Can you safely consume alcohol while taking phentermine. What are the potential dangers of mixing phentermine and alcohol. How does combining phentermine and alcohol impact weight loss efforts. What side effects may occur when drinking alcohol on phentermine.

Understanding Phentermine: A Prescription Weight Loss Medication

Phentermine is a widely prescribed weight loss medication in the United States. It’s available under various brand names, including Adipex-P, Ionamin, Phentride, and Teramine. Healthcare providers typically prescribe phentermine to individuals who are clinically obese or facing medical issues related to their weight.

As a Schedule IV controlled substance, phentermine carries potential risks of addiction, abuse, and dependence. However, when taken as prescribed by a qualified healthcare professional, it can be a safe and effective tool for weight management.

How Does Phentermine Work?

Phentermine functions as a stimulant, primarily by increasing the levels of norepinephrine (noradrenaline) in the brain. This neurotransmitter plays a crucial role in appetite regulation, helping to reduce food intake and facilitate weight loss. While the exact mechanisms are not fully understood, scientists believe that phentermine may also contribute to weight reduction through other pathways.

The Dangers of Mixing Phentermine and Alcohol

Combining phentermine with alcohol is strongly discouraged by medical professionals. This combination can lead to several adverse effects and potential risks:

• Increased severity of side effects
• Reduced effectiveness of phentermine
• Counterproductive impact on weight loss efforts
• Higher risk of substance abuse and addiction

Cardiovascular Concerns

One of the most significant risks of mixing phentermine and alcohol is the potential for exacerbated cardiovascular side effects. Phentermine alone can cause heart-related symptoms such as increased heart rate and elevated blood pressure. When combined with alcohol, these effects may be amplified, potentially leading to chest pain and dangerously high blood pressure. Individuals with pre-existing heart conditions are at an even greater risk and should be particularly cautious.

Impact on Weight Loss Goals

Alcohol consumption can significantly undermine the weight loss goals that phentermine is intended to support. How does alcohol interfere with weight loss efforts? Here are several ways:

1. High calorie and sugar content in alcoholic beverages
2. Increased fatigue, leading to reduced physical activity
3. Poor food choices often made while under the influence
4. Impaired fat burning due to alcohol’s effects on the liver

Side Effects of Phentermine and Alcohol Interaction

When phentermine and alcohol are combined, the risk of experiencing side effects increases significantly. These side effects can range from mild discomfort to severe health complications.

Neurological Effects

Both phentermine and alcohol can affect the central nervous system, but in different ways. Phentermine, as a stimulant, can cause:

• Overstimulation
• Restlessness
• Dizziness
• Insomnia
• Euphoria
• Mood changes
• Tremors
• Headaches
• In severe cases, psychosis

Alcohol, on the other hand, is a depressant and can lead to drowsiness and impaired coordination. The conflicting effects of these substances can be particularly dangerous, as one may mask the effects of the other, potentially leading to overconsumption of either substance.

The Risk of Substance Abuse and Addiction

Combining phentermine with alcohol significantly increases the risk of substance abuse and addiction. Phentermine, being a controlled substance, already carries a potential for dependence. When mixed with alcohol, this risk is amplified.

Why is the combination particularly risky?

The stimulant properties of phentermine can mask the depressant effects of alcohol, potentially leading to excessive alcohol consumption. Conversely, alcohol may tempt users to take larger doses of phentermine to counteract alcohol’s sedating effects. This dangerous cycle can quickly lead to substance abuse and addiction.

Phentermine’s Effects on the Brain

Understanding how phentermine affects the brain is crucial in comprehending the risks associated with mixing it with alcohol. As a stimulant, phentermine primarily acts on the central nervous system, influencing various neurotransmitters.

Neurotransmitter Interactions

Phentermine primarily affects norepinephrine levels in the brain. This neurotransmitter plays a crucial role in:

• Regulating appetite
• Increasing energy expenditure
• Enhancing focus and alertness
• Modulating mood

By increasing norepinephrine levels, phentermine helps suppress appetite and boost metabolism, facilitating weight loss. However, this mechanism also contributes to some of the drug’s side effects, such as increased heart rate and blood pressure.

Safety Considerations When Taking Phentermine

While phentermine can be an effective tool for weight loss, it’s crucial to use it safely and as prescribed. Certain individuals should avoid phentermine altogether, particularly those with a history of heart problems.

