Losing weight with phentermine

Phentermine and Topiramate

Before taking phentermine and topiramate,

  • tell your doctor and pharmacist if you are allergic to phentermine (Adipex-P, Suprenza); topiramate (Topamax); sympathomimetic amine medications such as midodrine (Orvaten, ProAmatine) or phenylephrine (in cough and cold medications); any other medications, or any of the ingredients in phentermine and topiramate capsules. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor if you are taking a monoamine oxidase inhibitor (MAOI) including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have taken one of these medications during the past two weeks. Your doctor will probably tell you not to take phentermine and topiramate if you are taking one or more of these medications or have taken one of these medications during the past 2 weeks.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention other prescription or nonprescription medications or herbal products for weight loss and any of the following: amitriptyline (Elavil); carbonic anhydrase inhibitors such as acetazolamide (Diamox), methazolamide, or zonisamide (Zonegran); diuretics (‘water pills’) including furosemide (Lasix) or hydrochlorothiazide (HCTZ); insulin or other medications for diabetes; ipratropium (Atrovent); lithium (Lithobid); medications for anxiety, high blood pressure, irritable bowel disease, mental illness, motion sickness, Parkinson’s disease, ulcers, or urinary problems; medications for seizures such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), or valproic acid (Stavzor, Depakene); pioglitazone (Actos, in Actoplus, in Duetact); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have glaucoma (condition in which increased pressure in the eye can cause vision loss) or an overactive thyroid gland. Your doctor will probably tell you not to take phentermine and topiramate.
  • tell your doctor if you have had a heart attack or a stroke in the past 6 months, if you have ever thought about killing yourself or tried to do so, and if you are following a ketogenic diet (high fat, low carbohydrate diet used to control seizures). Also tell your doctor if you have or have ever had depression; an irregular heartbeat; heart failure; seizures; metabolic acidosis (too much acid in the blood); osteopenia, osteomalacia, or osteoporosis (conditions in which the bones are brittle or weak and may break easily); ongoing diarrhea; any condition that affects your breathing; diabetes; kidney stones; or kidney or liver disease.
  • tell your doctor if you are pregnant or plan to become pregnant. If you take phentermine and topiramate during pregnancy, your baby may develop a birth defect called cleft lip or cleft palate. Your baby may develop this birth defect very early in the pregnancy, before you know that you are pregnant. You must use birth control to prevent pregnancy during your treatment. You must take a pregnancy test before you begin your treatment and once every month during your treatment. If you become pregnant while taking phentermine and topiramate, stop taking the medication and call your doctor immediately.

  • you can use oral contraceptives (birth control pills) to prevent pregnancy during your treatment with phentermine and topiramate. You may experience unusual spotting (unexpected vaginal bleeding) if you use this type of birth control. You will still be protected from pregnancy if you are spotting, but you can talk to your doctor about other forms of birth control if the spotting is bothersome.
  • tell your doctor if you are breast-feeding.

  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking phentermine and topiramate.
  • you should know that phentermine and topiramate may slow your thinking and movements and affect your vision. Do not drive a car or operate machinery until you know how this medication affects you.
  • do not drink alcoholic beverages while you are taking phentermine and topiramate. Alcohol can make the side effects of phentermine and topiramate worse.
  • you should know that phentermine and topiramate can prevent you from sweating and make it harder for your body to cool down when it gets very hot. Avoid exposure to heat, drink plenty of fluids and tell your doctor if you have a fever, headache, muscle cramps, or an upset stomach, or if you are not sweating as usual.
  • you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking phentermine and topiramate. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took antiepileptics such as topiramate to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behavior as early as 1 week after they started taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

Even doctors who prescribe the drug to only patients who really need it may not monitor these patients as closely as they should. Stacey’s doctor let her stay on phen for five months, which is a month longer than the twelve weeks stipulated by the FDA. Brittany’s doctor gave her a ‘script without requiring her to come back for so much as a single check-up. “My doctor didn’t give me any tests and I wasn’t monitored at all,” she says. Her heart often felt fluttery while she was on it, like paper blowing in the breeze: “That did freak me out, but nothing else worked.”

Over-prescribing is a common problem in modern medicine—and is not limited to diet pills (see: the opioid epidemic.) “It’s easier to prescribe a pill than talk about changing habits, so that’s what a lot of doctors do,” says Ari Levy, MD, founder and CEO of Shift, an integrative health and wellness practice in Chicago. (Levy himself does not prescribe weight-loss medications, focusing instead on nutrition and exercise.)

And anyway, for some women, phen really is a lifesaver: LaNise was over 200 pounds with high cholesterol and sleep apnea when her doctor put her on it for a short period of weeks to jump-start her weight loss. She was monitored closely the whole time, and now maintains her weight with nutrition and exercise. “I’m no longer at risk for diabetes,” she says.

But women who misuse the drug can be upping its potential danger. “People on phentermine should take the lowest dose possible, but many women will increase the dose to produce more weight loss,” says Dr. Ryan. “This is bad. Increasing the dosage does not produce more weight loss, but it produces more side effects.”

Phentermine can also be hard for some women to quit. The pounds pile right back on once you wean off, says Dr. Jampolis, unless you use the pill in combination with exercise and a healthy eating plan. And for those drawn in by the promise of effortlessly slipping into a size zero, the buzzy thrill of being on an upper can sometimes feel even harder to give up. “Part of phentermine’s popularity is that it’s a stimulant, and some people like that feeling,” Dr. Ryan says. It’s part of a class of drugs that has been shown to have potential for addiction.

Some women whose doctors cut them off turn to the black market to get their fix, ordering pills off the internet. A 2017 Atlanta Journal Constitution investigation alleged that a high-profile local weight-loss doctor had prescribed phentermine based on online requests from people she had never met in person—and charged them three times the normal cost. “You can easily order this stuff online,” says Julie Friedman, PhD, national senior director of the binge eating treatment and recovery at the Chicago-based Eating Recovery Center. “I talk to women who do it all the time.”

One Miami pharmacist received a nine-year prison sentence after he wrote prescriptions for phentermine to anyone who answered an online questionnaire—and one of his “patients,” states away in Texas, died of an overdose.

To help curb over-prescribing, physicians in Ohio are now forbidden from giving out any weight loss drug in a manner contrary to the FDA label. Those who do risk losing their medical license and being charged with a felony. Tennessee does not allow doctors to prescribe phentermine (and other amphetamine-like substances) without prior approval from the State Board of Medical Examiners.

“The problem is our culture—women still want to lose weight,” says Scritchfield. Despite all the focus on wellness and body positivity, and the trendy self-care posts on social media, “there is still a lot of body hatred happening,” she says, “and popping a pill provides quick relief.” Adds Dr. Levy, “Society still places a disproportionate emphasis on unattainable images.”

And anyway, the tyranny of wellness culture has become its own impossible ideal. You can spend hundreds of dollars a month on Moon Juice smoothies and chakra-based dieting plans—or $20 on a bottle of pills that will definitely work. Which would you choose?

Stacey, while now mostly phen-free, admits to keeping a small stash of meds on hand to help stop her from indulging in cake and pizza at birthday parties.

