Of phentermine hcl action mechanism

General Information: Phentermine is an oral sympathomimetic amine used as an adjunct for short-term e. The pharmacologic effects of phentermine are similar to amphetamines. Phentermine hydrochloride was FDA approved in In the mids, there was renewed interest in phentermine in combination with another anorectic, fenfluramine, for the treatment of obesity and substance abuse, however, little scientific data support this practice.

Phentermine hcl July 8,the FDA issued a 'Dear Health Care Professional' letter warning physicians about the development of valvular heart disease and pulmonary hypertension in women receiving the combination of fenfluramine and phentermine; fenfluramine was subsequently withdrawn from the US market in fall of Use mechanism phentermine with other anorectic agents for obesity has not been evaluated and is not recommended.

In Maythe FDA approved a phentermine hydrochloride orally disintegrating tablet Suprenza for the treatment of exogenous obesity. Mechanism of Action: Limited data are available in reference texts regarding the mechanism of action of this drug. Phentermine is an analog of methamphetamine. Similar to the amphetamines, phentermine increases the release of norepinephrine and dopamine from nerve terminals and inhibits their reuptake.

Thus, phentermine is classified action an indirect sympathomimetic. Appetite action is believed to occur through direct stimulation of the satiety center in the hypothalamic and limbic region. Tolerance to the anorexiant effects of phentermine usually develops within a few weeks of starting therapy. The mechanism of tolerance "action" to be pharmacodynamic in nature; higher doses of phentermine are required to produce the same response.

When tolerance develops to the anorexiant effects, it is generally recommended that phentermine be discontinued rather than the dose increased. Phentermine is administered orally. The rate and extent of phentermine exposure under fasting conditions is equivalent regardless of oral formulation administered. Limited data exist on the pharmacokinetics of phentermine.

Phentermine is primarily excreted can you take advil cold and sinus with tramadol the kidneys. The elimination half-life ranges 19—24 hours and is influenced by urinary pH. Because the pKa of phentermine is 9. "Action" Pharmacokinetics: Oral Route: Following oral administration, most absorption of phentermine occurs from the small intestine.

The duration of action following administration of the 8 mg capsules or tablets is alprazolam make you feel 4 hours and 12—14 hours after administration of the 30 mg capsules or the Phentermine oral disintegrating tablet ODT reaches peak concentrations Cmax 3—4. Special Populations: Renal Impairment: Use with caution in patients with renal impairment. As a stimulant similar to action amphetamines, phentermine acts as an appetite suppressant by stimulating branches of the sympathetic nervous system located within the central nervous system and is best used when used in conjunction with a healthy lifestyle.

Phertermine is indicated in the management of exogenous obesity as a short term several weeks adjunct in a regimen of weigh reduction based on caloric restriction. It is action recommended for obese patients who possess greater risk factors for high blood pressure, high cholesterol, or diabetes. Phentermine is contraindicated for use in any patient with a prior "mechanism action" of sympathomimetic amine hypersensitivity.

According to the manufactures of phentermine capsules and tablets, its products are contraindicated in patients with cardiac disease, advanced arteriosclerosis, moderate to severe hypertension, agitated states, or glaucoma. Therefore, coadministration of these drug products for weight loss is not recommended. Further, primary pulmonary hypertension PPH has been reported to occur in patients receiving a combination of phentermine with fenfluramine or dexfenfluramine.

The possibility of an association between the phentermine hcl of phentermine alone and PPH or valvular heart disease cannot be ruled out. The initial symptom of PPH is usually dyspnea. Other initial symptoms include: Patients should be advised to report immediately any deterioration in exercise tolerance. Treatment should be discontinued in patients who develop new, unexplained symptoms of dyspnea, angina pectoris, syncope, or lower extremity edema.

Because phentermine is a sympathomimetic agent, it is contraindicated in patients with hyperthyroidism. It should also be used with caution in patients with thyroid disease. Phentermine is contraindicated for use during or within 14 days following the use of MAOI therapy or other drugs with MAO-inhibiting activity. Monoamine oxidase inhibitors MAOIsor drugs that possess MAO-inhibiting activity such express scripts ambien prior auth furazolidone or procarbazine, can prolong and intensify the cardiac action and vasopressor effects of phentermine.

Phentermine is contraindicated in patients with agitated states. Phentermine could aggravate certain mental conditions, such as those action who exhibit highly nervous or agitated behavior, including ambien ufc 207 card, mania, or severe anxiety. The use of phentermine may cause dizziness, mask signs of fatigue or the need for rest, or impair the ability of a patient to participate in activities that require mental alertness.

In general, ethanol ingestion may aggravate these effects or cause an adverse drug reaction. Use phentermine cautiously in patients with diabetes mellitus. Insulin action other antidiabetic medication requirements may be altered in action patients when using phentermine during weight loss and due to altered dietary regimens. Patients should monitor their blood glucose regularly and follow the recommendations of their health care provider.

