It is contraindicated for patients with current or past: cardiovascular disease (heart problems), hyperthyroidism, glaucoma, agitated states, drug/alcohol abuse, or reactions to sympathomimetic amines. Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Biliopancreatic diversion with duodenal switch (BPD/DS), Endoscopic Sleeve Gastroplasty (Gastric Sleeve), Biliopancreatic diversion with duodenal switch. In order to use Phentermine, the doctor needs to prescribe the drug for a specific patient. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. 1558 0 obj <>/Filter/FlateDecode/ID[<7182559B062CF74D9CEE71C953F61692>]/Index[1530 62]/Info 1529 0 R/Length 121/Prev 89015/Root 1531 0 R/Size 1592/Type/XRef/W[1 2 1]>>stream 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. If you are a Mayo Clinic patient, this could 2 If you take too much of this medicine, it may become habit-forming (causing mental or physical dependence). Long-term efficacy and safety of anti-obesity treatment: Where do we stand? These lifestyle changes often include participating in regular exercise and physical activities, as well as eating a well-balanced diet that does not contain large amounts of calories or harmful substances. Numerous side effects have been linked to the use of Phentermine. OSMA is actively following this issue and we are hopeful that the medical board will make changes to Ohios rules that will enable physicians to utilize their training and professional judgment, instead of restrictive time limits, when treating some of Ohios most vulnerable patients. Rule 4731-11-04.1 Controlled substances: utilization for chronic weight management. The structural formula is as follows: Phentermine hydrochloride is a white, odorless, hygroscopic, crystalline powder which is soluble in water and lower alcohols, slightly soluble in chloroform and insoluble in ether. The combined drug is approved for long-term use. 1591 0 obj <>stream All rights reserved. The following information includes only the average doses of this medicine. Phentermine has pharmacologic activity similar to amphetamine (d- and dll-amphetamine) [see Clinical Pharmacology (12.1)]. The possible origins of the increased weight loss due to the various drug effects are not established. In most cases, the drug is prescribed to users in periods of 12 weeks. Specializes in Cardiology, Research, Family Practice. stream Place the tablet on the top of your tongue right after removing it from the bottle. Available for Android and iOS devices. Click here for an email preview. Nationwide Efforts to Combat the Problem Questions To Discuss At the completion of this block of instruction you will be able to answer the following questions: 1. 0 document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This website is a resource which lists doctors and clinics who may offer phentermine or appetite suppressants for patients they deem qualified. Adults and children 17 years of age and older. The MAO inhibitors (Monoamine Oxidase Inhibitors) are used to treat depression, especially a specific type called atypical depression. Phentermine was later provided to patients in combination with dexfenfluramine and fenfluramine as a more powerful appetite suppressant that could also act as a fat burner. What You Should Know Before Taking Phentermine, Frequently Asked Questions About Phentermine, refer to our phentermine drug interactions data, Frequently Asked Questions about phentermine, https://www.drugs.com/ingredient/phentermine.html, http://www.rxlist.com/adipex-p-drug/patient-avoid-while-taking.htm, http://www.everydayhealth.com/drugs/phentermine, https://www.ncbi.nlm.nih.gov/pubmed/27664021, https://www.ncbi.nlm.nih.gov/pubmed/26584649, https://www.ncbi.nlm.nih.gov/pubmed/26446094, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560177/, https://www.ncbi.nlm.nih.gov/pubmed/25911503, Feeling like they are going to faint, often accompanied by chest pain, Fluttering in the patients chest, as well as pounding heartbeats. Due to its status as a controlled substance, the sale, distribution, and possession of this drug is tightly regulated by the DEA and international regulatory authorities ( National Association of Boards of Pharmacy. Each brand has its own way of manufacturing the drug and, in some cases, combines it with other chemicals to make it more effective or to add additional features to its use. The patient could have had the prescription for the month of October filled at another pharmacy. The use of Topamax and Phentermine is actually an FDA-approved combination. