The drug is also available in regular capsules that are taken orally with a glass of water. 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. Patients must be informed that Phentermine hydrochloride is a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity, and that coadministration of Phentermine with other drugs for weight loss is not recommended [see Indications and Usage (1) and Warnings and Precautions (5.1)]. 3 include protected health information. 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. It is important to follow these instructions religiously. Moreover, it is strongly recommended to avoid or limit the alcohol intake. It is important not to perform activities that require a patient to be alert while experiencing mental impairment as an adverse effect. However, it caused a chronic condition known as pulmonary hypertension, which led to the death of many patients. It is illegal & unsafe to buy phentermine online consider Phen Caps instead! One of the most important things to consider is the fact that the drug should never be accompanied by an MAO inhibitor. To provide you with the most relevant and helpful information, and understand which 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. Other initial symptoms may include angina pectoris, syncope or lower extremity edema. The drug has two primary functions in the human body, which is the reason why it is always accompanied by these lifestyle changes. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. The combined drug is approved for long-term use. Portions of this document last updated: Feb. 01, 2023. Tablets containing 37.5 mg Phentermine hydrochloride (equivalent to 30 mg Phentermine base). If a patient would like to take other supplements, they should consult their doctor first. Specializes in Med nurse in med-surg., float, HH, and PDN. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. 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. Keep from freezing. information and will only use or disclose that information as set forth in our notice of Phentermine is a Schedule IV controlled substance. Burguera B, et al. Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. The use of Topamax and Phentermine is actually an FDA-approved combination. endstream endobj startxref Your doctor may prescribe both of these drugs separately, or choose to prescribe Qsymia, which is another medication that combines Phentermine and Topamax. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. A physician will usually start with a physical examination to determine if the patients health is in a state that will not be negatively affected when taking this drug. Advertising revenue supports our not-for-profit mission. The health information contained here is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. PDF What Every Pharmacist Needs to Know About Controlled Substances in iQJG\If6CuoG^|&qXegM,+vmC [To w{`F@kMxVBrH7.1g B;H _BfHPXK#Q 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 Numerous side effects have been linked to the use of Phentermine. You may opt-out of email communications at any time by clicking on Different brands manufacture, distribute and sell Phentermine drugs. "@Hw4`tqCA\+ q [AF]` b L ! Obesity has been linked to many different diseases, including type 2 diabetes and cardiovascular disease. 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. Losing weight during pregnancy can harm both a mother and her baby. , information is beneficial, we may combine your email and website usage information with You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. While suffering from any of these health concerns may be a cause for concern, it does not mean a patient will not be able to use Phentermine at all. Specializes in NICU, PICU, Transport, L&D, Hospice. The first use of Phentermine as a drug to help treat obesity dates back to 1938. The patient brings in a prescription for the same drug on November 1, 2013. ]^Ng8\!HqX 'nR l# w! {A6.q=0G: S:nR-`\ |%Tx F5z :^EU\)|\eyt0F The prescribing designation for anorexiants can be located on page 15 of The Formulary Developed by the Committee on Prescriptive Governance (The Formulary). x8FvuN3il&_t%(af?uE7wRu\BbK. Rule 4731-11-01 | Definitions. 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. However, if it is almost time for your next dose, skip the missed dose and go back to your . You may opt-out of email communications at any time by clicking on Your email address will not be published. other information we have about you. It also isn't for people who are pregnant, may become pregnant or are breastfeeding. It has the chemical name of ,,-Dimethylphenethylamine hydrochloride. Store at 20 to 25C (68 to 77F) [See USP Controlled Room Temperature]. They are usually real doctors who prescribe real phentermine without the now-mandatory face-to-face consultation. The CPG determination is specific to Qsymin, Belviq and Contrave only. Learn about the most popular weight loss medications. 