Who should avoid phentermine?

Phentermine may not be suitable for individuals with:

• Cardiovascular disease
• Uncontrolled high blood pressure
• Hyperthyroidism
• Glaucoma
• A history of drug abuse
• Pregnancy or breastfeeding

It’s essential to have a thorough discussion with a healthcare provider before starting phentermine to ensure it’s safe and appropriate for your individual circumstances.

Alternatives to Mixing Phentermine and Alcohol

Given the risks associated with combining phentermine and alcohol, it’s crucial to explore safer alternatives for those who wish to socialize or relax without compromising their weight loss journey.

Non-Alcoholic Alternatives

Consider these options as alternatives to alcoholic beverages:

• Sparkling water with fresh fruit
• Herbal teas (hot or iced)
• Non-alcoholic mocktails
• Kombucha (check for low sugar varieties)
• Flavored seltzer waters

These alternatives can provide a satisfying and refreshing experience without the risks associated with alcohol consumption while on phentermine.

Lifestyle Changes

In addition to avoiding alcohol, consider implementing these lifestyle changes to support your weight loss goals:

1. Regular exercise routine
2. Balanced, nutrient-rich diet
3. Adequate sleep and stress management
4. Social activities that don’t revolve around drinking
5. Mindfulness and meditation practices

These changes can complement the effects of phentermine and contribute to sustainable weight loss and overall health improvement.

Long-Term Considerations and Phentermine Use

While phentermine can be an effective short-term solution for weight loss, it’s important to consider the long-term implications of its use, especially when combined with lifestyle factors like alcohol consumption.

Duration of Treatment

Phentermine is typically prescribed for short-term use, usually up to 12 weeks. Why is long-term use discouraged? There are several reasons:

• Increased risk of side effects
• Potential for developing tolerance
• Risk of dependence
• Diminishing effectiveness over time

Healthcare providers closely monitor patients on phentermine and may adjust treatment plans based on individual responses and progress.

Developing Sustainable Habits

While phentermine can jump-start weight loss, it’s crucial to develop sustainable habits that support long-term weight management. These may include:

1. Adopting a balanced, nutritious diet
2. Incorporating regular physical activity
3. Practicing mindful eating
4. Managing stress through healthy coping mechanisms
5. Regular check-ins with healthcare providers

By focusing on these aspects, individuals can work towards maintaining their weight loss even after discontinuing phentermine use.

Recognizing and Addressing Substance Abuse

Given the potential for abuse with both phentermine and alcohol, it’s crucial to be aware of the signs of substance abuse and know how to seek help if needed.

Signs of Substance Abuse

Some indicators of substance abuse may include:

• Taking higher doses of phentermine than prescribed
• Using phentermine for longer than recommended
• Combining phentermine with alcohol or other substances despite warnings
• Experiencing withdrawal symptoms when not using the substance
• Neglecting responsibilities due to substance use
• Continued use despite negative consequences

If you or someone you know exhibits these signs, it’s important to seek professional help promptly.

Seeking Help

There are numerous resources available for individuals struggling with substance abuse:

1. Consult with your healthcare provider
2. Contact a substance abuse helpline
3. Seek support from local support groups
4. Consider professional addiction treatment programs
5. Engage with mental health professionals specializing in addiction

Remember, seeking help is a sign of strength, not weakness. Early intervention can significantly improve outcomes and support overall health and well-being.

Dangers, Risks And Side Effects Of Mixing Alcohol And Phentermine

There are several reasons why mixing alcohol and phentermine isn’t a good idea.

Can you drink alcohol while taking phentermine? While the risks may seem minimal on the surface, combining phentermine with alcohol can severely dilute the drug’s weight loss properties while putting you at risk of several undesirable side effects, including addiction. There are quite a few reasons mixing alcohol and phentermine isn’t a good idea:

• It makes the risk of serious interactions and side effects more likely.
• It can reduce the effectiveness of phentermine.
• Drinking isn’t generally a good idea when trying to lose weight.
• There is also a potential for abuse with phentermine use, and mixing alcohol and phentermine may make you more likely to abuse one or both substances or become addicted.

What Is Phentermine?

