More specifically, this medication is an option for people with a body mass index (BMI): Greater than 30 kg/m2 Greater than 27 kg/m2 + one or more weight-related condition Alternatively, 18.75 mg twice daily. [Who Prescribed Your Phentermine?]. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Ohio has some of the strictest rules in the country and. Highlighted below are the topics discussed at the meeting that OSMA is closely following. Y$iqzZz\vlt1a;svw&aBS8Z(HGCkr&_Qxt97t,GWceTL^QqX(%8_A2'"%tD'DNz"G*"Tc. If not, additional education or an additional certification may be needed. 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. Phentermine is not recommended for use in pediatric patients 16 years of age. 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. 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. Choosing a specialty can be a daunting task and we made it easier. ). Metabolism Phentermine has two metabolic pathways; hydroxylation and oxidation. Even patients who are overweight and pregnant at the same time are not allowed to use this product. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. To provide you with the most relevant and helpful information, and understand which 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. Please consult with your physician before you make any decisions regarding your health. Phentermine.com is a property of: Careworld LLC. 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. At January's meeting, the board discussed the rules and elected to investigate what other states are doing to regulate weight loss medication. 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. 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. If the drug is taken too late in the day, it may also cause insomnia. There is a problem with Phentermine is a popular prescription drug that is often used to treat obesity. Package insert / product label All rights reserved. It also isn't for people who are pregnant, may become pregnant or are breastfeeding. The Topamax is added to Phentermine in order to intensify its effects and to help patients lose weight faster. It is important to follow these instructions religiously. Your email address will not be published. If you are a good candidate for the medication, but your doctor does not prescribe phentermine, ask for a referral. 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. information is beneficial, we may combine your email and website usage information with 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. Overstimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, psychosis. 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. PDF Reference ID: 3115694 - Food and Drug Administration 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. After 12 weeks, the patient needs to take a break from the product as it may lead to physical dependence. If a patient would like to take other supplements, they should consult their doctor first. 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. 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 Make sure your hands are dry before touching the tablet. Phentermine HCl Tablets, USP 37.5 mg Prescribing phentermine - Medical Protection Phentermine is approved for use for up to 12 weeks. Some people also receive a phentermine prescription from their gynecologist (OB-GYN). 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. 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. 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 Phentermine is pregnancy category X, so it should never be taken while pregnant or nursing ( Review/update the information submitted for this request. "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. In addition to its function as an appetite suppressant, Phentermine drugs also act as energy boosters. The magnitude of increased weight loss of drug-treated patients over placebo-treated patients is only a fraction of a pound a week. ADIPEX-P (phentermine hydrochloride) tablets, for oral use CIV ADIPEX-P (phentermine hydrochloride) capsules, for oral use CIV Initial U.S. Approval: 1959 Store at 20 to 25C (68 to 77F) [See USP Controlled Room Temperature]. Phentermine Hydrochloride Tablets, USP 37.5 mg are white oval shaped bisected tablet with blue specs, debossed with 810 on bisected side. Mayo Clinic does not endorse companies or products. Tablets: 37.5 mg phentermine hydrochloride, USP (equivalent to 30 mg phentermine base). This content does not have an Arabic version. 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. Unpublished raw data. Unfortunately, the answer is no in most cases. 4 Despite the initial draw of saving time and money by completing your consultation online and receiving weight loss pills in the mail, using these online phentermine doctors is not safe. Tablets are packaged in bottles of 100 (NDC 42806-810-01); and 1000 (NDC 42806-810-10). ). Along with Ohio's telehealth law in Sub. 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. Children 15 years of age and youngerUse is not recommended. Below is a chart of body mass index (BMI) based on various heights and weights. Six years after the approval, a similar drug, called Aminorex, were released in Europe with the same purpose of helping obese individuals. PDF What Every Pharmacist Needs to Know About Controlled Substances in 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. information highlighted below and resubmit the form. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendations in this regard. Rule 4731-11-02 | General provisions. The plasma protein binding decreases as blood topiramate increases. Phentermine is a popular prescription drug that is often used to treat obesity. Prescribing Phentermine in ohio - Nurse Practitioners, NP - allnurses The medical board is currently reviewing its long-standing rules regarding prescribing controlled substances for the treatment of obesity. 