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. Talk with your doctor before starting an exercise program. Before taking phentermine, tell your doctor and pharmacist if you are allergic to phentermine, any other medications, or any of the ingredients in phentermine tablets. The doctor may advise the patient to complete the remaining period of the program or help him/her end the program safely. Learn more about popular brands, dosage, side effects, results, and weight loss alternatives. Wait, so NPs may prescribe Qsymia, but not phentermine? 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. Adipex-P (phentermine hydrochloride) capsules label, Greater than 27 kg/m2 + one or more weight-related condition, Vitals (heart rate, blood pressure, etc. Phentermine may decrease the hypotensive effect of adrenergic neuron blocking drugs. Doctors used it to help patients who experience certain health issues caused by obesity to lose weight and improve the symptoms they are experiencing. 5 Adults and children 17 years of age and older. He or she may prescribe the medication him/herself if you are an appropriate candidate, or he/she may choose to refer you to a specialist for further evaluation and follow-up. Le81g Of Rdb-YR!bLEbfYo9(e Taking too much Phentermine can be harmful to the patients body. health information, we will treat all of that information as protected health Plus, the doctors are not familiar with your overall health status, instead relying entirely on self-reported information, which is often incomplete or inaccurate. 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. (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. The dose of this medicine will be different for different patients. 6 Phentermine is a popular prescription drug that is often used to treat obesity. 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. Phentermine Monograph for Professionals - Drugs.com | Prescription Drug LiverTox National Institutes of Health. They help the body produce a larger amount of energy from fat cells, which further reduces body fat percentage. Take 1 tablet or capsule once a day before breakfast or 1-2 hours after breakfast. other information we have about you. Even patients who are overweight and pregnant at the same time are not allowed to use this product. In some cases, patients have also found that Phentermine interacts with drugs that contain Tranylcypromine, Henelzine, Isocarboxazid, Diethylpropion, Phendimetrazine, Amphetamine, and Benzphetamine. \ Detailed Phentermine dosage information Related/similar drugs Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. If we combine this information with your protected Phentermine: Package Insert / Prescribing Information - Drugs.com The board expressed concerns that removing the prescribing restrictions could lead to misuse of weight loss drugs such as phentermine. The MAO inhibitors (Monoamine Oxidase Inhibitors) are used to treat depression, especially a specific type called atypical depression. Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [see ClinicalPharmacology (12.3)]. 5 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. ADIPEX-P (phentermine hydrochloride) tablets, for oral use CIV ADIPEX-P (phentermine hydrochloride) capsules, for oral use CIV Initial U.S. Approval: 1959 Implementation of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. 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. 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. , Gastrointestinal symptoms include nausea, vomiting, diarrhea and abdominal cramps. Phentermine (Oral Route) Proper Use - Mayo Clinic Why is phentermine a controlled substance? Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Selling or giving away Phentermine may harm others and is against the law. 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. Medically reviewed by Drugs.com. 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. Phentermine has pharmacologic activity similar to amphetamine (d- and dll-amphetamine) [see Clinical Pharmacology (12.1)]. Mayo Clinic does not endorse companies or products. Create well-written care plans that meets your patient's health goals. If not, additional education or an additional certification may be needed. 4 ). Each capsule, for oral administration, contains 105 mg Phendimetrazine tartrate manufactured in a special base designed for prolonged release. The Topamax is added to Phentermine in order to intensify its effects and to help patients lose weight faster. APRNs Prescribing Weight Loss Medications. allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 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. 