As for Brittany, she and her husband moved, and she found herself states away from her phentermine-friendly doctor. Within months, she had gained all the weight back. When she went to a new physician and asked for a prescription, he refused and told her there were “better, old-fashioned ways” to lose a few pounds. That was a few years ago. She’s still trying.

*Name has been changed.

Related Story Leslie Goldman Leslie Goldman, MPH, is a freelance writer specializing in health, women’s issues, and parenting.

Diet pills review

Are Diet Pills or Supplements for Weight Loss Right For Me?

In addition to therapeutic lifestyle changes and medical nutrition plans, weight loss medications may be needed to get the results you are looking for. They come in several categories. Two prominent categories include appetite suppressants, also called anorectics, and those that cause malabsorption.

A drug called Orlistat, now under the brand name Alli®, which is available over-the-counter, is a drug that inhibits pancreatic lipase, an enzyme that breaks down fat and decreases fat absorption. There are other medications that have been approved for short term use at three month intervals.

Phentermine, which is generic for Adipex® and diethylproprion, which is generic for Tenuate®, are popular drugs used for their appetite suppressing qualities. Both phentermine and diethylproprion are controlled substances and may have side-effects.

New FDA approved diet pill – weight loss medication Qsymia

We are also happy to announce that we prescribe Qsymia™, a newly FDA approved medication for weight loss. W8MD can offer the brand name Qsymia or the generic combination with Phentermine an Topamax at a dollar a pill when medically appropriate as determined by the weight loss doctor after the consultation.

Qsymia must not be used in patients with glaucoma or hyperthyroidism. Qsymia can increase heart rate; this drug’s effect on heart rate in patients at high risk for heart attack or stroke is not known. Therefore, the use of Qsymia in patients with recent (within the last six months) or unstable heart disease or stroke is not recommended. Regular monitoring of heart rate is recommended for all patients taking Qsymia, especially when starting Qsymia or increasing the dose.

The FDA approved Qsymia with a Risk Evaluation and Mitigation Strategy (REMS), which consists of a Medication Guide advising patients about important safety information and elements to assure safe use that include prescriber training and pharmacy certification. The purpose of the REMS is to educate prescribers and their patients about the increased risk of birth defects associated with first trimester exposure to Qsymia, the need for pregnancy prevention, and the need to discontinue therapy if pregnancy occurs. Qsymia will only be dispensed through specially certified pharmacies.

Vivus Inc. will be required to conduct 10 postmarketing requirements, including a long-term cardiovascular outcomes trial to assess the effect of Qsymia on the risk for major adverse cardiac events such as heart attack and stroke.

The most common side effects of Qsymia are tingling of hands and feet (paresthesia), dizziness, altered taste sensation, insomnia, constipation, and dry mouth. Qsymia is marketed by Vivus Inc. in Mountain View, Calif. Learn more on Qsymia.

Orlistat Orlistat (Xenical) reduces intestinal fat absorption by inhibiting pancreatic lipase. Some side-effects of using Orlistat include frequent, oily bowel movements (steatorrhea). But if fat in the diet is reduced, symptoms often improve. Originally available only by prescription, it was approved by the FDA for over-the-counter sale in February 2007. On 26 May 2010, the U.S. Food and Drug Administration (FDA) has approved a revised label for Xenical to include new safety information about cases of severe liver injury that have been reported rarely with the use of this medication. Of the 40 million users of Orlistat worldwide, 13 cases of severe liver damage have been reported.

Diet pill – Belviq

Lorcaserin (Belviq for weight loss) was approved June 28, 2012 for obesity with other co-morbidities. The average weight loss by study participants was modest, but the most common side effects of the drug are considered benign.

An excerpt from the Bloom 1 Study conducted by Arena Pharmaceuticals and later submitted for FDA approval:

At the end of Year 1 of the BLOOM trial, using Intent-to-Treat with Last Observation Carried Forward analysis (ITT-LOCF), the proportion of patients achieving at least 5% body weight loss in the lorcaserin group (47.5%) was more than twice that achieved by the placebo group (20.3%).

Nearly three times as many patients achieved at least 10% weight loss in the lorcaserin group (22.6%) than in the placebo group (7.7%). Learn more on Belviq

New weight loss drugs approved in 2015

  • Contrave
  • Saxenda

Rimonabant weigth loss medication (Acomplia) is a recently developed anti-obesity medication. It is cannabinoid (CB1) receptor antagonist that acts centrally on the brain thus decreasing appetite. It may also act peripherally by increasing thermogenesis and therefore increasing energy expenditure.

Weight loss with Rimonabant however has not been shown to be greater than other available weight-loss medication. Due to safety concerns, primarily psychiatric in nature, the drug has not received approval in the United States or Canada, either as an anti-obesity treatment or as a smoking-cessation drug.

Exenatide Exenatide (Byetta) is a long-acting analogue of the hormone GLP-1, which the intestines secrete in response to the presence of food. Among other effects, GLP-1 delays gastric emptying and promotes a feeling of satiety. Some obese people are deficient in GLP-1, and dieting reduces GLP-1 further.

Pramlintide (Symlin) is a synthetic analogue of the hormone Amylin, which in normal people is secreted by the pancreas in response to eating. Among other effects, Amylin delays gastric emptying and promotes a feeling of satiety. A drawback is that Symlin must be injected at mealtimes.

Other drugs Other weight loss drugs

Alternative medicine Most supplements and alternative medicine has insufficient evidence to support or oppose its use.

Conjugated linoleic acid for weight loss: It is claimed to reduce body fat. It is possibly effective. The side effects include ppset stomach, nausea, loose stools
Green tea extract for weight loss: The claim is that it helps decrease appetite, and increases metabolism, fat cell death. There is insufficient evidence to evaluate this in studies. Side effects of this medication include Dizziness, insomnia, agitation, nausea, vomiting, bloating, gas, diarrhea

Khat weight loss supplement: The claim is that it reduces appetite. It’s long term use (high dosage) may cause liver damage, heart problems
Lipoic acid for weight loss: The claim is that it increases glucose absorption in muscles rather than fat.

ECA Stack for weight loss: The claim is that it increases metabolism. Side effects include severe skin reactions, irritability, nervousness, dizziness, trembling, headache, insomnia, profuse perspiration, dehydration, itchy scalp and skin, vomiting, hyperthermia, irregular heartbeat, seizures, heart attack, stroke, or death.

Raspberry ketone for weight loss: The claim is that it increases norepinephrine-induced lipolysis. There are no large studies to show clinical evidence in humans.

Risks and Benefits
While there are risks and benefits to almost anything in life, one benefit you will find at Dr. Tumpati’s W8MD Medical Weight Loss Center is knowledgeable staff that will take the time to review these medications with you. Ultimately it is up to you and your health provider to safely add medication to any weight loss program.