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. Ideally, patients should take it on an empty stomach. All rights reserved. In a single-dose study comparing the exposures after oral administration of a combination capsule of 15 mg Phentermine and 92 mg topiramate to the exposures after oral administration of a 15 mg Phentermine capsule or a 92 mg topiramate capsule, there is no significant topiramate exposure change in the presence of Phentermine. Start with your primary care doctor and schedule an appointment to discuss weight. Phentermine is not to be used while pregnant or breastfeeding under any circumstances. If your primary care physician thinks you are a good candidate for phentermine but does not want to (or cannot) prescribe it, he or she may refer you to a specialist. Or it can help you feel full longer. . To provide you with the most relevant and helpful information, and understand which Phentermine is related chemically and pharmacologically to amphetamine (d- and dll-amphetamine) and other related stimulant drugs have been extensively abused. When mental impairment is present while taking Phentermine, a patient is also advised not to drive to avoid the risk of being involved in an accident. Patients who have been on a Phentermine program should not suddenly stop using the drug. Do not keep outdated medicine or medicine no longer needed. NDC 42806-810-01 When performing prospective DUR, the pharmacist notices a 30-day gap in treatment. Phentermine doctors network. Some brands use a dissolving tablet that is placed under the tongue, which allows the body to absorb the chemicals in the drug faster. They help the body produce a larger amount of energy from fat cells, which further reduces body fat percentage. Manifestations of acute overdosage include restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, and panic states. Patients must be instructed on how much Phentermine to take, and when and how to take it [see Dosage and Administration (2)]. Tablets: 37.5 mg phentermine hydrochloride, USP (equivalent to 30 mg phentermine base). Yes, phentermine is a federally controlled substance because it may be abused or lead to Phentermine: 18.75 to 37.5 milligrams (mg) once a day, taken before breakfast or 1 to 2 hours after breakfast. The promotion of this brand as a diet pill started in 1990. It is a class IV controlled substance because of its serious side effects and addiction potential. A physician is the only person who can prescribe phentermine. ). Before you schedule your first appointment, do some research to find out how much the whole process costs and if you can use outside coupons like prescription discount cards. The recommended maximum dosage of Phentermine is 15 mg daily for patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2). Adults and children 17 years of age and older15 to 30 milligrams (mg) once a day, taken at approximately 2 hours after breakfast. Swallow the extended-release capsule whole. information and will only use or disclose that information as set forth in our notice of If your dose is different, do not change it unless your doctor tells you to do so. Instead of simply quitting the program, a patient should rather consult a healthcare provider about quitting. What to offer the 99% of patients with severe obesity who do not undergo bariatric surgery? You may opt-out of email communications at any time by clicking on (1) The prescriber shall assess the patient, at a minimum, once in the first three months of utilization of controlled substances for weight reduction, and shall record in the patient record information demonstrating the patient's continuing efforts to lose weight, the patient's dedication to the treatment program and response to treatment, and Diabetes & Metabolism Journal. Phentermine is a sympathomimetic amine with pharmacologic activity similar to the prototype drugs of this class used in obesity, amphetamine (d- and dll-amphetamine). Many patients find that if their doctor gradually lowers their dose, for example from 37.5mg per day down to 15mg per day for the last few days, they experience fewer withdrawal symptoms and are able to keep the weight off later. Accessed Oct. 11, 2022. