Phentermine

Registered South African indications:

• Management of obesity

Contraindications

South African recommendations

• Hypersensitivity to phentermine and sympathomimetic medicines or to any of the ingredients
• Pregnancy
• Lactation
• Pulmonary artery hypertension
• Arterial hypertension
• Cerebrovascular disease
• Cardiac disease including dysrhythmias, advanced arteriosclerosis
• Hyperthyroidism
• Agitated states or a history of psychiatric disorders including anorexia nervosa and depression
• Glaucoma
• History of drug/alcohol abuse or dependence
• Obstructive uropathy
• Poorly controlled epilepsy
• Children under 12 years old
• Coadministration with monoamine oxidase inhibitors or within 14 days following their administration

Cautions

• Renal impairment
• Elderly
• Pulmonary artery hypertension
• History of psychiatric disorders 
• Structural cardiac abnormalities
• Cardiomyopathy
• Diabetes mellitus
• Obese patients at risk of vascular disease
• Epilepsy
• Rapid weight loss
• May impair the ability to drive and operate machinery

Alert:  Counterfeit products of phentermine are common. When prescribed, encourage patients to purchase only from a reputable pharmacy. If unsure of authenticity, please contact manufacturer directly. 

Forms avail. in SA and covered in this monograph: cap

Dosages below include:

• South African registered indications and dosages

South African registered indications and dosages

Management of obesity
- As a short-term adjunct in a medically monitored comprehensive regimen of weight reduction for obese patients with a BMI of at least 30kg/m² or higher
- Can be initiated in patients with lower BMI with other risk factors, after excluding secondary organic causes of obesity

• Oral (cap): 15-30mg, dly in the morning at approx. 7am, swallowed whole; Max treatment duration: 3 months, after which a medical review is required

It is recommended that treatment should be initiated under the care of a medical practitioner experienced in the treatment of obesity

Phentermine is a short-term adjunct in a medically monitored comprehensive regimen of weight reduction which is based, for example, on diet (calorie/kilojoule restriction), exercise, and modification of behaviour in obese patients

The recommended dose of phentermine should not be exceeded, and it should not be combined with other appetite suppressants

A dose in the evening should be avoided, as phentermine may induce insomnia

Paed. forms avail. in SA and covered in this monograph: cap

Paed. dosages below include:

• South African registered indications and dosages

South African registered indications and dosages

Management of obesity
- As a short-term adjunct in a medically monitored comprehensive regimen of weight reduction for obese patients with a BMI of at least 30kg/m² or higher
- Can be initiated in patients with lower BMI with other risk factors, after excluding secondary organic causes of obesity

Younger than 12 years

• Contraindicated

Older than 12 years

• See adult dosage

Pregnancy

• Contraindicated
• Phentermine is contraindicated during pregnancy. There is inadequate information on the use of phentermine during pregnancy. Phentermine should not be used in pregnant women due to a lack of substantial benefit to the pregnant woman and an increased risk of  harm to the foetus

Breastfeeding

• Contraindicated
• The use of phentermine by breastfeeding mothers is contraindicated. There is no information on whether phentermine is excreted in breast milk, however other amphetamines become present in breast milk after administration

Renal Impairment

• Caution; dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Prohibited - In competition

Central Nervous System Disorders

• Overstimulation
• Restlessness
• Insomnia
• Nervousness
• Tremor
• Dizziness
• Headache
• Euphoria
• Fatigue
• Depression
• Psychotic episodes
• Hallucinations
• Impotence

Cardiovascular Disorders

• Tachycardia
• Palpitations
• Hypertension
• Precordial pain
• Stroke
• Angina
• Myocardial infarction
• Cardiac failure
• Cardiac arrest

Respiratory Disorders

• Onset or aggravation of exertional dyspnoea

 Gastrointestinal Disorders

• Nausea and vomiting
• Dry mouth
• Abdominal cramps
• Diarrhoea
• Constipation

Genitourinary Disorders

• Micturition disturbances
• Changes in libido

Skin and Subcutaneous Tissue Disorders

• Rash
• Facial oedema

Sensory

• Blurred vision
• Unpleasant taste

• Central nervous system stimulants
• Monoamine oxidase inhibitors
• Sympathomimetics
• Clonidoine
• Methyldopa
• Guanethidine
• Linezolid

Blood pressure

Phentermine is a sympathomimetic amine with pharmacologic activity similar to amphetamine. It stimulates hypothalamic release of norepinephrine, which reduces hunger signals. It also causes the release of epinephrine or adrenaline causing breakdown of stored fat.  

Alert:  Counterfeit products of Duromine  are common. When prescribed, encourage patients to purchase only from a reputable pharmacy. If unsure of authenticity, please contact manufacturer directly. 

Capsule 15mg

• Duromine (iNova) originator

Capsule 30mg

• Duromine (iNova) originator