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. PDF Phentermine Patient Information - American Association of Clinical Phentermine is not recommended for use in pediatric patients 16 years of age. If you are a Mayo Clinic patient, this could Medical Board Update - OSMA Today, Phentermine can still be obtained through the doctors prescription in the majority of countries around the world. include protected health information. Contraindications 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 Hyperthyroidism It is vital to talk with the doctor before using Phentermine with other products. 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. Below is a chart of body mass index (BMI) based on various heights and weights. Requirements may be altered [see Warnings and Precautions (5.9)]. ). Six years after the approval, a similar drug, called Aminorex, were released in Europe with the same purpose of helping obese individuals. This includes Chapter 4731-11, OAC, Controlled Substances pertaining to the prescribing of schedule II, III, and IV medications for purposes of weight loss. After the tablet has melted, swallow or take a sip of water. I hold a DEA cert. Accessed Oct. 11, 2022. Phentermine is 17.5% plasma protein-bound, while topiramate is 15 - 41% plasma protein-bound when the blood concentration range is 0.5 to 250 g/mL. @ d Drug information provided by: IBM Micromedex. Based on Ohio's opioid prescribing guidelines, we developed an opioid prescribing rule that applies to all BWC-certified prescribers. U.S. Food and Drug Administration. All rights reserved. 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. Some patients experience an increase in sexual interest, while others notice that they have a lower libido. Metabolism Phentermine has two metabolic pathways; hydroxylation and oxidation. 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. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. For some patients, half tablet (18.75 mg) daily may be adequate, while in some cases it may be desirable to give half tablets (18.75 mg) two times a day. ). 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. PDF State Medical Board of Ohio W0Qxe {>x??}# cGCSGGC[G(P A@3'i~ (2[n! 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. Comprehensive review of current and upcoming anti-obesity drugs. Swallow the tablet whole. State Medical Board of Ohio On Wednesday, February 8, the board voted to adopt new telehealth rules. Make sure your hands are dry before touching the tablet. Other brands of this drug include Suprenza, Phentercot, Acxion, Elvenir, Terflamex, Panbesy, Duromine, Fentermina, Phentermin, PHentermine and Lomaira. Phentermine Hydrochloride Tablets are indicated only as short-term (a few weeks) monotherapy for the management of exogenous obesity. 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 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. Chapter 4731-11 - Ohio Administrative Code | Ohio Laws Get the best fitness, food, and weight loss tips to succeed on your journey! FULL PRESCRIBING of the risk of hypertensive crisis. Phentermine.com is a property of: Careworld LLC. Phentermine hydrochloride USP is a sympathomimetic amine anorectic. As phentermine is similar to amphetamine, it is a controlled drug (class C5) and has the potential for abuse. Along with Ohio's telehealth law in Sub. Lomaira: One tablet three times a day, taken 30 minutes before meals. Dispense in a tight container as defined in the USP, with a child-resistant closure (as required). Phentermine is not a miracle drug taken daily and the body simply starts losing weight all by itself. The recommended maximum dosage of Phentermine is 15 mg daily for patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2). Since it may lead to such symptoms, it also has the potential to cause severe withdrawal symptoms, especially when a patient goes cold turkey. See full prescribing information for ADIPEX-P. Phentermine: MedlinePlus Drug Information The drug is usually prescribed at the lowest possible dose to new users, which is 15mg per day. Phentermine also is offered combined with topiramate for weight loss (Qsymia). If you miss a dose of this medicine, take it as soon as possible. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. It should also not be taken within 14 days after taking an MAO inhibitor. x\8zS wU^TM;J`Kc=@y\} Blf\3K|xL?D$aesY"_(ceD!s!@P,?K&Bd8cKS~zq=7'kiw\dqL:A ?O0O@+}y"z[?Os/Kht;[SN4h9c31{8Eh7dPc\BFE(e&9;!PUqK\aD 7) &\1!j-_Y7jD,Sp)AWc/igg?v{5\%a'd9"D0=gRGEZgpbMQJD *k*;1'w24w, d r d?&8xeEj`\2C6xrhq2@-{P5CbBL(/0m8&8Ltnvf};y852q*+I%l=+rwGUv*:!80|>tb?U?L,zG8%K`n]+:,LCE")Xz\^):{~{=vu=Qg`A\6qT=WCZ TcR%mi,OV_RtK1e&:By~i~!nu To provide you with the most relevant and helpful information, and understand which (phentermine hydrochloride) orally disintegrating tablet C IV . Obesity pillars roundtable: Phentermine - Past, present, and future Some weight loss clinics also insist that patients take additional supplements, such as vitamin B12 shots and 5-HTP, to boost phentermine despite the supplements unproven effectiveness. OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. hb```e````a`d`@ f(fcfILLvL~. L^%0:T'xHGi,KGyVfZ5WI6&ZU1/VqM4.ct\i2gTAtQV%[$*/tbn"xS8JU$bljsI2)bs_/FouVGwCqX';z{0REZbSX,bXWPS#Bf|il#o'y`?jv{;!bS F#vPGzD"1~5~F%mW9YlGIQVYOS~kojbdQS!