Phentermine is a weight-loss drug in the U.S. Phentermine is the generic name of a drug sold under the brand names Adipex-P, Ionamin, Phentride and Teramine. It’s primarily prescribed to people who are clinically obese or have medical problems related to their weight. Besides being available on its own, it can be prescribed combined with the drug topiramate for weight loss.

Is Phentermine Safe?

Phentermine is a Schedule IV controlled substance, meaning it carries a risk of addiction, abuse and dependence. However, it is safe when taken as prescribed by your doctor. For this reason, it’s important only to take phentermine that has been prescribed for you, exactly as prescribed. Some people should avoid phentermine for safety reasons, including those with a history of heart problems. Those with heart problems should also avoid taking phentermine with alcohol, which alone can cause stress and strain on the heart.

How Does Phentermine Work in the Body?

Phentermine is a stimulant and works in part by increasing the brain’s norepinephrine level (noradrenaline). Some neurotransmitters, including norepinephrine, act on areas of the brain that restrict appetite. Food intake is then reduced, which makes weight loss easier. However, it is possible that stimulants like phentermine also help you reduce weight in other ways, although scientists are unsure of this mechanism.

Side Effects Mixing Alcohol and Phentermine

People taking phentermine are warned against mixing it with alcohol. First, the interactions and side effects of mixing alcohol and phentermine will likely be more severe than with either substance alone. For example, phentermine side effects can include heart-related symptoms like issues with heart rate and high blood pressure. These cardiac side effects can worsen when mixing alcohol and phentermine.

Cardiovascular Side Effects

When mixing alcohol and phentermine, you may be at a higher risk of cardiovascular side effects such as chest pain and raised blood pressure. This is particularly true if you have heart disease and are taking phentermine.

Inhibit Weight Loss

Finally, remember phentermine is prescribed for weight loss. Mixing it with alcohol can be counterproductive for that goal since there are many ways alcohol use can sabotage weight loss efforts. For example, alcohol is full of sugar and calories. It can make you feel tired and less likely to be physically active. You may be more likely to make the wrong food choices when drinking. It may also make it harder for your body to burn fat since alcohol affects the liver. 

What Are The Effects of Phentermine on the Brain?

Like alcohol, phentermine can have some effects on the brain. However, as a stimulant, phentermine’s effects on the brain are different from alcohol and include:

• Overstimulation
• Restlessness
• Dizziness
• Insomnia
• Euphoria
• Mood changes
• Tremors
• Headache
• Psychosis

Phentermine has some similar effects to alcohol — like dizziness — but differs in other ways. While, as a central nervous system depressant, alcohol makes you sleepy, phentermine can make you alert. It may be tempting to try to override the side effects of one substance with the other, but this can be dangerous. For example, masking a drug’s side effects can cause you to consume more of the substances than you otherwise would.

Can Phentermine Be Abused?

Another reason you shouldn’t mix alcohol with phentermine is it raises your risk of addiction. Phentermine is a Schedule IV controlled substance with the potential for dependence, abuse and addiction. For this reason, it is designed for short-term use and is generally reserved for people whose benefit outweighs the risk. Because it is a stimulant, it can be abused to create a high, particularly when someone takes large doses.

If someone takes it for longer than instructed or takes large doses, they may experience addiction or other withdrawal effects like depression or fatigue when they attempt to stop taking it.

People with a history of drug or alcohol abuse are advised not to take phentermine.

If you or a loved one are struggling with alcohol or phentermine abuse, begin your recovery journey today. Call us at The Recovery Village to learn more about our evidence-based treatment programs.

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Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

Bray, George A. “Drug Insight: appetite suppressants”>[…] suppressants.” Nature clinical practice. Gastroenterology & hepatology, February 2005. Accessed August 21, 2022.

U.S. National Library of Medicine. “PHENTERMINE HYDROCHLORIDE capsule”>.” October 19, 2018. Accessed August 21, 2022.

Drugs.com. “Drug Interaction Report: phentermine, et[…]mine, ethanol.” Accessed August 21, 2022.

U.S. National Library of Medicine. “Phentermine and Topiramate”>.” January 15, 2017. Accessed August 21, 2022.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

What happens when you mix phentermine and alcohol?

Here is what you should know about drinking while taking these prescription weight loss pills

Phentermine is a common prescription weight loss drug that is typically prescribed for short-term use. For many people who struggle to manage their weight, it may be a viable option to help shed some pounds when used along with a regime that includes a healthy diet and exercise. If you’ve been prescribed phentermine, you may be wondering whether it’s safe to drink alcohol while taking it. 