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. 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. %PDF-1.6 % PDF State Medical Board of Ohio The most common side effects that patients experience include tremors, headaches, dizziness, dry mouth, diarrhea, constipation, upset stomach, feeling restless and being hyperactive. Ask your healthcare professional how you should dispose of any medicine you do not use. Required fields are marked *. Phentermine hydrochloride (phentermine HCL) is the active ingredient in phentermine weight loss pills. These are both major barriers to optimal medical care. 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. It depends on supplements a patient would like to take. Some brands use a dissolving tablet that is placed under the tongue, which allows the body to absorb the chemicals in the drug faster. = Perreault L. Obesity in adults: Drug therapy. But regarding phentermine monotherapy, phentermine hydrochloride (HCl) is a sympathomimetic Drug Enforcement Agency (DEA) scheduled IV drug approved as an anti-obesity medication and marketed in the US since 1959 (See Table 1).The reported weight reduction efficacy of phentermine [10] derived from . However, if it is almost time for your next dose, skip the missed dose and go back to your . Do not double doses. The usual duration of treatment is 12 weeks or less. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. Losing weight during pregnancy can harm both a mother and her baby. Tablets containing 37.5 mg Phentermine hydrochloride (equivalent to 30 mg Phentermine base). endstream endobj startxref Doctors often combined the use of Phentermine with diuretics, thyroid hormone medicines and digitalis. 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)]. This is a label given to drugs that can be misused. "@Hw4`tqCA\+ q [AF]` b L ! 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. Take 1 tablet or capsule once a day before breakfast or 1-2 hours after breakfast. 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. Rule 4731-11-04 - Ohio Administrative Code | Ohio Laws However, the medication does have a considerable street value. 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. 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)]. Want to get more tips, information, and motivation? Especially considering Ohios ability to track the prescribing and dispensing of the drug in Ohios drug database, OARRS. LiverTox National Institutes of Health. If the time is too close to the next dose, it is recommended to skip the dose they have missed. privacy practices. W0Qxe {>x??}# cGCSGGC[G(P A@3'i~ (2[n! They inhibit the activity of an entire enzyme family known as monoamine oxidase. While the drug is considered to be relatively safe for individuals who are older than 16, the recommended age is 18. I am finding limited information. 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. Mayo Clinic Proceedings. Wait, so NPs may prescribe Qsymia, but not phentermine? It is important not to perform activities that require a patient to be alert while experiencing mental impairment as an adverse effect. Learn about phentermine and succeed in your weight loss journey. You may opt-out of email communications at any time by clicking on Start with your primary care doctor and schedule an appointment to discuss weight. Phentermine Hydrochloride Tablets are indicated only as short-term (a few weeks) monotherapy for the management of exogenous obesity. Phendimetrazine Prescribing Information - Drugs.com The State Medical Board of Ohio met on January 13, 2021. It can help weight loss by making you less hungry. A single copy of these materials may be reprinted for noncommercial personal use only. 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. Patients are advised to report any symptoms or diseases they may have before the doctor prescribes the drug this may include high blood pressure and kidney problems, as well as any type of diabetes and thyroid disorders. 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. Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. 5 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. 1 The combined drug is approved for long-term use. 138 0 obj <>stream If you miss a dose of this medicine, take it as soon as possible. Although phentermine is the agent-of-choice among physicians specializing in obesity treatment, the use of this drug for obesity treatment by other physicians has long been curtailed because misapprehensions regarding phentermine safety. Specializes in NICU, PICU, Transport, L&D, Hospice. All rights reserved. %%EOF 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. , 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 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. 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. Patients should be advised to report immediately any deterioration in exercise tolerance. The initial symptom of PPH is usually dyspnea. 1 Taking Phentermine depends on the brand and preparation of the drug. Phentermine may decrease the hypotensive effect of adrenergic neuron blocking drugs. Other initial symptoms may include angina pectoris, syncope or lower extremity edema. 