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phentermine

 
Dictionary: phen·ter·mine   (fĕn'tər-mēn') pronunciation
n.
A drug that suppresses appetite by altering the body's metabolism of the neurotransmitters serotonin and norepinephrine, used in the management of obesity.

[PHEN(YL) + TER(TIARY) + (butyla)mine, one of its constituents.]


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Food and Nutrition: phentermine
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An appetite suppressant drug used in the treatment of obesity, especially in combination with fenfluramine (fen-phen); withdrawn in 1995 because of reports of heart valve damage.

Drug Info: Phentermine
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Brand names: Adipex-P®Atti-Plex P™Fastin®Ionamin®Kraft-Obese™Pro-Fast™ HSPro-Fast™ SAPro-Fast™ SRTara-8™

Chemical formula:



Phentermine Hydrochloride Oral tablet

What is this medicine?

PHENTERMINE decreases your appetite. It is used with a reduced calorie diet and exercise to help you lose weight.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•agitation
•glaucoma
•heart disease
•high blood pressure
•history of substance abuse
•lung disease called Primary Pulmonary Hypertension (PPH)
•thyroid disease
•an unusual or allergic reaction to phentermine, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. This medicine is usually taken 30 minutes before or 1 to 2 hours after breakfast. Avoid taking this medicine in the evening. It may interfere with sleep. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
•duloxetine
•MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
•medicines for colds or breathing difficulties like pseudoephedrine or phenylephrine
•procarbazine
•sibutramine
•SSRIs like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline
•stimulants like dexmethylphenidate, methylphenidate or modafinil
•venlafaxine

This medicine may also interact with the following medications:
•medicines for diabetes

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Notify your physician immediately if you become short of breath while doing your normal activities.

This medicine was intended to be used in addition to a healthy diet and exercise. The best results are achieved this way. This medicine is only indicated for short-term use. Eventually your weight loss may level out. At that point, the drug will only help you maintain your new weight. Do not increase or in any way change your dose without consulting your doctor.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•chest pain, palpitations
•depression or severe changes in mood
•increased blood pressure
•irritability
•nervousness or restlessness
•severe dizziness
•shortness of breath
•problems urinating
•unusual swelling of the legs
•vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•blurred vision or other eye problems
•changes in sexual ability or desire
•constipation or diarrhea
•difficulty sleeping
•dry mouth or unpleasant taste
•headache
•nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Medical Dictionary: phen·ter·mine
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(fĕn'tər-mēn')
n.

An oily liquid whose crystalline hydrochloride form is used in the treatment of obesity.

Wikipedia: Phentermine
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Phentermine
Systematic (IUPAC) name
2-methyl-1-phenylpropan-2-amine
Identifiers
CAS number 122-09-8
ATC code A08AA01 C01CA11
PubChem 4771
DrugBank APRD00093
ChemSpider 4607
Chemical data
Formula C10H15N 
Mol. mass 149.233 g/mol
Pharmacokinetic data
Bioavailability Peak plasma levels occur within 1 to 4.5 hours. Absorption is usually complete by 4 to 6 hours
Protein binding Approximately 96.3%
Metabolism hepatic
Half life 16 to 31 hours
Excretion Urinary elimination
Therapeutic considerations
Pregnancy cat.

C(US)

Legal status

Schedule IV(US)

Routes Oral, Insufflation, Intravenous
 Yes check.svgY(what is this?)  (verify)

Phentermine, a contraction of "phenyl-tertiary-butylamine", is an appetite suppressant of the amphetamine and phenethylamine class.

It is approved as an appetite suppressant to help reduce weight in obese patients when used short-term and combined with exercise, diet, and behavioral modification. It is typically prescribed for individuals who are at increased medical risk because of their weight and works by helping to release certain chemicals in the brain that control appetite.

Contents

History

In 1959 phentermine first received approval from the FDA as an appetite suppressing drug. Phentermine hydrochloride then became available in the early 1970s. It was previously sold as Fastin from King Pharmaceuticals for SmithKline Beecham, however in 1998 it was removed from the market. Medeva Pharmaceuticals sells the name brand of phentermine called Ionamin and Gate Pharmaceuticals sells it as Adipex-P. Phentermine is also currently sold as a generic. Since the drug was approved in 1959 there have been almost no clinical studies performed. The most recent study was in 1990 which combined phentermine with fenfluramine or dexfenfluramine and became known as Fen-Phen.[citation needed]

In 1997 after 24 cases of heart valve disease in Fen-Phen users, fenfluramine and dexfenfluramine were voluntarily taken off the market at the request of the FDA. Studies later proved that nearly 30% of people taking fenfluramine or dexfenfluramine had abnormal valve findings. The FDA did not ask manufacturers to remove phentermine from the market.

Phentermine is still available by itself in most countries, including the U.S. However, because it is similar to amphetamines, it is classified as a controlled substance in many countries. Internationally, phentermine is a schedule IV drug under the Convention on Psychotropic Substances.[1] In the United States, it is classified as a Schedule IV controlled substance under the Controlled Substances Act.