When taken alone, phentermine already has the potential to cause harmful side effects. Drinking alcohol can heighten this risk and make side effects potentially more severe. Although the extent of phentermine and alcohol interacting can depend on various factors, like how much of each substance is consumed, there is still a risk of side effects with moderate drinking. Even a small amount of alcohol can interact with phentermine.

Continue reading to learn more about mixing phentermine and alcohol and what you should know about the possible consequences. 

What is phentermine?

Phentermine, also known by the brand names Adipex-P and Lomaira, is an anorectic drug that helps suppress appetite. It is part of a drug class called sympathomimetic amines. Phentermine is believed to work in various ways, as it has central nervous system (CNS) stimulant effects and helps reduce feelings of hunger. 

Phentermine is FDA-approved as a weight loss drug for people with obesity (body mass index (BMI) over 30 kg/m2) or those who are overweight (BMI over 27 kg/m2) with a weight-related condition, such as high blood pressure or diabetes. It is typically taken as a 37.5 mg tablet or capsule once daily in the morning. 

Because it is chemically similar to the stimulant drug amphetamine, phentermine is classified as a Schedule IV controlled substance with a small risk of abuse and dependence.  

Some people may recognize phentermine as an ingredient of the prescription drug Qsymia, a weight-loss medication that contains a combination of topiramate and phentermine. Topiramate is an anticonvulsant or antiseizure medication that was FDA approved in 2012 to treat obesity when given in combination with phentermine.

Can you drink alcohol while taking phentermine?

In general, it’s not recommended to drink alcohol while taking phentermine due to the risk of cardiovascular side effects, including an increased heart rate or irregular heartbeat. While it’s a good idea to discuss any amount of alcohol use with a healthcare provider when you are taking any medications, the FDA label for phentermine advises against combining phentermine and alcohol because of an increased risk of adverse reactions.

How long after taking phentermine can you drink alcohol?

There isn’t a definitive answer to how long you should wait after taking phentermine to consume alcohol, but it’s generally recommended to avoid alcohol entirely while on this medication. As phentermine can stay in your system for up to 72 hours, you may want to wait at least a few days before drinking alcohol. 

If you must drink, keep consumption to a minimum and monitor your body’s reactions, as even a moderate amount of alcohol poses a risk of causing side effects with phentermine.

The consequences of mixing phentermine and alcohol

Mixing phentermine and alcohol could lead to overlapping side effects. As a stimulant drug, phentermine can increase your blood pressure and put stress on your heart. In addition, it may cause gastrointestinal issues and alter your mood and mental state. Alcohol can cause similar side effects, which could lead to amplified side effects of both substances.

Common side effects of mixing phentermine and alcohol

The combination of side effects of alcohol and phentermine is likely to be more severe than the side effects of either substance on its own. The most common of these may include:

• Dizziness
• Insomnia
• Headache
• Nausea
• Vomiting
• Dry mouth
• Constipation
• Euphoria
• Hyperactivity
• Palpitations
• Itching (hives) 
• Difficulty concentrating
• Problems with sexual function 
• Low sex drive

Severe side effects of phentermine and alcohol

Mixing phentermine and alcohol can also lead to serious side effects, some of which can be life-threatening. These side effects may include:

• Chest pain
• Stroke 
• Heart failure
• Heart disease
• Hypertension 
• Rapid heart rate (tachycardia)

Serious side effects of mixing alcohol and phentermine are often associated with chronic alcohol abuse—people who drink to excess regularly—although a night of binge drinking could also lead to these effects. People who abuse alcohol or have a history of alcohol substance use disorder are particularly vulnerable to these severe side effects. In addition, mixing phentermine with alcohol may worsen withdrawal symptoms for those undergoing alcohol substance use disorder treatments, such as an inpatient detox program.

It’s important to consult a healthcare provider about medical conditions you have before taking phentermine, as certain conditions increase the risk of these side effects. People with a history of heart disease, an overactive thyroid (hyperthyroidism), glaucoma, agitation, and a history of substance abuse or substance use disorder are not recommended to take phentermine. Consuming alcohol may also affect these conditions, which could increase complications further.

