NDC 42806-810-01 A weight loss doctor will be more familiar with the research on phentermine for weight loss and, in many cases, more likely to prescribe it. Each capsule, for oral administration, contains 105 mg Phendimetrazine tartrate manufactured in a special base designed for prolonged release. Phentermine is related chemically and pharmacologically to amphetamine (d- and dll-amphetamine) and other related stimulant drugs have been extensively abused. 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. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. other information we have about you. It helps patients lose weight by suppressing their appetite and boosting their energy levels, thus leading to a more active lifestyle and greater calorie burn. Follow your doctor's orders or the directions on the label. So some health care providers might order it for longer use. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. The MAO inhibitors (Monoamine Oxidase Inhibitors) are used to treat depression, especially a specific type called atypical depression. A total of 24 patients developed heart valve disease while taking this drug, which led the FDA to withdraw the product from the market in 1997. As mentioned above, new mothers should avoid using this medication when breastfeeding. CIV This website is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Current Obesity Reports. Apart from these brand names, other brands that contain the drug as part of their multi-ingredient formula also exist and the most popular one is Qsymia. In relatively short-term clinical trials, adult obese subjects instructed in dietary management and treated with anorectic drugs lost more weight on the average than those treated with placebo and diet. 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. Phentermine is intended to help overweight and obese patients who have already tried losing weight with diet and exercise. Advise pregnant women and nursing mothers not to use Phentermine [see Use in Specific Populations (8.1, 8.3)]. Unfortunately, patients experienced a variety of side effects, which included severe heart toxicity and hypertension. It is a class IV controlled substance because of its serious side effects and addiction potential. In most cases, the drug is prescribed to users in periods of 12 weeks. In some cases, the use of Phentermine has also led to the development of symptoms that are related to erectile dysfunction. History of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive heart failure, uncontrolled hypertension), During or within 14 days following the administration of monoamine oxidase inhibitors, Known hypersensitivity, or idiosyncrasy to the sympathomimetic amines, Effect on the ability to engage in potentially hazardous tasks [see, Withdrawal effects following prolonged high dosage administration [see, Development of primary pulmonary hypertension [see, Development of serious valvular heart disease [see, Effects on the ability to engage in potentially hazardous tasks [see, The risk of an increase in blood pressure [see, the potential for developing tolerance and actions if they suspect development of tolerance [see, the risk of dependence and the potential consequences of abuse [see. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Choosing a specialty can be a daunting task and we made it easier. This content does not have an English version. Studies do not permit conclusions as to the relative importance of the drug and non-drug factors on weight loss. [Who Prescribed Your Phentermine?]. But weight management can take time. 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. Another important fact to consider before taking Phentermine is that it should never be used by women who are pregnant or who are currently breastfeeding. State Medical Board of Ohio On Wednesday, February 8, the board voted to adopt new telehealth rules. A reduction in insulin or oral hypoglycemic medications in patients with diabetes mellitus may be required. 4 0 obj Take the disintegrating tablet with or without food. Tablets are packaged in bottles of 100 (NDC 42806-810-01); and 1000 (NDC 42806-810-10). Some weight loss clinics also insist that patients take additional supplements, such as vitamin B12 shots and 5-HTP, to boost phentermine despite the supplements unproven effectiveness. 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. Thus, in order to make the most of this drug, patients need make some effort too. (1/19/2016) Ohio Strenthens Opioid Prescribing Guidlines to Further Prevent Prescription Drug Abuse and Save . %%EOF This combination of ingredients was branded as Fen-Phen. This content does not have an Arabic version. W0Qxe {>x??}# cGCSGGC[G(P A@3'i~ (2[n! Any knowledge would be most appreciated. Tablets: 37.5 mg phentermine hydrochloride, USP (equivalent to 30 mg phentermine base). 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. I am looking for information/advice/links to prescribing Phentermine (adipex ) in conjunction with diet and exercise in My private PCP business in the state of Ohio. 4 Missed Dose . Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Apart from not combining Phentermine with the MAO inhibitors, a patient should also first ensure they are not allergic to Phentermine before they take it. 0 https://www.uptodate.com/contents/search. What could be the cause? Numerous side effects have been linked to the use of Phentermine. Taking more than the prescribed amount of Phentermine can lead to an overdose, which means if a patient misses a dose, they should never try to make up for it by taking more than the prescribed amount at the next dose. This search engine indexes the Drug Enforcement Administration Diversion Control Program Web Site (www.deadiversion.usdoj.gov) only. Amphetamines and other stimulant drugs have been extensively abused and the possibility of abuse of Phentermine should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. Why is phentermine a controlled substance? The board expressed concerns that removing the prescribing restrictions could lead to misuse of weight loss drugs such as phentermine. Here are the results of a recent poll that asked current phentermine patients where they received their phentermine prescription ( All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. % Patients with a larger body weight may need to take a larger dose, depending on whether they have any health concerns that may be worsened by the usage of a larger dose. The drug is usually prescribed at the lowest possible dose to new users, which is 15mg per day. Following the administration of Phentermine, Phentermine reaches peak concentrations (Cmax) after 3 to 4.4 hours. Typical actions of amphetamines include central nervous system stimulation and elevation of blood pressure. Since Phentermine is a drug that contains chemical compounds, it is important to know about all of the risks that are involved with its use and precautions a person should be aware of before the consumption. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. One should bear in mind that Phentermine is not only a drug to help reduce the baseline body weight of patients, but it also reduces a patients risk of developing certain health diseases. U.S. Food and Drug Administration. If the doctor finds that the patient is a good candidate for Phentermine, they may prescribe a certain dose and provide specific details on dosage and lifestyle choices that should accompany the use of this medicine. Some patients need to take the drug an hour before they eat breakfast, while others are advised to take it approximately one to two hours after breakfast. Phentermine: 18.75 to 37.5 milligrams (mg) once a day, taken before breakfast or 1 to 2 hours after breakfast. 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. If a patient would like to take other supplements, they should consult their doctor first. 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. This is a label given to drugs that can be misused. Doctors often advise patients that in the case of more serious side effects, they should immediately call for assistance. If you take too much of this medicine, it may become habit-forming (causing mental or physical dependence). endstream endobj startxref Before starting with consumption of this medication, patients should get informed about potential adverse effects to be able to determine whether a newly-developed symptom is a sign of a health issue or just a side effect associated with Phentermine. This site complies with the HONcode standard for trustworthy health information: verify here. Precaution should be taken if a patient has any existing health concerns as the drug may cause further harm to their body. Your email address will not be published. stream At January's meeting, the board discussed the rules and elected to investigate what other states are doing to regulate weight loss medication. The following adverse reactions are described, or described in greater detail, in other sections: The following adverse reactions to Phentermine have been identified: Primary pulmonary hypertension and/or regurgitant cardiac valvular disease, palpitation, tachycardia, elevation of blood pressure, ischemic events. If we combine this information with your protected Since it may lead to such symptoms, it also has the potential to cause severe withdrawal symptoms, especially when a patient goes cold turkey. The additional boost in energy will also increase the physical activity levels, thereby providing an additional method for them to lose weight and gain overall health benefits. ). FULL PRESCRIBING of the risk of hypertensive crisis. The medical boards ICD-10 Committee is tasked with reviewing ICD-10 data that physicians submit to the OARRS system when prescribing controlled substances. The dosage may be adjusted to the patients need. endstream endobj startxref Specializes in NICU, PICU, Transport, L&D, Hospice. Even patients who are overweight and pregnant at the same time are not allowed to use this product. Read more here: How much does phentermine cost? It is illegal & unsafe to buy phentermine online consider Phen Caps instead! Your doctor may prescribe both of these drugs separately, or choose to prescribe Qsymia, which is another medication that combines Phentermine and Topamax. The amount of weight loss associated with the use of an anorectic drug varies from trial to trial, and the increased weight loss appears to be related in part to variables other than the drugs prescribed, such as the physician-investigator, the population treated and the diet prescribed. Burguera B, et al. the unsubscribe link in the e-mail. 