Weight loss medications are only useful for those already on a healthy lifestyle program who are not losing weight as expected. They are especially beneficial for people with BMI of 27 or greater, who are concerned about their weight, disease risk and current health status.
No matter which program you choose, we are excited to be on your team. Numerous programs place emphasis on vitamin pills or herbs. They may promote certain medications, injections or surgery. Our programs are so flexible they work with any program you may be on. For example, you may want to add medication to the benefits of Weight Watchers® or Jenny Craig®. Any program you use that is effective for you can be continued.

At W8MD medical weight loss centers, we put the person first above all else. When you are first, you can’t lose. We will give the choices with no obligations, setup fees or mandatory products, with insurances accepted for weight loss visits.

This is so affordable compared to $325.00 consultations from some of the “Cash Only” weight loss clinics!

W8MD Weight Loss, Sleep & MedSpa

Frequently asked questions related diet pills

  • What are the best prescription diet pills?

In a large study with 30,000 patients, that compared the various prescription diet pills, this is what they found:

In this large study published in JAMA, in a sample of 30,000 patients, this is what they found – the goal is a weight loss of at least 5%:

  • 75 percent of participants taking phentermine-topiramate
  • 63 percent of participants taking liraglutide
  • 55 percent taking naltrexone-bupropion
  • 49 percent taking lorcaserin
  • 44 percent taking orlistat and
  • 23 percent of placebo participants had at least 5 percent weight loss
  • Do diet pills really work?

Yes. The FDA requirements for approval of any prescription diet pill must demonstrate safety and efficacy with a minimum weight loss of at least 5% of the baseline body weight and must be placebo controlled.

  • Are weight loss pills dangerous?

Although like all medications, they do have certain side effects, most weight loss medications are relatively benign and can offer significant health benefits through weight loss. It is important to keep in mind that losing even 5 pounds of weight, if maintained, can lead to overall improvement in morbidity and mortality of about 40% in men and 48% in women.

  • What is the best over the counter diet pill for belly fat?

Alli or orlistat might be the only OTC diet pill that has proven results although the side effects such as loose stools can be troublesome.

  • Are there any safe diet pills?

The new diet pills such as Saxenda, Contrave, Belviq, Qsymia, or traditional diet pills such as Phentermine, Diethylpropion and Phendimetrazine are safe when used in the right patient under careful medical supervision.

  • Are there any pills that burn belly fat?

While there is no way to target some areas versus the other, understanding the cause of the belly fat such as insulin resistance and reversing it via changes in the diet can help.

  • What can I take to burn belly fat?

Losing weight will help reduce belly fat.

  • Can doctors prescribe anything for weight loss?

Yes. Doctors can prescribe Saxenda, Contrave, Belviq, Qsymia, or traditional diet pills such as Phentermine, Diethylpropion and Phendimetrazine.

Other commonly asked questions at the weight loss doctor consultation:

  • What drug suppresses the appetite?
  • What is the most effective prescription weight loss pill?
  • What is the best appetite suppressant for weight loss?
  • What is the safest appetite suppressant?
  • What can I eat that has no calories?
  • What is the safest appetite suppressant over the counter?
  • What is the best over the counter diet pill for belly fat?
  • How can I reduce my appetite permanently?
  • What is the strongest natural appetite suppressant?
  • How can I shrink my stomach and reduce my appetite?
  • How can I stop feeling hungry all the time?
  • Can you shrink your stomach?
  • Why do I still feel hungry after eating a lot?
  • How do I stop my stomach from growling without eating?

Other commonly searched terms

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Weight Loss Prescription Diet Pills

    • Contrave (Bupropion and Naltrexone) – new weight loss medication
    • New weight loss drug FDA approved in December of 2014, Saxenda
    • Phentermine and Topiramate (Qsymia)- (Phentermine and Topiramate is one of the most popular and most effective weight loss medications) for fast weight loss!
    • Lorcaserin (Belviq) – FDA approved in June of 2012.
    • Phentermine (Adipex)
    • Topiramate (Topamax)
    • Phendimetrazine (Bontril)
    • Diethylpropion (Tenuate)
    • Xenical and others

Review of the best weight loss medications!

Success Stories

Insurance weight loss programs

Weight loss testimonials
“I lost 75 lbs with W8MD and feel great”. – J.W.Smith, CPA

Pennsylvania – Philadelphia
1718, Welsh Rd, Philadelphia, PA, 19115
215-676-2334
Pennsylvania – King of Prussia
987 Old Eagle School Rd, Ste 712, Wayne, PA, 19087
215-676-2334
New York City
Brooklyn, NY
2632 E 21st Street, Ste L2, Brooklyn, NY, 11235
718-946-5500
Manhattan, NY
401 E 55th Street New York New York 10022
718-946-5500

Adipex-P

WARNINGS

Included as part of the “PRECAUTIONS” Section

PRECAUTIONS

Coadministration With Other Drug Products For Weight Loss

ADIPEX-P® is indicated only as short-term (a few weeks ) monotherapy for the management of exogenous obesity. The safety and efficacy of combination therapy with ADIPEX-P® and any other drug products for weight loss including prescribed drugs, over-the-counter preparations, and herbal products, or serotonergic agents such as selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, fluvoxamine, paroxetine), have not been established. Therefore, coadministration of ADIPEX-P® and these drug products is not recommended.

Primary Pulmonary Hypertension

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 possibility of an association between PPH and the use of ADIPEX-P® alone cannot be ruled out; there have been rare cases of PPH in patients who reportedly have taken phentermine alone. The initial symptom of PPH is usually dyspnea. Other initial symptoms may include angina pectoris, syncope or lower extremity edema. Patients should be advised to report immediately 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, and patients should be evaluated for the possible presence of pulmonary hypertension.

Valvular Heart Disease

Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic and/or tricus pid valves, has been reported in otherwise healthy persons who had taken a combination of phentermine with fenfluramine or dexfenfluramine for weight loss. 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. The possibility of an association between valvular heart disease and the use of ADIPEX-P® alone cannot be ruled out; there have been rare cases of valvular heart disease in patients who reportedly have taken phentermine alone.

Development Of Tolerance, Discontinuation In Case Of Tolerance

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.

Effect On The Ability To Engage In Potentially Hazardous Tasks

ADIPEX-P® may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle; the patient should therefore be cautioned accordingly.

Risk Of Abuse And Dependence

ADIPEX-P® is related chemically and pharmacologically to amphetamine (d- and dll-amphetamine) and to other related stimulant drugs that have been extensively abused. The possibility of abuse of ADIPEX-P® should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. See Drug Abuse And Dependence and OVERDOSE.

The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage.

Usage With Alcohol

Concomitant use of alcohol with ADIPEX-P® may result in an adverse drug reaction.

Use In Patients With Hypertension

Use caution in prescribing ADIPEX-P® for patients with even mild hypertension (risk of increase in blood pressure).

Use In Patients On Insulin Or Oral Hypoglycemic Medications For Diabetes Mellitus

A reduction in insulin or oral hypoglycemic medications in patients with diabetes mellitus may be required.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment Of Fertility

Studies have not been performed with phentermine to determine the potential for carcinogenesis, mutagenesis or impairment of fertility.