What else should you not mix with phentermine?

Besides avoiding alcohol, you should be aware of other substances that can interact with phentermine. Combining phentermine with other anorectics or appetite-suppressant weight loss medications might lead to additional, potentially dangerous side effects. For example, taking phentermine during treatment with or within two weeks of stopping a monoamine oxidase inhibitor (MAOI) may increase the risk of hypertensive crisis or a severe increase in blood pressure. 

People with diabetes may need to adjust their insulin dosage or other antidiabetic medications, as phentermine can affect blood sugar levels. Phentermine may also decrease the blood pressure-lowering effects of certain drugs called adrenergic neuron-blocking agents.  

Be sure to inform your healthcare provider of all the medications and supplements you’re currently taking to avoid any drug interactions and reduce the risk of potential complications.  

How does alcohol mix with other weight-loss drugs?

Alcohol not only interacts with phentermine but also with other anorectics and weight-loss medications. Alcohol and many weight-loss drugs act on the central nervous system, causing various effects that can be unpredictable and potentially harmful. 

Over-the-counter diet pills, in particular, may contain stimulants, such as bitter orange, guarana, and yohimbe, which can be hazardous while drinking alcohol. These stimulants can increase heart rate and blood pressure, which may be amplified while drinking alcohol. 

Orlistat, a weight-loss drug also known by the brand name Xenical, is not known to interact with alcohol. This means it doesn’t mix in harmful ways with alcohol as other weight-loss drugs might. Orlistat works by blocking certain enzymes in your digestive system responsible for breaking down fat in your food. Still, eating a meal high in fat and drinking alcohol with orlistat might cause digestive problems, such as diarrhea or gas.  

Avoiding alcohol with obesity

The relationship between alcohol and obesity is complex. While moderate alcohol consumption is not typically linked to weight gain, heavy drinking may lead to increased caloric intake, which can cause weight gain. Alcohol may also increase appetite and reduce willpower, leading to overeating, especially unhealthy, high-calorie foods. 

Besides its direct effects on caloric intake, alcohol can affect the body’s metabolism, including the processing of fat and sugar. Chronic alcohol consumption can lead to liver disease, which can also affect metabolism and the body’s ability to lose weight. 

People struggling with obesity may want to avoid or limit alcohol consumption altogether as part of their weight-loss strategy. Avoiding alcohol may reduce caloric intake and also support making better decisions about food and other healthy lifestyle choices. 

Bottom line: Can you mix phentermine and alcohol?

Because of the potential for overlapping side effects, it’s not recommended to mix phentermine and alcohol. Doing so could lead to side effects that range from dizziness and headache to high blood pressure, heart attack, and stroke. In addition, alcoholic beverages may contain extra calories that could counteract the weight-loss benefits of phentermine.

Phentermine should only be taken as advised by a healthcare provider. Consult a medical professional if you have any concerns about taking phentermine with alcohol or other medications.  

Weight Loss Phentermine: Side Effects and Safety – Drug Information, Health Education

Home >> Drug Information, Health Education >> Is Phentermine Safe for Weight Loss?

Product Information

Phentermine is a prescription diet pill that suppresses appetite. For people who are obese or have a weight-related medical condition, this appetite suppressant can be life-changing. Phentermine is effective, safe for short term use (three months), and inexpensive. For people who just want to wear their skinny jeans, phentermine will never be recommended or prescribed medically.

What is phentermine?

Phentermine is the oldest prescription weight loss pill currently used to treat obesity. It is also the drug most commonly prescribed for this purpose, although there are newer options on the market.

First, it is popular because it is effective. Studies have shown that it can lead to a loss of 5% to 10% of body weight within 12 weeks when taken as part of a treatment plan that includes a low-calorie diet and increased physical activity.

Second, it’s inexpensive, according to Caroline M. Apovian, MD, professor at Boston University School of Medicine, specializing in endocrinology, diabetes, nutrition, and weight management. Many insurance companies do not pay for drugs or treatments for weight loss, despite the fact that there are many studies confirming the health risks of obesity. Phentermine may be the only viable option for people on a limited income.

Phentermine is available under the brand names Adipex-P and Lomaira.

How does phentermine help you lose weight?

