certain predisposed pts. only. prochlorperazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promazineMonitor Closely (1)promazine, phentermine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.promethazineMonitor Closely (2)promethazine, phentermine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. promethazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propylhexedrineMonitor Closely (2)phentermine and propylhexedrine both decrease sedation. Use Caution/Monitor. phentermine and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.protriptylineMonitor Closely (1)protriptyline increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)protriptyline, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.pseudoephedrineMonitor Closely (1)phentermine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (1)quetiapine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.rasagilineSerious - Use Alternative (1)rasagiline increases effects of phentermine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Phentermine should not be administered during or within 14 days following the use of most MAOIs or drugs with MAO-inhibiting activity. Risk of acute hypertensive episode. .risperidoneMonitor Closely (1)risperidone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sageMinor (1)sage increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.salmeterolMonitor Closely (2)salmeterol and phentermine both decrease sedation. Use Caution/Monitor. salmeterol and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.scullcapMonitor Closely (1)scullcap increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.selegilineSerious - Use Alternative (1)selegiline increases effects of phentermine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Phentermine should not be administered during or within 14 days following the use of most MAOIs or drugs with MAO-inhibiting activity. Risk of acute hypertensive episode. .selegiline transdermalContraindicated (1)selegiline transdermal increases effects of phentermine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.serdexmethylphenidate/dexmethylphenidateMonitor Closely (2)serdexmethylphenidate/dexmethylphenidate and phentermine both decrease sedation. Use Caution/Monitor. serdexmethylphenidate/dexmethylphenidate and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sertralineSerious - Use Alternative (1)sertraline, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.sevofluraneSerious - Use Alternative (1)sevoflurane increases toxicity of phentermine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.shepherd's purseMonitor Closely (1)shepherd's purse increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.solriamfetolMonitor Closely (1)phentermine and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sufentanilMonitor Closely (1)sufentanil increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.temazepamMonitor Closely (1)temazepam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.terbutalineMonitor Closely (2)terbutaline and phentermine both decrease sedation. Use Caution/Monitor. terbutaline and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.thioridazineMonitor Closely (2)thioridazine, phentermine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. thioridazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.topiramateMonitor Closely (1)topiramate increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)tramadol increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineContraindicated (1)tranylcypromine increases effects of phentermine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneMonitor Closely (1)trazodone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)trazodone, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. trazodone, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.triazolamMonitor Closely (1)triazolam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (2)trifluoperazine, phentermine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. trifluoperazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.triprolidineMonitor Closely (1)triprolidine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.venlafaxineSerious - Use Alternative (1)venlafaxine, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.xylometazolineMonitor Closely (2)phentermine and xylometazoline both decrease sedation. Use Caution/Monitor. phentermine and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.yerba mateMinor (1)yerba mate increases effects of phentermine by pharmacodynamic synergism. Minor/Significance Unknown.yohimbeSerious - Use Alternative (1)yohimbe, phentermine. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.yohimbineMonitor Closely (2)phentermine and yohimbine both decrease sedation. Use Caution/Monitor. phentermine and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ziconotideMonitor Closely (1)ziconotide increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziprasidoneMonitor Closely (1)ziprasidone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. Frequency Not Defined Bad taste in mouth Blurred vision Changes in libido Chills Constipation Diarrhea Drug-induced GI disturbance Dry mouth Dysphoric mood Dysuria Excitement Hair loss Headache Hypertension Impotence Insomnia Myalgia Nausea Nervousness Palpitations Restlessness Tachycardia Tremor Urticaria Vomiting Serious Heart valve disorder Primary pulmonary hypertension Psychotic disorder Contraindications Known hypersensitivity or idiosyncratic reaction to sympathomimetic amines History of cardiovascular disease (coronary artery disease, uncontrolled hypertension, arrhythmias, stroke, congestive heart failure) Glaucoma Agitated states Hyperthyroidism History of drug abuse Use of monoamine oxidase inhibitors (MAOIs) within preceding 14 days; concomitant administration of other CNS stimulants Pregnancy and breast feeding Cautions Primary pulmonary hypertension and valvular disease have been reported with therapy Avoid use of stimulants in patients with serious heart rhythm disturbances, cardiac abnormalities, cardiomyopathies, or other cardiac problems (see Contraindications) Caution in hypertension; risk of increase in blood pressure Patients with diabetes mellitus should use caution with antidiabetic agents like insulin or other hypoglycemic agents; dietary restrictions may lower requirements for antidiabetic therapy Drug has not been studied in renal impairment Use with caution in patients with seizure disorders or Tourette syndrome May impair ability to operate heavy machinery Concomitant administration with other weight-loss agents (eg, selective serotonin reuptake inhibitors [SSRIs], herbal preparations, other over-the-counter products) has not been studied Elderly are at high risk for myocardial infarction, hypertension, angina, or becoming dependent on phentermine with prolonged use Discontinue if weight loss has not occurred with 4 weeks of therapy Not approved for long-term use Discontinue if tolerance develops, and do not exceed recommended dosage to overcome tolerance Pregnancy category: X Lactation: Unknown if excreted in milk; contraindicatedPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Amphetamine-related anorexigenic agent; action in reducing appetite may be secondary to CNS effects that may involve stimulation of hypothalamus to release norepinephrine Absorption Peak plasma time: 3.0-4.4 hr (orally disintegrating tablet) Elimination Excretion: Urine (primarily) BRAND FORM. UNIT PRICE PILL IMAGE Adipex-P oral- 37.5 mg tabletAdipex-P oral- 37.5 mg capsuleAdipex-P oral- 37.5 mg tabletAdipex-P oral- 37.5 mg tabletLomaira oral- 8 mg tabletphentermine oral- 37.5 mg tabletphentermine oral- 37.5 mg tabletphentermine oral- 37.5 mg tabletphentermine oral- 37.5 mg capsulephentermine oral- 15 mg capsulephentermine oral- 30 mg capsulephentermine oral- 37.5 mg tabletphentermine oral- 15 mg capsulephentermine oral- 30 mg capsulephentermine oral- 37.5 mg tabletphentermine oral- 30 mg capsulephentermine oral- 30 mg capsulephentermine oral- 30 mg capsulephentermine oral- 37.5 mg capsulephentermine oral- 30 mg capsulephentermine oral- 15 mg capsulephentermine oral- 37.5 mg tabletphentermine oral- 30 mg capsulephentermine oral- 30 mg capsulephentermine oral- 37.5 mg capsulephentermine oral- 37.5 mg tabletphentermine oral- 15 mg capsulephentermine oral- 30 mg capsuleCopyright © 2010 First DataBank, Inc.Print Patient Educationphentermine oral PHENTERMINE - ORAL (FEN-ter-meen) COMMON BRAND NAME(S): Adipex-P, Ionamin, Pro-Fast USES: Phentermine is used with a doctor-approved exercise, behavior change, and reduced-calorie diet program to help you lose weight. It is used by certain overweight people, such as those who are obese or have weight-related medical problems. Losing weight and keeping it off can lessen the many health risks that come with obesity, including heart disease, diabetes, high blood pressure, and a shorter life.It is not known how this medication helps people to lose weight. It may work by decreasing your appetite, increasing the amount of energy used by your body, or by affecting certain parts of the brain. This medication is an appetite suppressant and belongs to a class of drugs called sympathomimetic amines. HOW TO USE: Take this medication by mouth as directed by your doctor, usually once a day, 1 hour before breakfast or 1 to 2 hours after breakfast. If needed, your doctor may adjust your dose to take a small dose up to 3 times a day. Carefully follow your doctor's instructions. Taking this medication late in the day may cause trouble sleeping (insomnia).If you are using sustained-release capsules, the dose is usually taken once a day before breakfast or at least 10 to 14 hours before bedtime. Swallow the medication whole. Do not crush or chew sustained-release capsules. Doing so can release all of the drug at once, increasing the risk of side effects.If you are using the tablets made to dissolve in the mouth, the dose is usually taken once a day in the morning, with or without food. First, dry your hands before handling the tablet. Place your dose on top of the tongue until it dissolves, then swallow it with or without water.The dosage and length of treatment are based on your medical condition and response to treatment. Your doctor will adjust the dose to find the best dose for you. Discuss the risks and benefits, and the length of phentermine treatment, with your doctor. To get the most benefit, take this medication regularly, exactly as prescribed, and for as long as directed by your doctor. To help you remember, take it at the same time(s) each day.If you suddenly stop using this medication, you may have withdrawal symptoms (such as depression, severe tiredness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used phentermine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a