Use In Specific Populations

Pregnancy

Pregnancy Category X

ADIPEX-P® is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. 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 has pharmacologic activity similar to amphetamine (d- and dll-amphetamine) . Animal reproduction studies have not been conducted with phentermine. 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.

Nursing Mothers

It is not known if ADIPEX-P® is excreted in human milk; however, other amphetamines are present in human milk. 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.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established. Because pediatric obesity is a chronic condition requiring long-term treatment, the use of this product, approved for short-term therapy, is not recommended.

Geriatric Use

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

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. 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.

Renal Impairment

Based on the reported excretion of phentermine in urine, exposure increases can be expected in patients with renal impairment .

Use caution when administering ADIPEX-P® to patients with renal impairment. In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73 m2 ), limit the dosage of ADIPEX-P® to 15 mg daily . ADIPEX-P® has not been studied in patients with eGFR less than 15 mL/min/1.73 m2, including end-stage renal disease requiring dialysis; avoid use in these populations.

Identification

Are you a new drug developer? Contact us to learn more about our customized products and solutions. Stay in the know! As part of our commitment to providing the most up-to-date drug information, we will be releasing #DrugBankUpdates with our newly added curated drug pages. #DrugBankUpdates Name Phentermine Accession Number DB00191 (APRD00093) Type Small Molecule Groups Approved, Illicit Description

Phentermine is a sympathomimetic amine anorectic agent and it was introduced in 1959 as part of an anti-obesity combination drug.1,2 It is chemically related to amphetamine and it is commonly referred to as an atypical amphetamine.4 Phentermine has not been reported an addictive potential which allows this agent to be classified under the Schedule IV drugs (low abuse potential).3

Phentermine was FDA approved for short-term weight management in 1959 and it became widely used in 1960. This initial product, formed by the combination of phentermine with fenfluramine and dexfenfluramine was discontinued after finding several reports of abnormal valves in nearly 30% of the consumers.6,8 Later on, phentermine was approved alone and in combination with topiramate in 2012 as a new alternative that required lower doses of phentermine to obtain the desired effect.5

Structure 3D Download Similar Structures

Structure for Phentermine (DB00191)

× Close Synonyms

  • alpha,alpha-Dimethylphenethylamine
  • Fentermina
  • Phentermine
  • Phentermine resin
  • Phenterminum

Product Ingredients

Ingredient UNII CAS InChI Key
Phentermine hydrochloride 0K2I505OTV 1197-21-3 NCAIGTHBQTXTLR-UHFFFAOYSA-N

Product Images

    Prescription Products

    Name Dosage Strength Route Labeller Marketing Start Marketing End
    Unlock Additional Data
    Ionamin Capsule 15 mg/1 Oral UCB Manufacturing Inc 1959-05-04 2006-04-01 US
    Ionamin Capsule 30 mg/1 Oral UCB Manufacturing Inc 1959-05-04 2007-01-01 US
    Phentermine Hydrochloride Tablet 37.5 mg/1 Oral Vintage Pharmaceuticals, LLC 2007-01-26 2007-01-26 US
    Suprenza Tablet, orally disintegrating 15 mg/1 Oral Akrimax Pharmaceuticals, LLC 2012-12-14 2018-09-30 US
    Suprenza Tablet, orally disintegrating 30 mg/1 Oral Akrimax Pharmaceuticals, LLC 2012-12-14 2018-09-30 US
    Suprenza Tablet, orally disintegrating 37.5 mg/1 Oral Akrimax Pharmaceuticals, LLC 2012-12-14 2018-09-30 US

    Additional Data Available

  • Application Number Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

    Learn more

  • Product Code Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Generic Prescription Products

Name Dosage Strength Route Labeller Marketing Start Marketing End
Unlock Additional Data
Adipex-P Tablet 37.5 mg/1 Oral Physicians Total Care, Inc. 2009-08-14 2013-06-30 US
Adipex-P Tablet 37.5 mg/1 Oral A S Medication Solutions 1990-09-30 Not applicable US
Adipex-P Tablet 37.5 mg/1 Oral PD-Rx Pharmaceuticals, Inc. 1990-09-30 Not applicable US
Adipex-P Capsule 37.5 mg/1 Oral Teva Select Brands 1990-09-30 Not applicable US
Adipex-P Tablet 37.5 mg/1 Oral A-S Medication Solutions 1990-09-30 2015-04-30 US
Adipex-P Tablet 37.5 mg/1 Oral Teva Select Brands 1990-09-30 Not applicable US
Lomaira Tablet 8 mg/1 Oral bryant ranch prepack 2016-09-12 Not applicable US
Lomaira Tablet 8 mg/1 Oral KVK-Tech, Inc. 2016-09-12 Not applicable US
Phentermine Capsule 30 mg/1 Oral A-S Medication Solutions 2017-03-20 2018-07-19 US
Phentermine Capsule 15 mg/1 Oral A-S Medication Solutions 2017-03-20 Not applicable US

Additional Data Available

  • Application Number Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

    Learn more

  • Product Code Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Mixture Products International/Other Brands Dapex (Fernidale Labs) / Duromine (iNova Pharmaceuticals) / Fastin (Hi-Tech Pharmaceuticals) / Obenix (Jones Pharma) / Obestin-30 (Fernidale Labs) / Oby-trim (Rexar) / Phentercot (Truven Health Analytics Inc) / Phentride (Truven Health Analytics Inc) / Umi-Pex (Fernidale Labs) Categories UNII C045TQL4WP CAS number 122-09-8 Weight Average: 149.2328
Monoisotopic: 149.120449485 Chemical Formula C10H15N InChI Key DHHVAGZRUROJKS-UHFFFAOYSA-N InChI InChI=1S/C10H15N/c1-10(2,11)8-9-6-4-3-5-7-9/h3-7H,8,11H2,1-2H3 IUPAC Name 2-methyl-1-phenylpropan-2-amine SMILES CC(C)(N)CC1=CC=CC=C1

Pharmacology

Indication

Phentermine is indicated, alone or in combination with topiramate, as a short-term adjunct, not pass a few weeks, in a regimen of weight reduction based on exercise, behavioral modifications and caloric restriction in the management of exogenous obesity for patients with an initial body mass index (BMI) greater than 30 kg/m2 or greater than 27 kg/m2 in presence of other risk factors such as controller hypertension, diabetes or hyperlipidemia.Label

Exogenous obesity is considered when the overweight is caused by consuming more food than the person activity level warrants. This condition commonly causes an increase in fat storage. It is an epidemic condition in the United States where over two-thirds of adults are overweight or obese and one in three Americans is obese. In the world, the incidence of obesity has nearly doubled.7

Associated Conditions

  • BMI >30 kg/m2

Pharmacodynamics

It is reported that the main mechanism of action of phentermine is the generation of appetite suppression, maybe due to the increase in leptin, but it is considered that other mechanisms should be involved.4 Some reports have indicated that the weight loss effect is mainly due to the increase in resting energy expenditure.3

In clinical studies where phentermine was used as a monotherapy and as combination therapy, this drug has shown an average weight loss of 3.6 kg when compared with the placebo in 2-24 weeks. Patients treated with phentermine also showed increased maintenance of the weight after treatment discontinuation.3 As well, even though it is a derivative of the amphetamines, it has not been registered to produce any of the effects of amphetamine such as central nervous system stimulation, elevation of blood pressure, tachyphylaxis or QTc prolongation.4