Phentermine (what is phentermine?) Medical jargon for anorexia, which simply means that it suppresses hunger. This is partly due to the release of certain chemicals in the brain in the area of ​​the hypothalamus that controls appetite. Karl Nadolsky, M.D., board certified endocrinologist specializing in diabetes, metabolism, and obesity at Spectrum Health in Grand Rapids, Michigan, and Fellow of the American College of Endocrinologists (FACE).

Therefore, phentermine helps reduce appetite by acting on the central nervous system.

How long should I take phentermine?

Phentermine is approved for short term use only. The long-term safety and effectiveness of phentermine has never been studied—and never will be, according to Dr. Apovian, who explains that the rigorous studies needed would be too expensive.

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Side effects of phentermine

Serious side effects are rare. The most common side effects of phentermine include:

• Rapid heartbeat
• Tingling in the arms or legs
• Dry mouth
• Insomnia
• Nervousness
• Constipation 90 055

You should not take phentermine if you have heart disease, including valvular heart disease, heart failure or high blood pressure, depression, an overactive thyroid gland, or glaucoma, or if you are pregnant, trying to conceive, or breastfeeding.

Is phentermine safe?

Phentermine is a drug that is often slanderous. Diet pills have a risky reputation for two main reasons:

1. Phentermine is an amphetamine-like drug.

It is chemically similar to amphetamines. So the US Food and Drug Administration (FDA) classifies it as a Schedule IV drug (i.e. a substance under federal control) because of concerns about potential abuse or addiction. Dr. Nadolsky points out that phentermine no amphetamine. According to him, phentermine is safe even with long-term use. And in my practice, I have never seen or heard of problems with phentermine.

2. Phentermine was half of the drug fen-fen.

In the 1990s, doctors prescribed phentermine with fenfluramine or dexfenfluramine, the combination of which was nicknamed fen-fen. Fen-fen turned into a weight loss miracle craze until the FDA realized in 1997 that fenfluramine and dexfenfluramine caused serious heart problems and took them off the market.

Essence

You should Only take phentermine or lose weight if you are obese – with a body mass index (BMI) over 30 – or a BMI over 27 if you have another serious obesity condition such as diabetes or hypertension.

The real danger of phentermine lies not in the drug itself, but in how it can be mishandled. There are what Dr. Nadolsky calls phentermine factories that are not affiliated with a hospital or other bona fide medical programs. They sell phentermine directly to customers who want to lose weight quickly and easily without risk factor checks, a practice that is both illegal and risky.

When phentermine is prescribed as part of an overall treatment plan by a physician specializing in obesity or endocrinology, who will exercise close supervision, phentermine is unlikely to be problematic. This should always be part of a balanced program combined with lifestyle changes such as:

• low-calorie, nutrient-rich diet
• increased physical activity
• behavioral changes

Without these essentials for healthy weight loss, you will probably gain all the pounds you lose after you stop taking phentermine.

With these key factors and appropriate medical supervision, phentermine can be very effective in a short-term weight loss program.

Benefits, Side Effects and Dosage

A properly balanced, low calorie diet and regular exercise are the cornerstones of weight loss, but some drugs can be powerful supporters.

One such drug is phentermine, one of the world’s most popular weight loss drugs.

It has been shown to be effective for short term weight loss when used along with a reduced calorie diet and exercise.

However, the use of phentermine for weight loss is not without risks and side effects.

This article explains everything you need to know about phentermine, including its benefits, dosage, and possible side effects.

• What is it
• How does it work?
• What is it used for?
• Dosages and forms
• Side effects and precautions
• Healthy weight loss

What is phentermine?

Phentermine is a prescription drug for weight loss.

The Food and Drug Administration (FDA) approved it in 1959 for short-term use up to 12 weeks for people over 16 years of age.

In the 1990s, drug manufacturers combined phentermine with other weight loss drugs. This combination of drugs has received the general name fen-fen.

Following reports of significant heart problems among users, the FDA withdrew two other drugs used in treatment, fenfluramine and dexfenfluramine, from the market.

Today, phentermine can be used alone and is marketed under the trade names Adipex-P, Lomaira and Suprenza. You can also find it in combination weight loss medications like Qsymia, which combines phentermine and another drug called topiramate.

Phentermine is a stimulant and is available by prescription. Since taking phentermine comes with a risk of addiction, it is considered a controlled substance. Chemically, it is similar to the stimulant amphetamine, which is also a controlled substance.