>|@Ph ohio.gov under the Practice APRN link.Although the Formulary allows CTP holders to prescribe these three drugs under the circumstances documented by their respective standard care arrangement, there are other factors that must be considered by the CTP holder prior to initiating Qsymin, Belviq or Contrave prescriptions for patients. Tell patients to keep Phentermine in a safe place to prevent theft, accidental overdose, misuse or abuse. 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. This site complies with the HONcode standard for trustworthy health information: verify here. Any knowledge would be most appreciated. %%EOF stream 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. %PDF-1.6 % 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. CTP holders continue to be prohibited from prescribing all other anorexiants including, but not limited to phentermine (Adipex). Or it can help you feel full longer. hYr ~{L(QdK4^bdsO_d;a BXO--p,!4!,WhfM/@c OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. %%EOF It should melt quickly. Phentermine is approved for use for up to 12 weeks. When breastfeeding, the drug may enter the breast milk and travel into the nursing babys body, which may cause harm to them. Take the disintegrating tablet with or without food. It can help weight loss by making you less hungry. 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 a reminder, Ohio law requires physicians who prescribe any controlled substances, not just opioids, to submit an ICD-10 code with that prescription. Phentermine, an amphetamine congener, is the most widely used anti-obesity drug in the U.S. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Press Releases. The risks include, but are not limited to: See also, for example, Adverse Reactions (6) and Use in SpecificPopulations (8). 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. 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. Encourage prescribers to incorporate best clinical practices when prescribing opioids for treating Ohio . They inhibit the activity of an entire enzyme family known as monoamine oxidase. PDF Mid-Level Practitioners Authorization by State The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage. In some cases, the use of this drug in combination with other pills may cause the effects of other drugs to increase. Like other weight-loss medicines ordered by providers, phentermine is meant to be only part of a weight-loss plan. 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. Mayo Clinic does not endorse companies or products. (2012). Phentermine The most common side effects that patients experience include tremors, headaches, dizziness, dry mouth, diarrhea, constipation, upset stomach, feeling restless and being hyperactive. 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)]. 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. 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. Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. endstream endobj startxref Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Patients must be instructed on how much Phentermine to take, and when and how to take it [see Dosage and Administration (2)]. The Formulary can be accessed on the Board of Nursing website: www.nursing. CIV Dosage form: tablet Highlighted below are the topics discussed at the meeting that OSMA is closely following. Phentermine Hydrochloride Tablets are indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index 30 kg/m2, or 27 kg/m2 in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia). 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. The possibility of an association between PPH and the use of Phentermine alone cannot be ruled out; there have been rare cases of PPH in patients who reportedly have taken Phentermine alone. Accessed Oct. 11, 2022. Phentermine is most commonly prescribed to patients who experience negative health effects to excessive amounts of body weight. 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. 2019; doi:10.1016/j.mayocp.2018.11.020. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). 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. Cumulative urinary excretion of Phentermine under uncontrolled urinary pH conditions was 62% to 85%. All rights reserved. With more than 4 million prescriptions written in the United States each year, phentermine is an undeniably popular weight loss medication ( Generic name: Phentermine hydrochloride 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. Do You Need a Prescription for Phentermine? Please consult with your physician before you make any decisions regarding your health. OhioBWC - Provider: (Opioid Educate) - About prescribing