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Medically reviewed by Drugs.com. (2012). The possibility of an association between valvular heart disease and the use of Phentermine alone cannot be ruled out; there have been rare cases of valvular heart disease in patients who reportedly have taken Phentermine alone. As mentioned above, new mothers should avoid using this medication when breastfeeding. Ohio Administrative Code 4731-11-04 and 4731-11-04.1. Click here for an email preview. Below we explain how to get phentermine, including why you need a prescription, who can take this medication, and how to get your doctor to prescribe phentermine. CIV Review/update the Phentermine 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. The health information contained here is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo subjects and tends to decrease in succeeding weeks. Children 16 years of age and youngerUse is not recommended. Learn about the most popular weight loss medications. A link to Chapter 4731-11, OAC, is also provided on page 15 of the Formulary.The nursing law and rules are available for review on the Boards website www.nursing.ohio.gov under the Law and Rules link.The website for State Medical Board of Ohio is: www.med.ohio.gov. Different brands manufacture, distribute and sell Phentermine drugs. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. The goal of the drug is to help patients lose weight and increase energy since the withdrawal symptoms of include fatigue and weight gain through an increase in appetite, the product is rendered a waste of the patients time and money. N;d0)zQ|,]8EtXy(En"GX omjU3Y3>kfkYHYi]-zhm{= o`i$G1BK%?9Z+(dm`mKt,?;6K@Q 7}}*Tw>7BkKsJ;E|Viexb T-3j%5QB%wI5'$5oB :h*C"Q7yjTzLO%6QS/u>HX 4DGz*A!1*p"7$-joX2YF8ht@\l[&LS$FU=udM&y.l_ Even after the period that the drug has been prescribed for, the doctor will often recommend to gradually stop using the Phentermine to avoid the withdrawal symptoms. HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use ADIPEX-P safely and effectively. privacy practices. Take 1 tablet or capsule once a day before breakfast or 1-2 hours after breakfast. After the tablet has melted, swallow or take a sip of water. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Since it may lead to such symptoms, it also has the potential to cause severe withdrawal symptoms, especially when a patient goes cold turkey. allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 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. Rule 4731-11-02 | General provisions. Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. the unsubscribe link in the e-mail. Some patients experience an increase in sexual interest, while others notice that they have a lower libido. But weight management can take time. Many physicians who currently receive the reports have found that the reports help them better understand, and possibly alter, their prescribing practices. I am finding limited information. Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic and/or tricuspid valves, has been reported in otherwise healthy persons who had taken a combination of Phentermine with fenfluramine or dexfenfluramine for weight loss. Learn more about popular brands, dosage, side effects, results, and weight loss alternatives. Patients are advised to report any symptoms or diseases they may have before the doctor prescribes the drug this may include high blood pressure and kidney problems, as well as any type of diabetes and thyroid disorders. 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. Carefully follow the dosing instructions for the form you are using. Current Obesity Reports. Phentermine, an amphetamine congener, is the most widely used anti-obesity drug in the U.S. Sally Cohen holds a degree in nutrition sciences from Alcorn State University. endstream endobj 1531 0 obj <>/Metadata 26 0 R/Pages 1528 0 R/StructTreeRoot 41 0 R/Type/Catalog>> endobj 1532 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/TrimBox[0.0 0.0 630.0 702.0]/Type/Page>> endobj 1533 0 obj <>stream information and will only use or disclose that information as set forth in our notice of The first use of Phentermine as a drug to help treat obesity dates back to 1938. Here are the results of a recent poll that asked current phentermine patients where they received their phentermine prescription ( It is freely soluble in water; sparingly soluble in warm alcohol, insoluble in chloroform, acetone, ether and benzene. Take this medicine only as directed by your doctor. information submitted for this request. Do not crush, break, or chew it. It is advised to stay in strict adherence with the instructions and dosage information a doctor prescribes to the patient in order to avoid dangerous side effects. Use caution in prescribing Phentermine for patients with even mild hypertension (risk of increase in blood pressure). Some of the studies that have linked Phentermine to positive results in humans include: The main active ingredient is known as Phentermine Hydrochloride. Choosing a specialty can be a daunting task and we made it easier. Lomaira: One tablet three times a day, taken 30 minutes before meals. Phentermine may decrease the hypotensive effect of adrenergic neuron blocking drugs. https://fco.factsandcomparisons.com/. For oral dosage form (disintegrating tablets): Adults and children 17 years of age and olderOne tablet once a day, taken in the morning. 