Your healthcare provider may prescribe phentermine if you are obese, as defined by a body mass index (BMI) of 30 or higher.

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Health care providers may also prescribe it if you are overweight with a BMI greater than or equal to 27 and have at least one weight-related condition such as high blood pressure, high cholesterol, or type 2 diabetes.

However, your healthcare provider will likely recommend other weight loss strategies first, such as exercise and a reduced-calorie diet.

General Information: Phentermine is an FDA approved weight loss drug. Its chemical structure is similar to that of the stimulant amphetamine, and it is only available by prescription.

How does phentermine work?

Phentermine belongs to a class of drugs called anorectics, also known as appetite suppressants.

Taking phentermine helps to suppress your appetite, thereby limiting the amount of calories you consume. Over time, this can lead to weight loss.

Although the exact way phentermine reduces appetite remains unclear, the drug is thought to work by increasing the levels of neurotransmitters in your brain.

Neurotransmitters – the chemicals norepinephrine, serotonin and dopamine – are your body’s chemical messengers.

As your levels of these three chemicals rise, your hunger will decrease.

However, within a few weeks you may develop a tolerance to the appetite-suppressing effects of phentermine. If this happens, talk to the healthcare professional who prescribed it.

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Trivia: Phentermine is said to reduce appetite by increasing neurotransmitter levels in your brain.

What is phentermine used for?

Phentermine is most commonly used for weight loss, but may also be used in combination with the drug topiramate to help with certain eating disorders such as Binge Eating Disorder (BED).

Phentermine is effective for weight loss

Several clinical studies have shown that phentermine can support meaningful weight loss.

Although the FDA has only approved it for short-term use of less than 12 weeks, off-label phentermine is often prescribed by healthcare professionals for longer use.

Doctors may prescribe it intermittently, meaning you take a break from taking the medicine for a certain period before you start taking it again.

Average weight loss with phentermine is 3% of your initial body weight after 3 months and 5-7% after 6 months. Some people report even greater weight loss than this.

To put this in perspective, a 5-7% weight loss is 10-14 pounds (4.5-6.4 kg) for a person who weighs 200 pounds (90.7 kg).

However, not everyone reacts to this medicine in the same way. If you haven’t lost much weight after 3 months of using it, your healthcare professional may recommend that you stop taking the drug.

Further, its effectiveness seems to decrease gradually after more than a year of prolonged use.

While phentermine is effective for weight loss, it may work better when combined with topiramate.

Topiramate is a drug that has been used on its own to treat seizures but, like phentermine, also has appetite-reducing properties.

Topiramate and phentermine is a combination drug sold under the brand name Qsymia. The FDA approved it in 2012 as a supplement to a healthy lifestyle such as increased exercise and a reduced calorie diet.

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Compared to three other commonly prescribed weight loss drugs, the combination of phentermine and topiramate was associated with the highest chance of losing at least 5% of initial body weight.

What’s more, a recent analysis of studies found that people who took the combination drug phentermine and topiramate lost an average of 16 pounds (7.3 kg) compared to placebo.

For those who took the drug for more than 56 weeks, this number increased to 17.8 pounds (8 kg).

In addition, the degree of weight loss increased with increasing dose. Average weight loss was:

• 7.8 lbs (3.55 kg) for 3.75/23 mg dose (Phentermine/Topiramate)
• 16 lbs (7.27 kg) for 7.5/46 mg dose
• 18 lbs (8.25 kg) for 15/92 mg dose

In phentermine-topiramate users, weight loss resulted in a significant reduction in waist circumference, as well as improved insulin sensitivity, improved blood sugar management, and decreased blood pressure .

Phentermine may be useful for some eating disorders

The combination of phentermine and topiramate may help reduce overeating in people with BED and bulimia nervosa.

BED is characterized by eating large amounts of food, often quickly and to the point of discomfort. It is also associated with feelings of loss of control during overeating, as well as feelings of shame or guilt afterwards.

Bulimia nervosa includes the same binge eating behaviors as BED, but also includes behaviors that people use to compensate for the effects of binge eating, such as self-induced vomiting.

In a small 12-week study in overweight people with BED, people who took the combination of phentermine and topiramate experienced a significant reduction in the frequency of binge eating episodes.