Mechanism of action

Phentermine is an indirect-acting sympathomimetic agent that acts by releasing noradrenaline from the presynaptic vesicles in the lateral hypothalamus. This increase in noradrenaline concentration in the synaptic cleft results in the stimulation of beta2-adrenergic receptors.3 Phentermine is classified as an indirect sympathomimetic due to the increase in the level of norepinephrine, dopamine and its indirect effect towards serotonin.10 Some reports have indicated that phentermine inhibits the neuropeptide Y which is a principal signaling pathway for the induction of hunger.8 This combined effect produces a continuous flight-or-fight response in the body which reduces the hunger signal as this state is on the immediate need for energy.8

Lastly, some reports have indicated that phentermine is a weak inhibitor of monoamine oxidase but this mechanism does not tend to produce a clinically significant response.9

Target Actions Organism
ASodium-dependent noradrenaline transporter inhibitor Humans
ASodium-dependent serotonin transporter inhibitor Humans
ASodium-dependent dopamine transporter inhibitor Humans
AAmine oxidase A antagonist Humans
AAmine oxidase B antagonist Humans
APro-neuropeptide Y inhibitor Humans

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Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.

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Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.

Learn more Absorption

Phentermine shows a dose-dependent pharmacokinetic profile. After oral administration of a dose of 15 mg, the maximal concentration was achieved after 6 hours and its bioavailability was not affected by the consumption of high-fat meals.4 The reported plasma concentration at steady-state is of around 200 ng/ml as observed in clinical trials.9

Volume of distribution

The reported volume of distribution for phentermine is reported to be of 5 L/kg.11

Protein binding

The protein binding of phentermine is determined to be of 17.5%.4

Metabolism

Phentermine undergoes minimal p-hydroxylation, N-oxidation and N-hydroxylation followed by conjugation. The total proportion of the drug that goes under metabolism only represents about 6% of the administered dose where about 5% is represented by the N-oxidized and N-Hydroxylated metabolites.9

  • Phentermine p-hydroxyphentermine
  • Phentermine N-hydroxyphentermine
    • N-hydroxyphentermine Nitrophentermine

Route of elimination

Phentermine is excreted mainly in the urine from which about 70-80% of the administered dose can be found as the unchanged drug.4

Half life

The mean terminal half-life of phentermine is reported to be of approximately 20 hours.4 In conditions where there is acidic urine (pH 9

Clearance

The reported clearance when administered orally is 8.79 L/h as observed in pharmacokinetic population studies.13

Toxicity

The reported LD50 after oral administration of phentermine in rats is reported to be of 151 mg/kg.12 Reports of acute overdose include restlessness, tremors, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations and panic state followed by fatigue, and depression. In the cardiovascular system, there are reports of tachycardia, arrhythmia, hypertension, hypotension, circulatory collapse. In the GI tract, there are symptoms of nausea, vomiting, diarrhea and abdominal cramps. The management of acute overdosage includes symptomatic treatment as well as lavage and sedation with barbiturates.Label

On the other hand, chronic overdosage is marked by dermatoses, insomnia, irritability, hyperactivity and personality changes. In severe cases, it can derive into a schizophrenia-like psychosis.Label

Studies regarding the carcinogenic potential have not been performed. On the case of mutagenic assays, phentermine was shown to not be mutagenic nor clastogenic.Label

Affected organisms

  • Humans and other mammals

Pathways Not Available Pharmacogenomic Effects/ADRs Not Available

Interactions

Drug Interactions This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

  • All Drugs
  • Approved
  • Vet approved
  • Nutraceutical
  • Illicit
  • Withdrawn
  • Investigational
  • Experimental
Drug Interaction
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1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid The risk or severity of hypertension can be increased when Phentermine is combined with 1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid.
1-benzylimidazole The therapeutic efficacy of 1-benzylimidazole can be decreased when used in combination with Phentermine.
2,4-thiazolidinedione The therapeutic efficacy of 2,4-thiazolidinedione can be increased when used in combination with Phentermine.
2,5-Dimethoxy-4-ethylamphetamine The risk or severity of serotonin syndrome can be increased when Phentermine is combined with 2,5-Dimethoxy-4-ethylamphetamine.
2,5-Dimethoxy-4-ethylthioamphetamine The risk or severity of serotonin syndrome can be increased when Phentermine is combined with 2,5-Dimethoxy-4-ethylthioamphetamine.
3-isobutyl-1-methyl-7H-xanthine The risk or severity of adverse effects can be increased when Phentermine is combined with 3-isobutyl-1-methyl-7H-xanthine.
3,5-diiodothyropropionic acid The risk or severity of adverse effects can be increased when Phentermine is combined with 3,5-diiodothyropropionic acid.
3,5-Diiodotyrosine The risk or severity of adverse effects can be increased when Phentermine is combined with 3,5-Diiodotyrosine.
4-Bromo-2,5-dimethoxyamphetamine The risk or severity of serotonin syndrome can be increased when Phentermine is combined with 4-Bromo-2,5-dimethoxyamphetamine.
4-hydroxycoumarin The metabolism of 4-hydroxycoumarin can be decreased when combined with Phentermine.

Additional Data Available

  • Extended Description Extended Description

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  • Severity Severity

    A severity rating for each drug interaction, from minor to major.

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  • Evidence Level Evidence Level

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  • Action Action

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Food Interactions

  • Limit caffeine intake.
  • Take without regard to meals.

General References External Links Human Metabolome Database HMDB0014337 KEGG Drug D05458 KEGG Compound C07438 PubChem Compound 4771 PubChem Substance 46508515 ChemSpider 4607 BindingDB 50246598 ChEBI 8080 ChEMBL CHEMBL1574 Therapeutic Targets Database DAP000719 PharmGKB PA164748099 RxList RxList Drug Page Drugs.com Drugs.com Drug Page Wikipedia Phentermine ATC Codes A08AA01 — Phentermine

  • A08AA — Centrally acting antiobesity products
  • A08A — ANTIOBESITY PREPARATIONS, EXCL. DIET PRODUCTS
  • A08 — ANTIOBESITY PREPARATIONS, EXCL. DIET PRODUCTS
  • A — ALIMENTARY TRACT AND METABOLISM

FDA label (306 KB) MSDS (48.2 KB)

