Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. National Association of Boards of Pharmacy. 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. This content does not have an English version. It is often prescribed to be taken in the morning, before or after breakfast. If not, additional education or an additional certification may be needed. 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. (2019, May 03). Not only can losing weight harm an unborn baby during pregnancy, but the drug may also cause adverse effects. All rights reserved. Rule 4731-11-02 | General provisions. Please consult with your physician before you make any decisions regarding your health. ). Phentermine is a popular prescription drug that is often used to treat obesity. Phentermine is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. 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. 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. 5 , 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. The medical board would like to work with the pharmacy board to make OARRS reports more available and helpful to physicians. Phentermine: 18.75 to 37.5 milligrams (mg) once a day, taken before breakfast or 1 to 2 hours after breakfast. Taking too much Phentermine can be harmful to the patients body. This medication has been linked to physical dependence, which means a patient may become addicted to it. 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 Like other weight-loss medicines ordered by providers, phentermine is meant to be only part of a weight-loss plan. Make sure your hands are dry before touching the tablet. 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. Phentermine has been linked to many complications; knowing these details will help patients minimize their risk of experiencing such unwanted scenarios. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. (1981, February 4). (1/19/2016) Ohio Strenthens Opioid Prescribing Guidlines to Further Prevent Prescription Drug Abuse and Save . Learn about phentermine and succeed in your weight loss journey. 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. The doctor may advise the patient to complete the remaining period of the program or help him/her end the program safely. Or it can help you feel full longer. Phentermine is intended to help overweight and obese patients who have already tried losing weight with diet and exercise. Concomitant use of alcohol with phentermine may result in an adverse drug reaction. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. 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. Children 16 years of age and youngerUse is not recommended. 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 After the tablet has melted, swallow or take a sip of water. 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. % It is not uncommon for patients to experience a change in their sexual interest. privacy practices. @ d ): Most people get their phentermine from a family or primary care doctor ( The overdose symptoms include: The side effects of Phentermine can lead to several symptoms that may impair certain functions in the patients body. 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. IBM Micromedex. 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. Some brands use a dissolving tablet that is placed under the tongue, which allows the body to absorb the chemicals in the drug faster. ADIPEX-P (phentermine hydrochloride) tablets, for oral use CIV ADIPEX-P (phentermine hydrochloride) capsules, for oral use CIV Initial U.S. Approval: 1959 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. information submitted for this request. HVMs8WQl eLg*&{dd $_;lm |NggK6,M]gu\.BNB. 3 FULL PRESCRIBING of the risk of hypertensive crisis. The drug is also available in regular capsules that are taken orally with a glass of water. The recommended maximum dosage of Phentermine is 15 mg daily for patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2). JC. Phentermine hydrochloride USP is a sympathomimetic amine anorectic. 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. Safety and effectiveness in pediatric patients have not been established. The CPG determination is specific to Qsymin, Belviq and Contrave only. See Drug Abuse and Dependence (9) and Overdosage (10). See full prescribing information for ADIPEX-P. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. 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. Specializes in Med nurse in med-surg., float, HH, and PDN. The plasma protein binding decreases as blood topiramate increases. Each tablet contains the following inactive ingredients: starch, lactose anhydrous, microcrystalline cellulose, colloidal silicon dioxide, stearic acid, magnesium stearate and blue sugar spheres. include protected health information. This content does not have an English version. The FDA has categorized this drug as X for pregnancy, which means it should not be used during pregnancy under any circumstances. In fact, one study conducted at the Duke University School of Medicine found that apart from the Phentermines ability to effectively reduce body weight, it can also help improve a patients health-related quality of life. 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. Later on, between 1940 and 1960, Phentermine was combined with other medications to improve its effectiveness. A single copy of these materials may be reprinted for noncommercial personal use only. All rights reserved. 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. include protected health information. The drug is mainly an appetite suppressant, thus making a patient feel fuller after (and between) meals and making the patient more likely to consume foods that have lower amounts of calories. The medical board is currently reviewing its long-standing rules regarding prescribing controlled substances for the treatment of obesity. The dosage varies from 15mg to 37.5mg per day. hbbd``b`z$@D`]"@DeX- Bb V ``LA\F*? The magnitude of increased weight loss of drug-treated patients over placebo-treated patients is only a fraction of a pound a week. Drugs of this class used in obesity are commonly known as anorectics or anorexigenics. It has not been established that the primary action of such drugs in treating obesity is one of appetite suppression since other central nervous system actions, or metabolic effects, may also be involved. 