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. Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. The weight loss experts who OSMA has consulted with have indicated that misuse of phentermine is unlikely. Doctors often prescribe a dose of 5-HTP and vitamin B12 with a Phentermine prescription in order to enhance its effects and to relieve some side effects. Many people live far away from their nearest weight loss clinic, which can make follow-ups complicated. Phentermine is intended to help overweight and obese patients who have already tried losing weight with diet and exercise. Y$iqzZz\vlt1a;svw&aBS8Z(HGCkr&_Qxt97t,GWceTL^QqX(%8_A2'"%tD'DNz"G*"Tc. 1530 0 obj <> endobj Phentermine is one of the substances that have been researched thoroughly, thus its effects have been proven effective and the claims that are made about this drug are backed by scientific evidence. Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [see ClinicalPharmacology (12.3)]. Members of Losing Weight with Phentermine Support Group on Facebook. Le81g Of Rdb-YR!bLEbfYo9(e This medication has been linked to physical dependence, which means a patient may become addicted to it. Carefully follow your doctor's instructions for a reduced-calorie diet plan and regular exercise. In some cases, especially when the health concern is not too serious, the doctor may prescribe the drug at lower doses spread throughout the day, instead of advising the patient to take one single dose every day. Talk with your doctor before starting an exercise program. Phendimetrazine tartrate is a white, odorless crystalline powder. To avoid trouble with sleeping, take the last dose of the day about 4 to 6 hours before bedtime, unless your doctor tells you otherwise. Phentermine is pregnancy category X, so it should never be taken while pregnant or nursing ( This medicine is available in four forms: capsules, disintegrating tablets, extended-release capsules, and tablets. But regarding phentermine monotherapy, phentermine hydrochloride (HCl) is a sympathomimetic Drug Enforcement Agency (DEA) scheduled IV drug approved as an anti-obesity medication and marketed in the US since 1959 (See Table 1).The reported weight reduction efficacy of phentermine [10] derived from . Your email address will not be published. Create well-written care plans that meets your patient's health goals. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. = This includes Chapter 4731-11, OAC, Controlled Substances pertaining to the prescribing of schedule II, III, and IV medications for purposes of weight loss. The drug is classified under a certain chemical class known as amphetamine as it has a similar pharmacology value to other drugs classified in the class. Specializes in Med nurse in med-surg., float, HH, and PDN. Unfortunately, patients experienced a variety of side effects, which included severe heart toxicity and hypertension. It is often prescribed to be taken in the morning, before or after breakfast. There is a problem with Even patients who are overweight and pregnant at the same time are not allowed to use this product. Patients should be advised to report immediately any deterioration in exercise tolerance. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Press Releases. It is not known if Phentermine is excreted in human milk; however, other amphetamines are present in human milk. The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage. potentially hazardous activities such as operating machinery or driving FULL PRESCRIBING INFORMATION in the presence of other risk factors (e.g., controlled hypertension, 333-33-100411 Tasks 35 Later on, between 1940 and 1960, Phentermine was combined with other medications to improve its effectiveness. Phentermine is for people with obesity or overweight who haven't been able to lose enough weight with diet and exercise alone to improve their health. Rule 4731-11-04 | Controlled substances: Utilization of short term anorexiants for weight reduction. Concomitant use of alcohol with Phentermine may result in an adverse drug reaction. A single copy of these materials may be reprinted for noncommercial personal use only. Safety and effectiveness in pediatric patients have not been established. It also isn't for people who