. 4-6 hours prior to going to bed.

The following information is specific only to the average doses of Phentermine. The recommended dose of Phentermine may be different for different patients. If your dose is different, do NOT change it unless your doctor tells you to do so.

Adults under Age 60

Oral dosage form (Capsules) - 15 to 37.5 mg once/day before breakfast or 1-2 hours after breakfast.

Oral dosage form (Tablets) - 15 to 37.5 mg once/day before breakfast or 1-2 hours after breakfast. Instead of taking it once a day, your doctor may tell you to take 15 to 37.5 mg in divided doses one-half hour before meals.

Oral resin dosage form (Capsules) - 15 to 30 mg once/day before breakfast.

Adults Age 60 and Over

A reduced dosage may be necessary. Consult your physician.

Infants and Children

Phentermine is NOT recommended for children under age 16.

Maximum Dosage Recommendations
Take Phentermine ONLY as directed by your doctor.

Do NOT take more of it

Do NOT take it more often, and

Do NOT take it for a longer time than your doctor ordered.

If too much Phentermine is taken, it may cause unwanted effects or become habit-forming.
Please speak with your doctor if you think that Phentermine is not working properly after you have taken it for a few weeks. DO NOT increase the dose.

Missed Dose
If you miss a dose, take it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and take only the scheduled dose. Do NOT double the dose.

In Case of Overdose
It is unlikely for an overdose of Phentermine to be life-threatening.

If you or someone you know takes a much larger dose than recommended, please phone a doctor, 911, or the nearest poison control center immediately.

Storage
Keep this and all medications out of children's reach.

Store away from heat and direct light.

Do NOT store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.

Do NOT keep outdated medicine past the expiration date. Discarded medicine should be kept out of children's reach.

What to tell the Doctor PRIOR to talking Phentermine
The presence of other medical problems may affect the use of Phentermine (or other appetite suppressants). Please inform your doctor if you suffer from, or have suffered from:

Advanced Atherosclerosis

Alcohol Abuse (or history of)

Allergies - Inform your doctor if you have ever had any unusual or allergic reaction to:

• Phentermine
• Amphetamine
• Sextroamphetamine
• Ephedrine
• Epinephrine
• Isoproterenol
• Metaproterenol
• Methamphetamine
• Norepinephrine
• Phenylephrine
• Phenylpropanolamine
• Pseudoephedrine
• Terbutaline
• Food preservatives

Diabetes Mellitus (sugar diabetes) - It may be necessary to change the amount of insulin or oral antidiabetic medicine that you take.

Drug Abuse or Dependence (or history of) - Dependence on Phentermine may be more likely to develop.

Family History of Mental Illness - Mental depression or other mental illness may be more likely to occur.

Glaucoma

Hyperthyroidism (over-active thyroid) - Phentermine may worsen the condition.

Kidney Disease - The chance of serious side effects may increase due to higher blood levels of Phentermine.

Mental Illness

Moderate to Severe Hypertension (high blood pressure)

Symptomatic Cardiovascular Disease

The use of a Monoamine Oxidase (MAO) inhibitor within the last 2 weeks

Precautions
Please use Phentermine with caution as it is similar chemically to amphetamines and has the potential for psychological dependency.

Adults Age 60 and Over - There is no specific information comparing the use of appetite suppressants in the elderly with use in other age groups. Therefore, it may not be known if they work in exactly the same way they do in younger adults, or if they cause different side effects or problems in older people.

Adverse reactions may be more likely and more severe in older patients, especially when taken in combination with drugs that act on the central nervous system.

Alcohol - Alcohol may increase unwanted side effects of dizziness, therefore, it is advisable to limit alcohol use while taking Phentermine (or other appetite suppressants).

Breast Feeding - Use of Phentermine (or other appetite suppressants) while breast-feeding is NOT recommended; it may pass into breast milk, causing unwanted effects in nursing babies. Please consult your doctor for advice.

Diabetes - Phentermine may affect blood sugar levels. If you are diabetic and notice a change in the results of your urine or blood sugar test or if you have any questions or concerns, please consult your doctor.

Driving and Hazardous Work - Phentermine (or other appetite suppressants) may cause some people to feel a false sense of well-being or to become dizzy, lightheaded, drowsy, or less alert than normal. Do NOT drive or engage in hazardous work until you know how the medicine affects you.

Hyperthyroidism (over-active thyroid) - Phentermine (or other appetite suppressants) may worsen the condition.

Infants and Children - Phentermine (or other appetite suppressants) are NOT recommended for use by children under age 16. Studies on appetite suppressants have been done only in adult patients, and there is no specific information comparing use of Sympathomimetic appetite suppressants in children with use in other age groups.