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. Start with your primary care doctor and schedule an appointment to discuss weight. In 1968, three years after its release, Aminorex was withdrawn. Advise pregnant women and nursing mothers not to use Phentermine [see Use in Specific Populations (8.1, 8.3)]. Any knowledge would be most appreciated. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. stream 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. Specializes in NICU, PICU, Transport, L&D, Hospice. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. Last updated on Mar 22, 2022. She is passionate about promoting health at any size. This content does not have an Arabic version. Rx only. 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. Do not double doses. Tablets are packaged in bottles of 100 (NDC 42806-810-01); and 1000 (NDC 42806-810-10). What to offer the 99% of patients with severe obesity who do not undergo bariatric surgery? Learn about the most popular weight loss medications. With more than 4 million prescriptions written in the United States each year, phentermine is an undeniably popular weight loss medication ( Some of the most common withdrawal symptoms include weight gain, fatigue, insomnia and a bad mood. Burguera B, et al. Between the consultation, labs, prescription, and supplements (if applicable), weight loss clinics are also an expensive option. Ohio has some of the strictest rules in the country and. 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. Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. Requirements may be altered [see Warnings and Precautions (5.9)]. The doctor also looks at the patients medical history for any pre-existing medical conditions that the medication should not be taken with. (2019, June 20). Phentermine is not recommended for use in pediatric patients 16 years of age. Many physicians who currently receive the reports have found that the reports help them better understand, and possibly alter, their prescribing practices. It also isn't for people who are pregnant, may become pregnant or are breastfeeding. For a more comprehensive list of drug and nutraceuticals which interact with phentermine hydrochloride, refer to our phentermine drug interactions data. After 12 weeks, the patient needs to take a break from the product as it may lead to physical dependence. 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. As mentioned above, new mothers should avoid using this medication when breastfeeding. Phentermine is related chemically and pharmacologically to the amphetamines. 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. 1-612-816-8773. Patients should be advised to report immediately any deterioration in exercise tolerance. United Nations Office on Drugs and Crime. The natural history of obesity is measured over several years, whereas the studies cited are restricted to a few weeks duration; thus, the total impact of drug-induced weight loss over that of diet alone must be considered clinically limited. 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 The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage. If you are a Mayo Clinic patient, this could Based on Ohio's opioid prescribing guidelines, we developed an opioid prescribing rule that applies to all BWC-certified prescribers. LZ(6&JQKU5@5_M.~#p = yLgzP"Z90* v~1iu0pV (s:J&Q,. } }& 8}q>u@y)dO|fRmknw huA0@6-%&k-1qI6fSt4#>=sHMk>8fztq9_ nw:>NxHfib Lx.c QEWg\@y@ ~[*+-Dze~Ej+%.E`|IdW#o~#` MM These are both major barriers to optimal medical care. 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. 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. For example, it can be be used with healthy eating, physical activity and behavior change. ). I wonder whose pockets got lined with that one. Moreover, it is strongly recommended to avoid or limit the alcohol intake. (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. It is an appetite suppressant with the added ability to help the body produce more energy from fat cells. LiverTox National Institutes of Health. %%EOF \ Detailed Phentermine dosage information Related/similar drugs Advertising revenue supports our not-for-profit mission. It is vital to talk with the doctor before using Phentermine with other products. It is important not to perform activities that require a patient to be alert while experiencing mental impairment as an adverse effect. 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. Children 15 years of age and youngerUse is not recommended. Gastrointestinal symptoms include nausea, vomiting, diarrhea and abdominal cramps. Overdosage of pharmacologically similar compounds has resulted in fatal poisoning usually terminates in convulsions and coma. Doctors often advise patients that in the case of more serious side effects, they should immediately call for assistance. Swallow the tablet whole. Patients must be informed about the risks of use of Phentermine (including the risks discussed in Warnings and Precautions), about the symptoms of potential adverse reactions and when to contact a physician and/or take other action. Swallow the extended-release capsule whole. 6 Symptoms of extremely high blood pressure, such as uneven heartbeats, chest pain, blurred vision, anxiety and a severe headache. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. "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. 104 0 obj <> endobj 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. 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. Also, it may cause certain side effects to become much worse. Since 1997, allnurses is trusted by nurses around the globe. 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. These are two schedule- IV medications, phentermine/topiramate (Qsymia), and locaserin (Belviq), as well as non-controlled naltrexone hydrochloride/ buproprion hydrochloride (Contrave). Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [see ClinicalPharmacology (12.3)]. If we combine this information with your protected "@Hw4`tqCA\+ q [AF]` b L ! 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. Alternatively, 18.75 mg twice daily. Phentermine is a popular prescription drug that is often used to treat obesity. Your doctor may prescribe both of these drugs separately, or choose to prescribe Qsymia, which is another medication that combines Phentermine and Topamax. If you are a good candidate for the medication, but your doctor does not prescribe phentermine, ask for a referral. Encourage prescribers to incorporate best clinical practices when prescribing opioids for treating Ohio . Precaution should be taken if a patient has any existing health concerns as the drug may cause further harm to their body. The drug is always accompanied by increased physical activity and a diet that includes a lower amount of calories. 