Phentermine is a medication classified as an “anoretic” medication, meaning it helps you lose weight, and has been an FDA approved medication since 1959. Simply stated, phentermine stimulates the brain to increase activity of the sympathetic nervous system. In doing so, our appetite is suppressed and our cravings are decreased, while our metabolism is increased. The medication lasts about 10-12 hours in most patients and is usually taken in the morning. It is classified by the DEA as a controlled substance and can only be obtained with a prescription from a doctor. The brand name version of phentermine is Adipex. It is your choice if you prefer the brand name or generic. Both are effective.
Is Phentermine the same as Fen-Phen?
No. Fen-Phen was a combination drug containing both fenfluramine (no longer on the market) and phentermine (still on the market). This combination worked well to help with weight loss but had potential cardiovascular side effects, including heart valve damage. Although Fen-Phen was removed by the FDA, the individual drug, phentermine, remained after many safety studies were completed. Phentermine’s safety has not been questioned nor did it play a role in any of the adverse effects of Fen-Phen.
What are the side effects?
The most common side effect is dry mouth, however, this can be a good thing because it encourages you to drink more water. Some patients experience insomnia or trouble sleeping, especially if they take the medication later in the day. Some patients may feel jittery or anxious, however, many patients interpret this as feeling more energetic. This is a direct result of the activation of the sympathetic nervous system which is the same system that causes the “fight or flight” reflex. If you have an arrhythmia (which will be detected by Dr. Lahiri during your initial visit with an ECG), this medication can cause it to worsen, so not everyone can take phentermine. At Care First Medical Weight Loss we are very diligent about patient safety. We will not prescribe a medication if f there is potential for complications becauseof pre-existing medical problems.
Is it expensive?
Most pharmacies charge about $25-30 for a month supply of phentermine if you are paying cash. Some insurances do cover phentermine and because it is generic, you may have no or minimal copay. We do not dispense pills from the office, rather, you are given a prescription to take to the pharmacy of your choice.
How long can I take it?
While the FDA originally approved phentermine for short term weight loss of 12 weeks or less, it has been safely prescribed by experienced physicians for much longer. Our goal is to help you lose weight and then maintain your weight loss. If taking phentermine longer than 12 weeks is necessary and you have no medical reasons why you can’t take it, then you can stay on the medication longer. In the newer medication, Qsymia which contains phentermine, length of treatment can be as long as two years. We have successfully treated patients with phentermine on a longer term basis.
How do I find out if I can take phentermine?
Coming for a consult with Dr Lahiri will help to determine if you are a candidate for treatment with phentermine. This 45 minute visit will include a full medical history, physical exam, ECG, and body composition analysis. The good news that if phentermine is contraindicated - there are several other medication options that help you to achieve safe and effective weight loss. We also prescribe Qysmia, Belviq, Contrave and Saxenda at our center.
Qsymia® is an FDA-approved prescription medicine that may help some obese adults or some overweight adults who also have weight related medical problems lose weight and keep the weight off. Qsymia should be used with a reduced-calorie diet and increased physical activity. Qysmia is a combination of phentermine and topiramate. Phentermine is an appetite suppressant that has been a FDA approved medication since 1959. Topiramate is a medication that is also used for migraine headache prevention, seizures and other medical problems. It does have the side effect of reducing appetite and cravings. Due to this effect it was included in the combination medication “Qysmia.”
How do I get a prescription ?
To see if you qualify for Qsymia and if it is an option for you, please call our office and setup a no obligation consultation.
Belviq is one of the newer medications to obtain FDA approval to help with weight loss in patients who are overweight with medical issues or are obese. Unlike some of the other medications recently approved, this is a new medication entirely, not a combination of older medications like Qsymia or Contrave. The generic name is lorcaserin and it has been FDA approved since 2012. What is unique about Belviq is that it doesn’t “speed you up” in any way, as its mechanism of action is totally different than phentermine or Qsymia. Instead of stimulating your sympathetic nervous system (the same part of your nervous system that is activated when you are excited, such as just before a big business meeting or a big sporting event), it increases activity of a neurotransmitter called serotonin. In fact, it specifically stimulates a receptor in your brain that serotonin attaches to that signals the feeling of satiety or fullness.
One of the latest medications to gain FDA approval for weight loss in overweight or obese patients is Contrave (naltrexone HCL/bupropion HCL) 8mg/90mg extended-release tablets. Contrave takes two older, well established medications, and combines them in a special extended release tablet at a lower dose than available as separate medications. Contrave has shown to increase weight loss when combined with diet and lifestyle changes. It works in about two thirds of patients that take the medication to produce clinically meaningful weight loss safely. While Contrave is not for everyone, we can determine at your visit if you are a candidate. Insurance coverage is fairly good with many patients insurance plans covering the majority of the cost of the medication. If you don’t have insurance, or your plan doesn’t cover the cost of the medication, the manufacturer has a rebate program that you may be entitled to. The ideal patient for Contrave is someone with cravings for carbohydrates as one of the main issues in the battle with their weight. It is also helpful in patients who cannot tolerate other weight loss medications that might make them feel jittery, like phentermine or Qsymia. To support patients in their weight loss journey, Contrave offers a support program called Scale Down. This program allows you to receive extra support information as well as a wireless scale that will connect to your smart phone, for free! To find out if you can take Contrave and if we think it will help you, please call the office to setup your consultation with Dr. Lahiri
Saxenda is an exciting new option in the treatment of obesity. The drug is not new in that it has been on the market under the brand name Victoza since 2010. Dr. Lahiri has had a lot of success treating his obese patients with Saxenda.
Who Is Saxenda For?
Saxenda is a medication for chronic weight management. It is for people with overweight and weight-related complications or obesity. It is meant to be used together with a lifestyle therapy regimen involving a reduced calorie diet and increased physical activity.
How Does Saxenda Work?
Saxenda works in the brain as an appetite suppressant. It also delays gastric emptying. This means that while on Saxenda a patient’s stomach takes longer to empty food into the small intestine. This causes patients to feel full for longer on smaller amounts of food.
Who Should Not Use Saxenda?
Women who are pregnant, nursing, or planning to become pregnant People who have been diagnosed with medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 or have a close family member with those diseases.