Kidney Disease - The chance of serious side effects may increase due to higher blood levels of Phentermine.

Pregnancy - Phentermine has not been shown to cause birth defects in humans. Prior to taking this medication, tell your doctor if you are pregnant or attempting to become pregnant.

Surgery, Dental Treatment, or Emergency Treatment - Taking Phentermine in conjunction with medicines that are used during surgery or dental or emergency treatments may cause serious side effects. Prior to surgery or treatment, inform the doctor or dentist that you are using this medicine.

Other medicines
Certain medicines should never be used together, however, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.

When you are taking Phentermine (or other appetite suppressants), it is especially important that you inform your doctor if you are taking any of the following:

Amantadine, i.e. - Symmetrel
Amphetamines
Caffeine, i.e. - NoDoz
Chlophedianol, i.e. - Ulone
Cocaine
Medicine for asthma or other breathing problems
Medicine for colds, sinus problems, or hay fever or other allergies (including nose drops or sprays)
Methylphenidate, i.e. - Ritalin
Nabilone, i.e. - Cesamet
Other diet pills or Selective serotonin reuptake inhibitors, such as:
citalopram, i.e. - Celexa
fluvoxamine, i.e. - Luvox
sertraline, i.e. - Zoloft
fluoxetine, i.e. - Prozac
paroxetine, i.e. - Paxil
Pemoline, i.e.- Cyler - These medicines in conjunction with Sympathomimetic appetite suppressants may increase the central nervous system (CNS) stimulant effects, such as irritability, nervousness, trembling or shaking, or trouble in sleeping.

Monoamine Oxidase (MAO) inhibitors - Phentermine (or any other appetite suppressant) taken in conjunction with or less than 14 days after taking a monoamine oxidase (MAO) inhibitor may suddenly provoke extremely high blood pressure.

Monoamine Oxidase (MAO) inhibitors include:

furazolidone, i.e.- Furoxone
phenelzine, i.e. - Nardil
selegiline, i.e. - Eldepryl
isocarboxazid, i.e.- Marplan
procarbazine, i.e.- Matulane
tranylcypromine, i.e. - Parnate
Tricyclic antidepressants - Using these medicines with Sympathomimetic appetite suppressants may cause high blood pressure or irregular heartbeat.

Tricyclic antidepressants include:

amitriptyline, i.e. - Elavil
clomipramine, i.e. - Anafranil
amoxapine, i.e. - Asendin
doxepin, i.e. - Sinequan
nortriptyline, i.e.- Aventyl
trimipramine, i.e. - Surmontil
amoxapine, i.e. - Asendin
desipramine, i.e.- Pertofrane
imipramine, i.e. - Tofranil
protriptyline, i.e. - Vivactil

Side Effects
Along with its needed effects, Phentermine may cause unwanted side effects, some being symptoms of serious heart or lung problems.

Please consult your doctor immediately if you notice:

Chest pain
Decreased ability to exercise
Fainting
Swelling of feet or lower legs
Trouble in breathing
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine.

Inform your doctor if any of the following side effects persist or are bothersome:

More Common Symptoms

Depression
Drowsiness
Increased blood pressure
Irritability
Nervousness
Sense of well-being
Tiredness
Less Common to Rare Symptoms

Blurred vision
Change in sexual desire
Clumsiness
Confusion
Diarrhea
Dizziness
Dry mouth
Headache
Irregular heartbeat
Nausea or vomiting
Psychosis
Skin rash or itching
Stomach pain
Tiredness
Unpleasant taste
Other side effects not listed above may occur in some patients. If you notice any other side effects, please inform your doctor.

Possible Overdose Symptoms:

Confusion Convulsions (seizures)
Dizziness Fast Breathing
Fever Hallucinations
Hostility with urge to attack Irregular blood pressure
Irregular heartbeat Lightheadedness or Fainting
Mental Depression, following a period of excitement Tremors, Trembling, or Shaking
Overactive Reflexes Panic
Restlessness Severe nausea, vomiting or diarrhea
Stomach cramps Tiredness or Weakness

Physical or Mental Dependence on Phentermine
If you have been taking Phentermine for a long time or in large doses and you think you may have become mentally or physically dependent on it, please speak to your doctor.

Some signs of dependence on Phentermine (or other appetite suppressants) are:

a strong desire or need to continue taking the medicine.
a need to increase the dose to receive the effects of the medicine.
Withdrawal side effects may include:

Changes in personality
Excessive, excited activity
Irritability (severe)
Extreme tiredness or weakness
Mental depression or illness (severe)
Nausea or vomiting
Skin disease
Stomach Cramps or Pain
Trembling
Trouble in Sleeping or Nightmares (severe)