Clinical Trials

Clinical Trials

Phase Status Purpose Conditions Count
0 Completed Treatment BMI >30 kg/m2 / High Blood Pressure (Hypertension) 1
1 Completed Not Available Substance Abuse 1
1 Completed Basic Science Cocaine Use Disorders 1
1 Completed Treatment BMI >30 kg/m2 1
1 Completed Treatment Binge Eating Disorder (BED) / Bulimia Nervosa 1
1 Completed Treatment Healthy Volunteers / Substance Abuse 1
1 Completed Treatment Hepatic Impairment 1
1 Completed Treatment Impaired kidney function 1
1 Withdrawn Basic Science Healthy Volunteers / Substance Abuse 1
2 Completed Treatment BMI >27 kg/m2 / BMI >30 kg/m2 1
2 Completed Treatment BMI >30 kg/m2 1
2 Completed Treatment Bariatric Surgery Procedures / BMI >30 kg/m2 / Metabolic Surgery / Weight Loss 1
2 Completed Treatment BMI >30 kg/m2 / Heart Diseases / Vascular Diseases 1
2 Completed Treatment Binge Eating Disorder (BED) 1
2 Completed Treatment Diabetes 1
2 Not Yet Recruiting Treatment Adolescents / Drug Therapy / Obesity, Morbid / Post-gastrointestinal bypass surgery / Young Adults 1
2 Recruiting Treatment Obesity, Adolescent 1
3 Completed Treatment BMI >30 kg/m2 2
3 Recruiting Treatment BMI >30 kg/m2 1
3 Recruiting Treatment BMI >30 kg/m2 / Polycystic Ovaries Syndrome 1
4 Active Not Recruiting Treatment BMI >30 kg/m2 1
4 Completed Treatment BMI >30 kg/m2 3
4 Completed Treatment Chronic Weight Management 1
4 Completed Treatment Obesity, Childhood / Pediatric Obesity 1
4 Recruiting Treatment Adolescent Overweight / Obesity in Adolescence / Obesity, Adolescent 1
4 Recruiting Treatment BMI >30 kg/m2 1
4 Recruiting Treatment BMI >30 kg/m2 / Non-alcoholic Fatty Liver / Obesity, Morbid / Post-gastrointestinal bypass surgery / Weight Loss 1
4 Unknown Status Not Available BMI >30 kg/m2 1
Not Available Completed Basic Science BMI >27 kg/m2 / BMI >30 kg/m2 / Metabolic Diseases 1
Not Available Completed Treatment BMI >27 kg/m2 / BMI >30 kg/m2 1
Not Available Completed Treatment BMI >30 kg/m2 / Phentermine Withdrawal 1
Not Available Withdrawn Treatment BMI >30 kg/m2 1

Pharmacoeconomics

Manufacturers

  • Baxter healthcare corp anesthesia critical care
  • Teva pharmaceuticals usa inc
  • Glaxosmithkline
  • Ferndale laboratories inc
  • Shire richwood inc
  • Mm mast and co
  • Abc holding corp
  • Able laboratories inc
  • Actavis totowa llc
  • Barr laboratories inc
  • Camall co inc
  • Duramed pharmaceuticals inc sub barr laboratories inc
  • Ivax pharmaceuticals inc
  • Kvk tech inc
  • Lannett co inc
  • Lannett holdings inc
  • Mutual pharmaceutical co inc
  • Sandoz inc
  • Tg united inc
  • Tg united labs llc
  • Usl pharma inc
  • Vitarine pharmaceuticals inc
  • Watson laboratories inc
  • Actavis elizabeth llc
  • Caraco pharmaceutical laboratories ltd
  • Vintage pharmaceuticals inc
  • Solvay pharmaceuticals
  • Ucb inc
  • Quantum pharmics ltd

Packagers

  • Apotheca Inc.
  • A-S Medication Solutions LLC
  • Blenheim Pharmacal
  • Bryant Ranch Prepack
  • C.O. Truxton Inc.
  • Calvin Scott and Co. Inc.
  • Caraco Pharmaceutical Labs
  • Carlisle Laboratories Inc.
  • Corepharma LLC
  • Darby Dental Supply Co. Inc.
  • DispenseXpress Inc.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • EMS Acquisition Corp.
  • Eon Labs
  • Gate Pharmaceuticals
  • H.J. Harkins Co. Inc.
  • Keltman Pharmaceuticals Inc.
  • Kraft Pharmaceutical Co. Inc.
  • KVK-Tech Inc.
  • Lake Erie Medical and Surgical Supply
  • Lannett Co. Inc.
  • Macnary Ltd.
  • Major Pharmaceuticals
  • MCR American Pharmaceuticals Inc.
  • Medisca Inc.
  • Mutual Pharmaceutical Co.
  • Nucare Pharmaceuticals Inc.
  • Palmetto Pharmaceuticals Inc.
  • PCA LLC
  • PD-Rx Pharmaceuticals Inc.
  • Pharma Pac LLC
  • Physicians Total Care Inc.
  • Preferred Pharmaceuticals Inc.
  • Prepak Systems Inc.
  • Prescript Pharmaceuticals
  • Qualitest
  • Quality Research Pharmaceutical Inc.
  • Rebel Distributors Corp.
  • Redpharm Drug
  • Southwood Pharmaceuticals
  • Stat Rx Usa
  • Superior Pharmeceuticals
  • Teva Pharmaceutical Industries Ltd.
  • UCB Pharma
  • United Research Laboratories Inc.
  • Vintage Pharmaceuticals Inc.

Dosage forms

Form Route Strength
Capsule Oral
Capsule Oral 15 mg
Capsule Oral 30 mg
Tablet Oral 8 mg/1
Capsule Oral 15 mg/1
Capsule Oral 30 mg/1
Capsule Oral 37.5 mg/1
Tablet Oral 30 mg/1
Tablet Oral 37.5 mg/1
Capsule, extended release Oral 15 mg/1
Capsule, extended release Oral 30 mg/1
Capsule, extended release Oral
Tablet, orally disintegrating Oral 15 mg/1
Tablet, orally disintegrating Oral 30 mg/1
Tablet, orally disintegrating Oral 37.5 mg/1

Prices

Unit description Cost Unit
Phentermine hcl powder 10.71USD g
Ionamin 30 mg capsule sa 2.87USD capsule
Adipex-P 37.5 mg capsule 2.2USD capsule
Adipex-p 37.5 mg tablet 2.15USD tablet
Phentermine 37.5 mg tablet 1.54USD tablet
Phentermine HCl 15 mg capsule 1.18USD capsule
Phentermine HCl 30 mg capsule 1.17USD capsule
Ionamin 15 mg capsule sa 1.15USD capsule
Phentermine HCl 37.5 mg capsule 1.0USD capsule
Phentermine HCl 37.5 mg tablet 1.0USD tablet
Phentermine 8 mg tablet 0.54USD tablet

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only. Patents Additional Data Available

  • Filed On Filed On

    The date on which a patent was filed with the relevant government.