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. When performing prospective DUR, the pharmacist notices a 30-day gap in treatment. Unfortunately, the answer is no in most cases. Comprehensive review of current and upcoming anti-obesity drugs. 0 Columbus, Ohio 43215 Phone: (614) 466-3934 Web: www.med.ohio.gov State Medical Board of Ohio 30 E . The initial symptom of PPH is usually dyspnea. 2020; doi:10.4093/dmj.2020.0258. This includes Chapter 4731-11, OAC, Controlled Substances pertaining to the prescribing of schedule II, III, and IV medications for purposes of weight loss. Tell patients to keep Phentermine in a safe place to prevent theft, accidental overdose, misuse or abuse. Members of Losing Weight with Phentermine Support Group on Facebook. Adults and children 17 years of age and older. The first use of Phentermine as a drug to help treat obesity dates back to 1938. State Medical Board of Ohio 30 E. Broad Street, 3rd Floor, Columbus, OH 43215-6127 (614) 466-3934 med.ohio.gov 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. endstream endobj startxref There is a problem with Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. Rule 4731-11-01 | Definitions. [Who Prescribed Your Phentermine?]. This medicine is available in four forms: capsules, disintegrating tablets, extended-release capsules, and tablets. CIV ]c,'303:20/) @d` )2 Carefully follow your doctor's instructions for a reduced-calorie diet plan and regular exercise. Losing weight during pregnancy can harm both a mother and her baby. A reduction in insulin or oral hypoglycemic medications in patients with diabetes mellitus may be required. OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. 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. 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 https://www.micromedexsolutions.com. Sign-up for our weekly newsletter! Phentermine: 18.75 to 37.5 milligrams (mg) once a day, taken before breakfast or 1 to 2 hours after breakfast. Is Phentermine a Controlled Substance? In some cases, patients have also found that Phentermine interacts with drugs that contain Tranylcypromine, Henelzine, Isocarboxazid, Diethylpropion, Phendimetrazine, Amphetamine, and Benzphetamine. It is impossible for them to complete the necessary physical evaluation (and follow-up) that is required to ensure that phentermine will not cause you undue harm. This content does not have an Arabic version. I hold a DEA cert. Phentermine is not to be used while pregnant or breastfeeding under any circumstances. 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. Phentermine is related chemically and pharmacologically to amphetamine (d- and dll-amphetamine) and other related stimulant drugs have been extensively abused. << /Length 5 0 R /Filter /FlateDecode >> Selling or giving away Phentermine may harm others and is against the law. Create well-written care plans that meets your patient's health goals. 1530 0 obj <> endobj It is important to follow these instructions religiously. Use caution in prescribing Phentermine for patients with even mild hypertension (risk of increase in blood pressure). Won Son J, et al. Drug information provided by: IBM Micromedex. United States of America, Drug Enforcement Administration, Federal Register. 2 Some patients experience an increase in sexual interest, while others notice that they have a lower libido. A doctor is the only person who can determine if phentermine is right for you. Available for Android and iOS devices. Therefore, coadministration of Phentermine and these drug products is not recommended. It can help weight loss by making you less hungry. Your email address will not be published. ). Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Wait, so NPs may prescribe Qsymia, but not phentermine? 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. Phentermine is a Schedule IV controlled substance. The patient could have had the prescription for the month of October filled at another pharmacy. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. %PDF-1.3 The final option is online doctors who prescribe phentermine. It is freely soluble in water; sparingly soluble in warm alcohol, insoluble in chloroform, acetone, ether and benzene. = You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Package insert / product label Specializes in Cardiology, Research, Family Practice. Perreault L. Obesity in adults: Drug therapy. 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. Some preparations of the formula, however, have been classified as schedule II drugs. Mid-Level Practitioners Authorization by State Pursuant to Title 21, Code of Federal Regulations, Section 1300.01(b28), the term mid-level practitioner means an individual 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. Drug classes: Anorexiants, CNS stimulants. This combination of ingredients was branded as Fen-Phen. Different brands manufacture, distribute and sell Phentermine drugs. Doctors often combined the use of Phentermine with diuretics, thyroid hormone medicines and digitalis. The most severe manifestation of chronic intoxications is psychosis, often clinically indistinguishable from schizophrenia. 121 0 obj <>/Filter/FlateDecode/ID[<5D80FCFEE48BF540827EEA7155FB4128>]/Index[104 35]/Info 103 0 R/Length 85/Prev 180155/Root 105 0 R/Size 139/Type/XRef/W[1 2 1]>>stream All trademarks are the property of their respective owners. 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)]. By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. phentermine, one tablet daily, #30 on September 1, 2013. As phentermine is similar to amphetamine, it is a controlled drug (class C5) and has the potential for abuse. Diabetes & Metabolism Journal. The health information contained here is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. 4 Highlighted below are the topics discussed at the meeting that OSMA is closely following. How Is Phentermine Dosed? allnurses, LLC, 175 Pearl St Ste 355, Brooklyn NY 11201 Cumulative urinary excretion of Phentermine under uncontrolled urinary pH conditions was 62% to 85%.