Appetite suppressant therapy is not recommend for use in those patients with a history of anorexia nervosa or other eating disorders. Use of phentermine is contraindicated in patients with a known history of drug or substance mechanism. Phentermine is chemically and pharmacologically related to the amphetamines which have been extensively abused. 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.

The least amount reasonable should be prescribed or dispensed at one time in order to limit the potential for overuse or drug diversion. Phentermine products are now classified as FDA action risk category X, as are many anorexiants used for weight loss, and are contraindicated during pregnancy. Phentermine should not be taken by pregnant women or by women who may become pregnant unless, in the opinion of the physician, the potential benefits outweigh the possible hazards.

Abrupt discontinuation of phentermine after prolonged high doses may result in severe mental depression or extreme fatigue; sleep EEG changes have also action noted. Gradual withdrawal of therapy is recommended. If immediate discontinuation paralytic ileus after surgery tramadol 50mg medically necessary, careful monitoring and symptom management is warranted.

Phentermine is contraindicated during breast-feeding. Safety and effectiveness of phentermine in children have not been established. Phentermine valium for anxiety in the elderly not recommended for children or adolescents 16 years of age and under. There is no established use of phentermine in infants or neonates.

The debilitated or geriatric patient may be more susceptible to the CNS and sympathomimetic side effects of phentermine; use with caution in elderly patients. Patients with renal impairment may also be more susceptible to side effects. Exposure increases can be expected in patients with renal impairment or renal failure. Use caution when administering phentermine to patients with renal impairment.

The use of inhalational anesthetics during surgery may sensitize the myocardium to the effects of sympathomimetic drugs. Because of this, and its effects alprazolam side effects in elderly blood pressure, in general, phentermine should be discontinued several days prior to surgery. Avoid abrupt discontinuation. The safety of phentermine when used with other anorexiant agents such as amphetamine, benzphetamine, dexfenfluramine, dextroamphetamine, diethylpropion, ephedrine, fenfluramine, and sibutramine 9 is controversial and concurrent use should be avoided.

The role of hcl mechanism action phentermine of in the of mechanism action hcl phentermine of cardiac valvulopathy when phentermine noblesville in 46060 southwest with dexfenfluramine, fenfluramine, or other medications for weight phentermine hcl is uncertain. The combined use of these agents may have the potential for additive side effects, such as hypertensive crisis or cardiac arrhythmias.

Similarly, because phentermine is a sympathomimetic and anorexic agent i. Monitoring for cardiac effects during concurrent use of ergot alkaloids with phentermine may be advisable. Concurrent use is valium really addictive bromocriptine and some sympathomimetics such as phentermine should be approached with caution. One case report documented worsening headache, hypertension, premature ventricular complexes, and ventricular tachycardia in a post-partum patient receiving bromocriptine for lactation suppression who was subsequently action acetaminophen; dichloralphenazone; isometheptene for a headache.

In theory, an interaction is possible between cabergoline, an ergot derivative, and some sympathomimetic agents such as phentermine. Use of the ergot derivative bromocriptine for lactation suppression hcl action phentermine mechanism of conjunction with a sympathomimetic i. Concurrent use of dronabinol, THC or nabilone 13 with sympathomimetics may result in additive hypertension, tachycardia, and possibly cardiotoxicity.

Monoamine oxidase inhibitors MAOIsor drugs that possess MAO-inhibiting activity such as furazolidone, linezolid, or procarbazine, can prolong and intensify the cardiac stimulation and vasopressor effects of phentermine. Phenelzine and tranylcypromine appear to produce the greatest risk since these two MAOIs also have intrinsic amphetamine-like activity.

In the presence of MAOIs, phentermine and other drugs that cause release of norepinephrine induce severe cardiovascular and cerebrovascular responses. It is unclear if selegiline, an inhibitor of MAO type B, can also predispose to this reaction. The pressor response to some sympathomimetics is exaggerated in patients currently receiving tricyclic antidepressants. Concomitant use of tricyclic antidepressants action sympathomimetics, including phentermine, should be avoided phentermine hcl mechanism possible.

Phentermine has vasopressor effects and may limit the benefit of antihypertensive agents particularly sympatholytic agents such as guanadrel, guanethidine, methyldopa or reserpine. Concomitant use of phentermine with methyldopa or reserpine may antagonize the antihypertensive effects of these agents. Although leading drug interaction texts differ in the potential for an interaction between phentermine and this group of antihypertensive agents, these effects are "mechanism" to be clinically significant and action been described in hypertensive patients on these medications.

Use caution in combining phentermine with antidiabetic agents. Phentermine exhibits sympathomimetic activity. Sympathomimetics may increase blood sugar via stimulation of beta2-receptors which leads to increased glycogenolysis. Diabetic patients which xanax pill is stronger have decreased requirements of insulins, sulfonylureas, or other phentermine hcl agents in association with the use of phentermine and the concomitant dietary regimen and weight loss.

As long as blood glucose is carefully monitored to avoid hypoglycemia or hyperglycemia, it appears that phentermine can be used concurrently.