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Properties

State Solid Experimental Properties Predicted Properties

Property Value Source
Water Solubility 0.757 mg/mL ALOGPS
logP 2.32 ALOGPS
logP 2.08 ChemAxon
logS -2.3 ALOGPS
pKa (Strongest Basic) 10.25 ChemAxon
Physiological Charge 1 ChemAxon
Hydrogen Acceptor Count 1 ChemAxon
Hydrogen Donor Count 1 ChemAxon
Polar Surface Area 26.02 Å2 ChemAxon
Rotatable Bond Count 2 ChemAxon
Refractivity 48.34 m3·mol-1 ChemAxon
Polarizability 17.87 Å3 ChemAxon
Number of Rings 1 ChemAxon
Bioavailability 1 ChemAxon
Rule of Five Yes ChemAxon
Ghose Filter No ChemAxon
Veber’s Rule Yes ChemAxon
MDDR-like Rule No ChemAxon

Predicted ADMET features

Property Value Probability
Human Intestinal Absorption + 0.9964
Blood Brain Barrier + 0.959
Caco-2 permeable + 0.7688
P-glycoprotein substrate Non-substrate 0.6477
P-glycoprotein inhibitor I Non-inhibitor 0.934
P-glycoprotein inhibitor II Non-inhibitor 0.9801
Renal organic cation transporter Non-inhibitor 0.8236
CYP450 2C9 substrate Non-substrate 0.8411
CYP450 2D6 substrate Substrate 0.7204
CYP450 3A4 substrate Non-substrate 0.6493
CYP450 1A2 substrate Non-inhibitor 0.7962
CYP450 2C9 inhibitor Non-inhibitor 0.8861
CYP450 2D6 inhibitor Inhibitor 0.7825
CYP450 2C19 inhibitor Non-inhibitor 0.8996
CYP450 3A4 inhibitor Non-inhibitor 0.7348
CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.8782
Ames test Non AMES toxic 0.9681
Carcinogenicity Non-carcinogens 0.6949
Biodegradation Not ready biodegradable 0.9303
Rat acute toxicity 2.8400 LD50, mol/kg Not applicable
hERG inhibition (predictor I) Weak inhibitor 0.9867
hERG inhibition (predictor II) Non-inhibitor 0.8734

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST) (7.33 KB) Spectra

Spectrum Spectrum Type Splash Key
Predicted GC-MS Spectrum – GC-MS Predicted GC-MS Not Available
Mass Spectrum (Electron Ionization) MS splash10-0a4i-9100000000-7037d3f1fad22de72c33
Predicted MS/MS Spectrum – 10V, Positive (Annotated) Predicted LC-MS/MS splash10-0ue9-0900000000-f2eb273dfd0ec45869c5
Predicted MS/MS Spectrum – 20V, Positive (Annotated) Predicted LC-MS/MS splash10-0f89-2900000000-f527ee48b9e2784c178c
Predicted MS/MS Spectrum – 40V, Positive (Annotated) Predicted LC-MS/MS splash10-0159-4900000000-548f73a83354267c9f81
Predicted MS/MS Spectrum – 10V, Negative (Annotated) Predicted LC-MS/MS splash10-0002-0900000000-c7ab0aa268d14ae3da39
Predicted MS/MS Spectrum – 20V, Negative (Annotated) Predicted LC-MS/MS splash10-0002-1900000000-ce1c08c021fbc1cc5c8c
Predicted MS/MS Spectrum – 40V, Negative (Annotated) Predicted LC-MS/MS splash10-001i-2900000000-94b2b38953d359938c0a
1H NMR Spectrum 1D NMR Not Applicable
13C NMR Spectrum 1D NMR Not Applicable

Taxonomy

Description This compound belongs to the class of organic compounds known as amphetamines and derivatives. These are organic compounds containing or derived from 1-phenylpropan-2-amine. Kingdom Organic compounds Super Class Benzenoids Class Benzene and substituted derivatives Sub Class Phenethylamines Direct Parent Amphetamines and derivatives Alternative Parents Phenylpropanes / Aralkylamines / Organopnictogen compounds / Monoalkylamines / Hydrocarbon derivatives Substituents Amphetamine or derivatives / Phenylpropane / Aralkylamine / Organic nitrogen compound / Organopnictogen compound / Hydrocarbon derivative / Primary amine / Organonitrogen compound / Primary aliphatic amine / Amine Molecular Framework Aromatic homomonocyclic compounds External Descriptors primary amine (CHEBI:8080)

Targets

Kind Protein Organism Humans Pharmacological action Yes Actions Inhibitor General Function Norepinephrine:sodium symporter activity Specific Function Amine transporter. Terminates the action of noradrenaline by its high affinity sodium-dependent reuptake into presynaptic terminals. Gene Name SLC6A2 Uniprot ID P23975 Uniprot Name Sodium-dependent noradrenaline transporter Molecular Weight 69331.42 Da Kind Protein Organism Humans Pharmacological action Yes Actions Inhibitor General Function Serotonin:sodium symporter activity Specific Function Serotonin transporter whose primary function in the central nervous system involves the regulation of serotonergic signaling via transport of serotonin molecules from the synaptic cleft back into t… Gene Name SLC6A4 Uniprot ID P31645 Uniprot Name Sodium-dependent serotonin transporter Molecular Weight 70324.165 Da

  1. John CE, Jones SR: Voltammetric characterization of the effect of monoamine uptake inhibitors and releasers on dopamine and serotonin uptake in mouse caudate-putamen and substantia nigra slices. Neuropharmacology. 2007 Jun;52(8):1596-605. Epub 2007 Mar 16.
  2. Johnson GJ, Leis LA, Dunlop PC, Weir EK: The effect of the anorectic agent, d-fenfluramine, and its primary metabolite, d-norfenfluramine, on intact human platelet serotonin uptake and efflux. J Thromb Haemost. 2003 Dec;1(12):2663-8.
  3. Mekontso-Dessap A, Brouri F, Pascal O, Lechat P, Hanoun N, Lanfumey L, Seif I, Benhaiem-Sigaux N, Kirsch M, Hamon M, Adnot S, Eddahibi S: Deficiency of the 5-hydroxytryptamine transporter gene leads to cardiac fibrosis and valvulopathy in mice. Circulation. 2006 Jan 3;113(1):81-9. Epub 2005 Dec 27.
  4. Rothman RB, Ayestas MA, Dersch CM, Baumann MH: Aminorex, fenfluramine, and chlorphentermine are serotonin transporter substrates. Implications for primary pulmonary hypertension. Circulation. 1999 Aug 24;100(8):869-75.
  5. Zolkowska D, Rothman RB, Baumann MH: Amphetamine analogs increase plasma serotonin: implications for cardiac and pulmonary disease. J Pharmacol Exp Ther. 2006 Aug;318(2):604-10. Epub 2006 Apr 27.

Kind Protein Organism Humans Pharmacological action Yes Actions Inhibitor General Function Monoamine transmembrane transporter activity Specific Function Amine transporter. Terminates the action of dopamine by its high affinity sodium-dependent reuptake into presynaptic terminals. Gene Name SLC6A3 Uniprot ID Q01959 Uniprot Name Sodium-dependent dopamine transporter Molecular Weight 68494.255 Da

  1. John CE, Jones SR: Voltammetric characterization of the effect of monoamine uptake inhibitors and releasers on dopamine and serotonin uptake in mouse caudate-putamen and substantia nigra slices. Neuropharmacology. 2007 Jun;52(8):1596-605. Epub 2007 Mar 16.
  2. Gruner JA, Marcy VR, Lin YG, Bozyczko-Coyne D, Marino MJ, Gasior M: The roles of dopamine transport inhibition and dopamine release facilitation in wake enhancement and rebound hypersomnolence induced by dopaminergic agents. Sleep. 2009 Nov;32(11):1425-38.