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. Phendimetrazine tartrate is a white, odorless crystalline powder. include protected health information. This site complies with the HONcode standard for trustworthy health information: verify here. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class in which these phenomena have been looked for. The Ohio Emergency and Acute Care Facility Opioids and Other Controlled Substances Prescribing Guidelines offer clinical guidance for the acute care environment where there is no established patient-doctor relationship. Animal reproduction studies have not been conducted with Phentermine. What to offer the 99% of patients with severe obesity who do not undergo bariatric surgery? Studies have not been performed with Phentermine to determine the potential for carcinogenesis, mutagenesis or impairment of fertility. But the rate of misuse seems to be low. The medical board is currently reviewing its long-standing rules regarding prescribing controlled substances for the treatment of obesity. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. the current rules place time limitations on prescriptions that, many times, force physicians to stop a medication that is showing positive weight loss results. Learn about phentermine and succeed in your weight loss journey. Dosage form: tablet 1530 0 obj <> endobj They are usually real doctors who prescribe real phentermine without the now-mandatory face-to-face consultation. 1 Unpublished raw data. As much as 33% of the U.S. adult population are considered to be obese. Lomaira: One tablet three times a day, taken 30 minutes before meals. Six years after the approval, a similar drug, called Aminorex, were released in Europe with the same purpose of helping obese individuals. hbbd``b`z$@D`]"@DeX- Bb V ``LA\F*? Special Populations Geriatric Patients Select dosage with caution, starting at lower end of dosage range. There are reports of patients who have increased the dosage of these drugs to many times than recommended. The CPG determination is specific to Qsymin, Belviq and Contrave only. The strength and dosage of Phentermine depend on the brand that is prescribed and the patients specific condition. Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Ohio Administrative Code 4731-11-04 and 4731-11-04.1. If you are a good candidate for the medication, but your doctor does not prescribe phentermine, ask for a referral. Taking Phentermine depends on the brand and preparation of the drug. If obesity is impacting your fertility or reproductive health, or if you have a specific condition that affects weight (such as PCOS), your gynecologist may consider prescribing phentermine as a short-term weight management strategy. See DrugAbuse and Dependence (9.3). Mayo Clinic Proceedings. The possibility of abuse of Phentermine should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. The first use of Phentermine as a drug to help treat obesity dates back to 1938. This does not only include prescription drugs but also: Common drugs that are known to interact with Phentermine include Dopamine, Venlafaxine, Linezolid, Ephedrine, Isoproterenol, Epinephrine, Norepinephrine and a Phenylephrine injection. 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. All trademarks are the property of their respective owners. Le81g Of Rdb-YR!bLEbfYo9(e Use of Phentermine is contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors because of the risk of hypertensive crisis. Losing weight during pregnancy can harm both a mother and her baby. Instead, wait until you can go to a local doctor or consider other, over-the-counter weight loss options. Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Some of the studies that have linked Phentermine to positive results in humans include: The main active ingredient is known as Phentermine Hydrochloride. Available for Android and iOS devices. If you are allergic to other stimulants, amphetamines, cold medications or diet pills, you have a higher risk of being allergic to these pills too. The Topamax is added to Phentermine in order to intensify its effects and to help patients lose weight faster. Tak YJ, et al. The dosage varies from 15mg to 37.5mg per day. Ideally, patients should take it on an empty stomach. Common side effects of phentermine include: Phentermine is one of the most prescribed weight-loss medicines. When performing prospective DUR, the pharmacist notices a 30-day gap in treatment. Systemic exposure of Phentermine may increase up to 91%, 45%, and 22% in patients with severe, moderate, and mild renal impairment, respectively [see Dosage and Administration (2.2) and Use in Specific Populations (8.6)]. (5) A treatment plan based upon the clinical information obtained, to include all of the following components: (a) Diagnosis; (b) Objective goals for treatment; (c) Rationale for the medication choice and dosage; and (d) Planned duration of treatment and steps for further assessment and follow-up. If the drug is taken too late in the day, it may also cause insomnia. The risks include, but are not limited to: See also, for example, Adverse Reactions (6) and Use in SpecificPopulations (8). In some cases, the side effects were life-threatening and led to the death of a patient. BMI is calculated by taking the patients weight, in kilograms (kg), divided by the patients height, in meters (m), squared. Metabolism Phentermine has two metabolic pathways; hydroxylation and oxidation. Phentermine Hydrochloride Tablets are indicated only as short-term (a few weeks) monotherapy for the management of exogenous obesity. iQJG\If6CuoG^|&qXegM,+vmC [To w{`F@kMxVBrH7.1g B;H _BfHPXK#Q Y$iqzZz\vlt1a;svw&aBS8Z(HGCkr&_Qxt97t,GWceTL^QqX(%8_A2'"%tD'DNz"G*"Tc. In addition to its function as an appetite suppressant, Phentermine drugs also act as energy boosters. Dosage should be individualized to obtain an adequate response with the lowest effective dose. 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 the unsubscribe link in the e-mail. 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. I wonder whose pockets got lined with that one. Ohio has some of the strictest rules in the country andthe current rules place time limitations on prescriptions that, many times, force physicians to stop a medication that is showing positive weight loss results. As a reminder, Ohio law requires physicians who prescribe any controlled substances, not just opioids, to submit an ICD-10 code with that prescription. 2 These are all promoted as weight loss pills that assist obese individuals. The dose of this medicine will be different for different patients. The patient brings in a prescription for the same drug on November 1, 2013. Some of these include: As with many other prescription drugs, Phentermine can also interact with certain medications. This content does not have an English version. 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. https://www.micromedexsolutions.com. It's designed to help prevent opioid dependence for Ohio's injured workers through its three primary goals. However in the presence of topiramate, Phentermine Cmax and AUC increase 13% and 42%, respectively. Rx only. For more information, the rule package submitted to the Common Sense Initiative (CSI) office for review can be found here:https://med.ohio.gov/LinkClick.aspx?fileticket=Q2JmI7o-3HI%3d&portalid=0, 2023 The Ohio State Medical Association. It should also not be taken within 14 days after taking an MAO inhibitor. Press Releases. Phentermine also is offered combined with topiramate for weight loss (Qsymia). Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. health information, we will treat all of that information as protected health Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. 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. Along with Ohio's telehealth law in Sub. Diabetes & Metabolism Journal. Members of Losing Weight with Phentermine Support Group on Facebook. Adults and children 17 years of age and older. While these are the most common side effects of the drug, they are not the only consequences associated with the intake of this medication. Ask your healthcare professional how you should dispose of any medicine you do not use. Accessed Oct. 11, 2022. ). Do not double doses. The recommended maximum dosage of Phentermine is 15 mg daily for patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2). health information, we will treat all of that information as protected health The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Package insert / product label In order to determine the effectiveness of certain pharmaceuticals, supplements and other substances, clinical trials and scientific research are often conducted among a group of volunteers. 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. It should melt quickly. Plus, the doctors are not familiar with your overall health status, instead relying entirely on self-reported information, which is often incomplete or inaccurate. Especially considering Ohios ability to track the prescribing and dispensing of the drug in Ohios drug database, OARRS. Phentermine also is offered combined with topiramate for weight loss (Qsymia). Create well-written care plans that meets your patient's health goals. The weight loss experts who OSMA has consulted with have indicated that misuse of phentermine is unlikely. After the tablet has melted, swallow or take a sip of water. Do not crush, break, or chew it. 