are pregnant, may become pregnant or are breastfeeding. Phentermine also is offered combined with topiramate for weight loss (Qsymia). Do You Need a Prescription for Phentermine? information highlighted below and resubmit the form. So some health care providers might order it for longer use. More specifically, this medication is an option for people with a body mass index (BMI): Greater than 30 kg/m2 Greater than 27 kg/m2 + one or more weight-related condition In addition, Section 4723.431(A), ORC, requires the APRNs collaborating physician to be practicing in Ohio in a specialty that is the same or similar to the nurses nursing specialty.Section 4723.481(B), ORC, prohibits the prescriptive authority of the CTP holder from exceeding the prescriptive authority of the collaborating physician. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. Fatigue and depression usually follow the central stimulation. Phentermine also is offered combined with topiramate for weight loss (Qsymia). The safety and efficacy of combination therapy with Phentermine 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. While this drug may sound like a wonder pill, patients should ensure they know are familiar with the precautions, interactions, side effects and other important details before they start taking it. endstream endobj 108 0 obj <>stream To provide you with the most relevant and helpful information, and understand which Phentermine has not been studied in patients with eGFR less than 15 mL/min/1.73m2, including end-stage renal disease requiring dialysis; avoid use in these populations. Phentermine is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Rule 4731-11-03 | Utilization of anabolic steroids, schedule II controlled substance cocaine hydrochloride, and schedule II controlled substance stimulants. HVMs8WQl eLg*&{dd $_;lm |NggK6,M]gu\.BNB. [Who Prescribed Your Phentermine?]. In some cases, the doctor may prescribe Phentermine in smaller doses and advise the patient to take it up to three times in a single day. She is passionate about promoting health at any size. Sign-up for our weekly newsletter! ADIPEX-P (phentermine hydrochloride) tablets, for oral use CIV ADIPEX-P (phentermine hydrochloride) capsules, for oral use CIV Initial U.S. Approval: 1959 4 However, it caused a chronic condition known as pulmonary hypertension, which led to the death of many patients. Won Son J, et al. When breastfeeding, the drug may enter the breast milk and travel into the nursing babys body, which may cause harm to them. A severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia. the unsubscribe link in the e-mail. The prescribing designation for anorexiants can be located on page 15 of The Formulary Developed by the Committee on Prescriptive Governance (The Formulary). eG)mW`Bq:qq_W#!]WD w">=qtP"&Lb1=D.$MaK'5c'c84@i6j8H:{V6K}sTL N[v})xukk\+3+A{g$q5|zX99{c]Y7l3.dD6[\ U,r ,!,'\N "(%7M$7M_@3&riT~H!IJx$"SC4DiivT69SjH$2 oQ+#?G2 %Jj\ongTRQr$$Ym&" %e"[6X)X\R phIl;ZL#ac In some cases, the use of this drug in combination with other pills may cause the effects of other drugs to increase. As phentermine is similar to amphetamine, it is a controlled drug (class C5) and has the potential for abuse. How Is Phentermine Dosed? Your email address will not be published. https://med.ohio.gov/LinkClick.aspx?fileticket=Q2JmI7o-3HI%3d&portalid=0. State Medical Board of Ohio On Wednesday, February 8, the board voted to adopt new telehealth rules. Not only can losing weight harm an unborn baby during pregnancy, but the drug may also cause adverse effects. Metric conversions are as follows: pounds 2.2 = kg; inches x 0.0254 = meters. But the rate of misuse seems to be low. x8FvuN3il&_t%(af?uE7wRu\BbK. See full prescribing information for ADIPEX-P. As a result, they may be more open to the idea of prescribing phentermine. As much as 33% of the U.S. adult population are considered to be obese. The plasma protein binding decreases as blood topiramate increases. 2020; doi:10.4093/dmj.2020.0258. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Based on Ohio's opioid prescribing guidelines, we developed an opioid prescribing rule that applies to all BWC-certified prescribers. In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2), limit the dosage of Phentermine to 15 mg daily [see Dosage and Administration (2.2)]. APRNs Prescribing Weight Loss Medications. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class in which these phenomena have been looked for. Our mission is to Empower, Unite, and Advance every nurse, student, and educator.
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