Mechanism of action

Phentermine.jpg

Phentermine, in doses clinically used, works on the hypothalamus portion of the brain to release norepinephrine, a neurotransmitter or chemical messenger that signals a fight-or-flight response, reducing hunger. Phentermine works outside the brain as well to release epinephrine or adrenaline causing fat cells to break down stored fat, but the principal basis of efficacy is hunger-reduction. At high doses, phentermine releases serotonin and dopamine as well, but such doses are never used in clinical medicine.[2]

Dosing and administration

Generally, it is recommended by the Food and Drug Administration (FDA) that phentermine should be used short-term (usually interpreted as 'up to 12 weeks'), while following nonpharmacological approaches to weight loss such as healthy dieting and exercise. [3]

Contraindications and warnings

  • Patients with the following should not use Phentermine:
  • Some medical conditions may interact with Phentermine, patients with the following should consult with their doctor before using phentermine:
  • Some medicines may interact with phentermine, such as the following:
    • Dexfenfluramine, fenfluramine, furazolidone, or MAOIs (eg, phenelzine) because the risk of serious side effects, such as increasing headache, high blood pressure, slow heart rate, elevated temperature, or possibly fatal lung problems, may be increased
    • Guanadrel(Hylorel) or guanethidine(Ismelin) because their effectiveness may be decreased by phentermine
    • Antacids: Antacids may decrease the excretion of phentermine. [4]
    • Carbonic anhydrase inhibitors (acetazolamide, dichlorphenamide, methazolamide): Carbonic anhydrase inhibitors may decrease the excretion of phentermine.[4]

Side effects

Generally, phentermine appears to be relatively well tolerated.[5] It can produce side effects consistent with its catecholamine-releasing properties, e.g., tachycardia (increased heart rate) and elevated blood pressure, but the incidence and magnitude of these appear to be less than with the amphetamines. Because phentermine acts through sympathomimetic pathways, the drug may increase blood pressure and heart rate. It may also cause palpitations, restlessness, and insomnia. Additionally, phentermine has the potential to cause physical and psychological dependence.

More common

  • Insomnia
  • Hypertension
  • Irritability
  • Nervousness
  • Euphoria
  • Dry mouth
  • Unpleasant taste
  • Blurred vision
  • Heartburn/Acid reflux
  • Changes in libido
  • Clumsiness
  • Confusion
  • Diarrhea
  • Dizziness
  • Headache
  • Arrhythmia
  • Nausea or vomiting
  • Psychosis
  • Skin rash or itching
  • Stomach pain
  • Fatigue
  • Pupil dilation

Less common

  • Convulsions (seizures)
  • Dizziness
  • Fever
  • Hallucinations
  • Hostility with urge to attack
  • Irregular blood pressure
  • Lightheadedness or fainting
  • Periods of mania followed by period of depression
  • Tremors, trembling or shaking
  • Overactive reflexes
  • Panic
  • Restlessness
  • Severe nausea, vomiting or diarrhea
  • Stomach cramps
  • Weakness

Commercial trade names

  • Adipex P (Immediate release)
  • Anoxine-AM
  • Ionamin (Slow Release Resin, Australia, discontinued in the US)
  • Duramine (Slow Release Resin, New Zealand, Australia & South Africa)
  • Mirapront
  • Obephen
  • Obermine
  • Obestin-30
  • Phentremene
  • Phentrol
  • Phenterex
  • Phentromin
  • Pro-Fast SA
  • Redusa
  • Panbesy
  • Phentermine Trenker
  • Obenix
  • Oby-Trim
  • Teramine
  • Zantryl
  • Sinpet (MX)
  • Supremin (PH)
  • Umine (NZ)
  • Weltmine (KP)

References

  1. ^ Incb.org (PDF file)
  2. ^ Rothman RB, Baumann MH, Dersch CM, et al. (January 2001). "Amphetamine-type central nervous system stimulants release norepinephrine more potently than they release dopamine and serotonin". Synapse 39 (1): 32–41. doi:10.1002/1098-2396(20010101)39:1<32::AID-SYN5>3.0.CO;2-3. PMID 11071707. 
  3. ^ http://www.fda.gov/bbs/topics/news/new00575.html
  4. ^ a b "Phentermine". Merck & Co., Inc.. 2008. http://www.merck.com/mmpe/lexicomp/phentermine.html. Retrieved 2008-05-15. 
  5. ^ Nelson DL, Gehlert DR (February 2006). "Central nervous system biogenic amine targets for control of appetite and energy expenditure". Endocrine 29 (1): 49–60. doi:10.1385/ENDO:29:1:149. PMID 16622292. 

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Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
Food and Nutrition. A Dictionary of Food and Nutrition. Copyright © 1995, 2003, 2005 by A. E. Bender and D. A. Bender. All rights reserved.  Read more
Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Medical Dictionary. The American Heritage® Stedman's Medical Dictionary Copyright © 2002, 2001, 1995 by Houghton Mifflin Company Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Phentermine" Read more