Yes

Anorexiant

Short-term adjunct in a regimen of weight reduction based on exercise, behavioral modification, and caloric reduction in the management of exogenous obesity for patients with an initial body mass index greater than or equal to 30 kg/m² or greater than or equal to 27 kg/m² in the presence of other risk factors (diabetes, hypertension)

5'0"

140 lb: BMI = 27

150 lb: BMI = 29

160 lb: BMI = 31

170 lb: BMI = 33

180 lb: BMI = 35

190 lb: BMI = 37

200 lb: BMI = 39

210 lb: BMI = 41

220 lb: BMI = 43

230 lb: BMI = 45

240 lb: BMI = 47

250 lb: BMI = 49

5'3"

140 lb: BMI = 25

150 lb: BMI = 27

160 lb: BMI = 28

170 lb: BMI = 30

180 lb: BMI = 32

190 lb: BMI = 34

200 lb: BMI = 36

210 lb: BMI = 37

220 lb: BMI = 39

230 lb: BMI = 41

240 lb: BMI = 43

250 lb: BMI = 44

5'6"

140 lb: BMI = 23

150 lb: BMI = 24

160 lb: BMI = 26

170 lb: BMI = 28

180 lb: BMI = 29

190 lb: BMI = 31

200 lb: BMI = 32

210 lb: BMI = 34

220 lb: BMI = 36

230 lb: BMI = 37

240 lb: BMI = 39

250 lb: BMI = 40

5'9"

140 lb: BMI = 21

150 lb: BMI = 22

160 lb: BMI = 24

170 lb: BMI = 25

180 lb: BMI = 27

190 lb: BMI = 28

200 lb: BMI = 30

210 lb: BMI = 31

220 lb: BMI = 33

230 lb: BMI = 34

240 lb: BMI = 36

250 lb: BMI = 37

6'0"

140 lb: BMI = 19

150 lb: BMI = 20

160 lb: BMI = 22

170 lb: BMI = 23

180 lb: BMI = 25

190 lb: BMI = 26

200 lb: BMI = 27

210 lb: BMI = 29

220 lb: BMI = 30

230 lb: BMI = 31

240 lb: BMI = 33

250 lb: BMI = 34

6'3"

140 lb: BMI = 18

150 lb: BMI = 19

160 lb: BMI = 20

170 lb: BMI = 21

180 lb: BMI = 23

190 lb: BMI = 24

200 lb: BMI = 25

210 lb: BMI = 26

220 lb: BMI = 28

230 lb: BMI = 29

240 lb: BMI = 30

250 lb: BMI = 31

C-IV

C

Known hypersensitivity or idiosyncrasy to sympathomimetic amines; patients with advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension (stage II or III), hyperthyroidism, glaucoma, agitated states; patients with a history of drug abuse; use during or within 14 days following MAO inhibitor therapy; stimulant medications are contraindicated for use in children with attention deficit/hyperactivity disorders and concomitant Tourette's syndrome or tics

Use with caution in patients with bipolar disorder, diabetes mellitus, cardiovascular disease, seizure disorders, insomnia, porphyria, or mild hypertension (stage I). May exacerbate symptoms of behavior and thought disorder in psychotic patients. Potential for drug dependency exists - avoid abrupt discontinuation in patients who have received for prolonged periods. Use in weight reduction programs only when alternative therapy has been ineffective. Stimulant use has been associated with growth suppression, and careful monitoring is recommended.

Cardiovascular: Hypertension, palpitations, tachycardia, primary pulmonary hypertension and/or regurgitant cardiac valvular disease

Central nervous system: Euphoria, insomnia, overstimulation, dizziness, dysphoria, headache, restlessness, psychosis

Dermatologic: Urticaria

Gastrointestinal: Nausea, constipation, xerostomia, unpleasant taste, diarrhea

Endocrine & metabolic: Changes in libido, impotence

Hematologic: Blood dyscrasias

Neuromuscular & skeletal: Tremor

Ocular: Blurred vision

Symptoms of overdose include hyperactivity, agitation, hyperthermia, hypertension, seizures

There is no specific antidote for phentermine intoxication and the bulk of the treatment is supportive. Hyperactivity and agitation usually respond to reduced sensory input, however with extreme agitation haloperidol (2-5 mg I.M. for adults) may be required. Hyperthermia is best treated with external cooling measures, or when severe or unresponsive, muscle paralysis with pancuronium may be needed. Hypertension is usually transient and generally does not require treatment unless severe. For diastolic blood pressures >110 mm Hg, a nitroprusside infusion should be initiated. Seizures usually respond to diazepam IVP and/or phenytoin maintenance regimens.

Phentermine may decrease the hypotensive effect of guanethidine and other antihypertensives

Hypoglycemic agents may need to be adjusted when phentermine is used in a diabetic receiving a special diet

Phentermine is structurally similar to dextroamphetamine and is comparable to dextroamphetamine as an appetite suppressant, but is generally associated with a lower incidence and severity of CNS side effects. Phentermine, like other anorexiants, stimulates the hypothalamus to result in decreased appetite; anorexiant effects are most likely mediated via norepinephrine and dopamine metabolism. However, other CNS effects or metabolic effects may be involved.

Absorption: Well absorbed; resin absorbed slower and produces more prolonged clinical effects

Half-life: 20 hours

Elimination: Primarily unchanged in urine

Oral:

Adults: 8 mg 3 times/day 30 minutes before meals or food or 15-37.5 mg/day before breakfast or 10-14 hours before retiring

CNS

Use vasoconstriction with caution in patients taking phentermine. Amphetamines enhance the sympathomimetic response of epinephrine and norepinephrine leading to potential hypertension and cardiotoxicity.

Up to 10% of patients may present with hypertension. The use of local anesthetic without vasoconstrictor is recommended in these patients.

Take during day to avoid insomnia; do not discontinue abruptly, may cause physical and psychological dependence with prolonged use

Dose should not be given in evening or at bedtime

Capsule, as hydrochloride: 15 mg, 18.75 mg, 30 mg, 37.5 mg

Capsule, resin complex, as hydrochloride: 15 mg, 30 mg

Tablet, as hydrochloride: 8 mg, 37.5 mg

Devan GS, "Phentermine and Psychosis," Br J Psychiatry, 1990, 156:442-3.

Hamer R and Phelps D, "Inadvertent Intra-arterial Injection of Phentermine: A Complication of Drug Abuse," Ann Emerg Med, 1981, 10:148-50.

Kokkinos J and Levine SR, "Possible Association of Ischemic Stroke With Phentermine," Stroke, 1993, 24(2):310-3.

Levine B, Caplan YH, and Dixon AM, "A Fatality Involving Phentermine," J Forensic Sci, 1984, 29(4):1242-5.