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 Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. The FDA in the United States first approved the use of Amphetamine as a drug that can be used to suppress a patients appetite in 1959. For a more comprehensive list of drug and nutraceuticals which interact with phentermine hydrochloride, refer to our phentermine drug interactions data. , 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. Yes, you need a prescription for phentermine. Based on Ohio's opioid prescribing guidelines, we developed an opioid prescribing rule that applies to all BWC-certified prescribers. The usual adult dose is one tablet (37.5 mg) daily, as prescribed by the physician, administered before breakfast or 1 to 2 hours after breakfast. Phentermine is a sympathomimetic amine with pharmacologic activity similar to the prototype drugs of this class used in obesity, amphetamine (d- and dll-amphetamine). The following information includes only the average doses of this medicine. endstream endobj 105 0 obj <> endobj 106 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/Type/Page>> endobj 107 0 obj <>stream %PDF-1.6 % It can help weight loss by making you less hungry. hb```e````a`d`@ f(fcfILLvL~. The State Medical Board of Ohio met on January 13, 2021. . Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. 1 At its May 18, 2015 meeting, the Committee on Prescriptive Governance (CPG) determined that three medications approved by the FDA for long-term weight management may be prescribed by APRNs with a CTP (CTP holder) if agreed to by the CTP holder and his/her collaborating physician and stated within the CTP holders standard care arrangement. Carefully follow your doctor's instructions for a reduced-calorie diet plan and regular exercise. Store at 20 to 25C (68 to 77F) [See USP Controlled Room Temperature]. 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. Phentermine is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. https://med.ohio.gov/LinkClick.aspx?fileticket=Q2JmI7o-3HI%3d&portalid=0. Accessed Oct. 11, 2022. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendations in this regard. All rights reserved. Trends in Prescribing and Dispensing Patterns . Click here for an email preview. 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. information submitted for this request. The magnitude of increased weight loss of drug-treated patients over placebo-treated patients is only a fraction of a pound a week. It is an appetite suppressant with the added ability to help the body produce more energy from fat cells. Doctors often combined the use of Phentermine with diuretics, thyroid hormone medicines and digitalis. In order to help patients reduce their risk of developing these diseases when they are obese, doctors usually prescribe Phentermine. << /Length 5 0 R /Filter /FlateDecode >> ), Cannot find a doctor in your network that prescribes phentermine. Do not crush, break, or chew it. Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [see ClinicalPharmacology (12.3)]. According to the medical board, at this time, only physicians who prescribe opioids are receiving benchmark style reports and the board thinks that all prescribers who report into OARRS should receive the same information. "@Hw4`tqCA\+ q [AF]` b L ! (2009, April 06). Being extremely irritable and confused, or experienced unusual behavior or thoughts. (1981, February 4). 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. With respect to the care and treatment of patients with obesity, APRNs are required to incorporate the State Medical Board rules applicable to physicians and prescribing practices. Medically reviewed by Drugs.com. Avoid use of Phentermine in patients with eGFR less than 15 mL/min/1.73m2 or end-stage renal disease requiring dialysis [see Use in Specific Populations (8.6) and Clinical Pharmacology (12.3)]. Intravenous phentolamine (Regitine, CIBA) has been suggested on pharmacologic grounds for possible acute, severe hypertension, if this complicates overdosage. The CPG determination is specific to Qsymin, Belviq and Contrave only. information highlighted below and resubmit the form. information submitted for this request. 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. Do You Need a Prescription for Phentermine? Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Phen Caps is recommended by over 30,000 people like you who want to lose weight fast and effectively without the drawbacks of prescription medications. To provide you with the most relevant and helpful information, and understand which Of course, it is taken orally. National Association of Boards of Pharmacy. Duromine is not funded by Pharmac, so patients pay $160-$200 per month when they present a standard prescription of 30mg daily - in addition to the GP consultation fee. The Formulary can be accessed on the Board of Nursing website: www.nursing. You may opt-out of email communications at any time by clicking on