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. Numerous side effects have been linked to the use of Phentermine. Selling or giving away Phentermine may harm others and is against the law. Following the administration of Phentermine, Phentermine reaches peak concentrations (Cmax) after 3 to 4.4 hours. Patients must be instructed on how much Phentermine to take, and when and how to take it [see Dosage and Administration (2)]. Phentermine also has many potential drug interactions (e.g., with MAOIs), so the prescribing doctor and pharmacist know about ALL other medications and supplements taken within the last two weeks. Phentermine hydrochloride: Usual dosage is 8 mg 3 times daily (given 30 minutes before meals) or 15-37.5 mg once daily (in the morning). Encourage prescribers to incorporate best clinical practices when prescribing opioids for treating Ohio . , Swallow the tablet whole. How Is Phentermine Dosed? Adipex-P (phentermine hydrochloride) capsules label, Greater than 27 kg/m2 + one or more weight-related condition, Vitals (heart rate, blood pressure, etc. Obesity pillars roundtable: Phentermine - Past, present, and future The risks include, but are not limited to: See also, for example, Adverse Reactions (6) and Use in SpecificPopulations (8). Phentermine: 18.75 to 37.5 milligrams (mg) once a day, taken before breakfast or 1 to 2 hours after breakfast. (2019). Lomaira: One tablet three times a day, taken 30 minutes before meals. ). RPYcn@b[%XYK'Q %[.()GTkJ WCf.-i>n-oIzE*D40f#Gp'LcddmE8;>u?X"tO 1]M={4,ReC8E8Z Q1Lt$-XpFCrTJ 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. Advertising revenue supports our not-for-profit mission. Carefully follow your doctor's instructions for a reduced-calorie diet plan and regular exercise. Broad St., 3 rd Floor GUIDANCE DOCUMENT: Physician Assistant Prescriptive Authority Effective 10/15/15 The following information is provided as guidance, and may not reference all statutes and rules Studies have not been performed with Phentermine to determine the potential for carcinogenesis, mutagenesis or impairment of fertility. As a reminder, Ohio law requires physicians who prescribe any controlled substances, not just opioids, to submit an ICD-10 code with that prescription. Some of the studies that have linked Phentermine to positive results in humans include: The main active ingredient is known as Phentermine Hydrochloride. Cardiovascular effects include arrhythmia, hypertension or hypotension, and circulatory collapse. Dr. Lazarus, we will discuss combination phentermine therapy later in this roundtable discussion. 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. 2021; doi:10.1007/s13679-020-00422-w. Other brands of this drug include Suprenza, Phentercot, Acxion, Elvenir, Terflamex, Panbesy, Duromine, Fentermina, Phentermin, PHentermine and Lomaira. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Ohio Administrative Code 4731-11-04 and 4731-11-04.1. Copyright 2023 IBM Watson Health. Children 16 years of age and youngerUse is not recommended. But weight management can take time. The drug is also available in regular capsules that are taken orally with a glass of water. 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. 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)]. However in the presence of topiramate, Phentermine Cmax and AUC increase 13% and 42%, respectively. All rights reserved. While discussing the use of Phentermine with the doctor, a patient is provided a list of lifestyle changes to implement while using this product. However, it caused a chronic condition known as pulmonary hypertension, which led to the death of many patients. hb``````>X,K10wdjdZ(`l Ro4' b2h>$:-9.AKL1}c$vEP;-@c=en`Y %YQh` &^ Today, Phentermine can still be obtained through the doctors prescription in the majority of countries around the world. PDF label - Food and Drug Administration 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. These are two schedule- IV medications, phentermine/topiramate (Qsymia), and locaserin (Belviq), as well as non-controlled naltrexone hydrochloride/ buproprion hydrochloride (Contrave). All trademarks are the property of their respective owners. Phentermine hydrochloride, an anorectic agent for oral administration, is available as a tablet containing 37.5 mg of Phentermine hydrochloride (equivalent to 30 mg of Phentermine base). allnurses is a Nursing Career & Support site for Nurses and Students. The medication has been classified as a controlled substance in most countries and is also classified as a schedule IV prescription drug. Do not crush, break, or chew it. (1/19/2016) Ohio Strenthens Opioid Prescribing Guidlines to Further Prevent Prescription Drug Abuse and Save . Phentermine is a Schedule IV controlled substance. Many people live far away from their nearest weight loss clinic, which can make follow-ups complicated. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo subjects and tends to decrease in succeeding weeks. Create well-written care plans that meets your patient's health goals. United States of America, Drug Enforcement Administration, Federal Register. Your email address will not be published. Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [see ClinicalPharmacology (12.3)]. hWmo8+jE'"m{F 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. All rights reserved.5115 Parkcenter Avenue Suite 200 Dublin, OH 43017ph: 800.766.6762info@osma.org. Take this medicine only as directed by your doctor. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. 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. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Metric conversions are as follows: pounds 2.2 = kg; inches x 0.0254 = meters. (2009, April 06). Generic name: Phentermine hydrochloride Symptoms of extremely high blood pressure, such as uneven heartbeats, chest pain, blurred vision, anxiety and a severe headache. 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). Is Phentermine a Controlled Substance? Existing health conditions that may act as a problem include diabetes, thyroid disorders, hypertension and kidney disease. << /Length 5 0 R /Filter /FlateDecode >> Le81g Of Rdb-YR!bLEbfYo9(e The drug has two primary functions in the human body, which is the reason why it is always accompanied by these lifestyle changes. Phentermine also is offered combined with topiramate for weight loss (Qsymia). Phentermine: MedlinePlus Drug Information