Kind Protein Organism Humans Pharmacological action Yes Actions Antagonist General Function Serotonin binding Specific Function Catalyzes the oxidative deamination of biogenic and xenobiotic amines and has important functions in the metabolism of neuroactive and vasoactive amines in the central nervous system and peripheral… Gene Name MAOA Uniprot ID P21397 Uniprot Name Amine oxidase A Molecular Weight 59681.27 Da

  1. Rothman RB: Is phentermine an inhibitor of monoamine oxidase? A critical appraisal. Synapse. 1999 May;32(2):141-5.
  2. Ulus IH, Maher TJ, Wurtman RJ: Characterization of phentermine and related compounds as monoamine oxidase (MAO) inhibitors. Biochem Pharmacol. 2000 Jun 15;59(12):1611-21.
  3. Kilpatrick IC, Traut M, Heal DJ: Monoamine oxidase inhibition is unlikely to be relevant to the risks associated with phentermine and fenfluramine: a comparison with their abilities to evoke monoamine release. Int J Obes Relat Metab Disord. 2001 Oct;25(10):1454-8.
  4. Nandigama RK, Newton-Vinson P, Edmondson DE: Phentermine inhibition of recombinant human liver monoamine oxidases A and B. Biochem Pharmacol. 2002 Mar 1;63(5):865-9.

Kind Protein Organism Humans Pharmacological action Yes Actions Antagonist General Function Primary amine oxidase activity Specific Function Catalyzes the oxidative deamination of biogenic and xenobiotic amines and has important functions in the metabolism of neuroactive and vasoactive amines in the central nervous system and peripheral… Gene Name MAOB Uniprot ID P27338 Uniprot Name Amine oxidase B Molecular Weight 58762.475 Da

  1. Rothman RB: Does phentermine inhibit monoamine oxidase? Lancet. 1999 Apr 17;353(9161):1362-3.
  2. Rothman RB: Is phentermine an inhibitor of monoamine oxidase? A critical appraisal. Synapse. 1999 May;32(2):141-5.
  3. Ulus IH, Maher TJ, Wurtman RJ: Characterization of phentermine and related compounds as monoamine oxidase (MAO) inhibitors. Biochem Pharmacol. 2000 Jun 15;59(12):1611-21.
  4. Kilpatrick IC, Traut M, Heal DJ: Monoamine oxidase inhibition is unlikely to be relevant to the risks associated with phentermine and fenfluramine: a comparison with their abilities to evoke monoamine release. Int J Obes Relat Metab Disord. 2001 Oct;25(10):1454-8.
  5. Nandigama RK, Newton-Vinson P, Edmondson DE: Phentermine inhibition of recombinant human liver monoamine oxidases A and B. Biochem Pharmacol. 2002 Mar 1;63(5):865-9.

Kind Protein Organism Humans Pharmacological action Yes Actions Inhibitor General Function Receptor binding Specific Function NPY is implicated in the control of feeding and in secretion of gonadotrophin-release hormone. Gene Name NPY Uniprot ID P01303 Uniprot Name Pro-neuropeptide Y Molecular Weight 10851.29 Da

  1. May S. (2009). Weight-Loss Drugs. Chelsea House Publishers.

Enzymes

Kind Protein Organism Humans Pharmacological action No Actions Substrate General Function Vitamin d3 25-hydroxylase activity Specific Function Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react… Gene Name CYP3A4 Uniprot ID P08684 Uniprot Name Cytochrome P450 3A4 Molecular Weight 57342.67 Da

  1. QSYMIA (phentermine/topiramate) FDA label

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There is additional data available for commercial users including Adverse Effects, Contraindications, and Blackbox Warnings. Contact us to learn more about these and other features.

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Drug created on June 13, 2005 07:24 / Updated on February 02, 2020 04:04

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 4/2/2019

Adipex-P (phentermine) is an appetite suppressant used in combination with diet and exercise for the short-term treatment of obesity. A generic version of Adipex-P is available. Side effects of Adipex-P include:

  • nausea,
  • vomiting,
  • upset stomach,
  • diarrhea,
  • dry mouth,
  • constipation,
  • an unpleasant taste in mouth,
  • hives,
  • impotence,
  • palpitations,
  • high blood pressure,
  • hyperactivity,
  • sleep problems (insomnia),
  • restlessness,
  • headache,
  • tremors,
  • dizziness, and
  • increased or decreased interest in sex.

Tell your doctor if you have serious side effects of Adipex-P including:

  • shortness of breath, even with mild exertion;
  • chest pain, feeling like you might pass out;
  • swelling in your ankles or feet;
  • pounding heartbeats or fluttering in your chest;
  • confusion or irritability, unusual thoughts or behavior;
  • feelings of extreme happiness or sadness; or
  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, chest pain, shortness of breath, uneven heartbeats, seizure).

Adipex-P has been associated with pulmonary hypertension and defects in heart valves.

The recommended dose of Adipex-P is 30 mg once daily. Adipex-P may interact with alcohol, monoamine oxidase inhibitors (MAOIs), insulin or oral diabetes medications, blood pressure medications, or antidepressants. Tell your doctor all medications and supplements you use. Adipex-P is not recommended for use during pregnancy; weight loss during pregnancy can harm a fetus, even if you are overweight. Do not use Adipex-P if you are pregnant. Adipex-P passes into breast milk and may harm a nursing baby. Breastfeeding while taking Adipex-P is not recommended. Long-term use of Adipex-P may cause physical and psychological dependence. A withdrawal reaction consisting of excessive drowsiness, fatigue, tremors and depression may occur after prolonged use.

Our Adipex-P Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I discuss with my healthcare provider before taking phentermine?

You should not use phentermine if you are allergic to it, or if you have:

  • a history of heart disease (coronary artery disease, heart rhythm problems, congestive heart failure, stroke);
  • severe or uncontrolled high blood pressure;
  • overactive thyroid;
  • glaucoma;
  • extreme agitation or nervousness;
  • a history of drug abuse; or
  • if you take other diet pills.

Do not use phentermine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Weight loss during pregnancy can harm an unborn baby, even if you are overweight. Do not use phentermine if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

You should not breast-feed while using phentermine.

Tell your doctor if you have ever had:

  • heart disease or coronary artery disease;
  • a heart valve disorder;
  • high blood pressure;
  • diabetes (your diabetes medication dose may need to be adjusted); or
  • kidney disease.

Phentermine is not approved for use by anyone younger than 16 years old.

How should I take phentermine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Phentermine is usually taken before breakfast, or 1 to 2 hours after breakfast. Follow your doctor’s dosing instructions very carefully.

Never use phentermine in larger amounts, or for longer than prescribed. Taking more of this medication will not make it more effective and can cause serious, life-threatening side effects.

Phentermine is for short-term use only. The effects of appetite suppression may wear off after a few weeks.

Phentermine may be habit-forming. Misuse can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

Call your doctor at once if you think this medicine is not working as well, or if you have not lost at least 4 pounds within 4 weeks.

Do not stop using phentermine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

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