In another 12-week study, people with BED or bulimia nervosa received a combination of drugs or a placebo.

In 28 days, treatment with the combination of phentermine and topiramate reduced participants’ binge days from 16. 2 to 4.2. The same results were not observed in the placebo group.

Although these results are promising, larger studies are still needed.

If you think you have BED, bulimia nervosa, or an eating disorder, it’s important to talk to a healthcare professional.

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General Information: Phentermine in combination with topiramate has been shown to promote significant weight loss and may help reduce the frequency of binge eating episodes.

Phentermine Dosage and Composition

Phentermine dosages vary depending on its form and concentration.

Phentermine

Until 2016, the only available doses of phentermine were 15, 30 and 37.5 mg.

However, because best practice for clinicians is to prescribe the lowest effective dose, the FDA approved an 8-mg formula (Lomaira) in 2016 that can be taken up to three times daily, at least 30 minutes before meals.

If you are prescribed a higher dose (15, 30 or 37.5 mg), you can take it once a day in the morning before breakfast or 1-2 hours after breakfast.

To prevent insomnia or difficulty falling or staying asleep, you should avoid taking your last dose too late in the day.

Phentermine and topiramate

The combination of phentermine and topiramate – sold under the brand name Qsymia – is a medicine used for weight loss.

This medicine is available in four doses ranging in strength from phentermine 3.75-15 mg and topiramate 23-92 mg. It is offered in extended release capsules to be taken in the morning.

After you have taken the lowest dose for 14 days, your doctor may decide to change you to a higher dose.

According to the FDA, you should stop using the medication if you do not lose 3% of your body weight after 12 weeks of the highest daily dose.

General information: The dosage of phentermine varies depending on whether it is used alone or with topiramate.

Phentermine Side Effects and Precautions

Phentermine itself is for short-term use only, as there are few long-term studies on its safety.

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One study noted that people did not experience significant side effects when they took phentermine for up to 24 months.

However, the FDA approved phentermine in combination with topiramate for long-term use because the doses of the two ingredients are lower than the maximum doses of the individual drugs.

The most commonly reported side effects of phentermine and combination phentermine and topiramate are:

• dry mouth
• trouble sleeping
• dizziness
• palpitations

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• fatigue
• Constipation
• irritability
• nausea
• vomiting

Although rare, some serious side effects may occur, such as increased blood pressure, suicidal ideation, metabolic acidosis, increased creatinine, harm to the fetus, visual problems, cognitive impairment, and hypokalemia .

You should not take phentermine if you have heart disease, hyperthyroidism, glaucoma, severe kidney or liver disease, or if you are pregnant or breastfeeding.

Phentermine should also not be given in combination with monoamine oxidase inhibitors (MAOIs), a class of drugs used to treat depression.

Talk to a healthcare professional if you are taking other medicines, such as antihypertensives or antiepileptics.

Your healthcare professional will determine if phentermine is right for you and if it is safe for you.

General Information: Although some common side effects are associated with the use of phentermine and topiramate, most people tolerate them. However, people who have certain medical conditions or who are pregnant or breastfeeding should not use phentermine and topiramate.

Healthy Ways to Promote and Maintain Weight Loss

Most often, health care providers will prescribe phentermine and topiramate after you have tried other weight loss lifestyle modifications without seeing significant results.

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While phentermine can be a powerful weight loss tool, the only proven way to lose weight and keep it off in the long run is through a healthy lifestyle.

Without these habit changes, you may gain back all the weight you lost – and possibly more – after you stop taking phentermine.

Instead, opt for healthy, sustainable lifestyle habits that promote health beyond weight loss.

Extensive research has shown that exercise, nutrition, stress management and proper sleep are critical to promoting health and reducing the risk of disease.

What’s more, long-term medication is not without risk, and costs can increase, especially if you don’t have insurance.

For these reasons, your healthcare professional will likely recommend you make healthy lifestyle changes before recommending a weight loss drug.

Some examples of healthy lifestyle changes you can make include:

• Reduced calorie eating. If you need to lose weight, you can try eating 300-500 fewer calories a day. A registered dietitian can help you find this range based on your preferences and goals.
• Give priority to foods rich in nutrients. Nutrient-rich foods such as fruits and vegetables are relatively low in calories and high in nutrients such as fibre, vitamins and minerals.
• Increased physical activity. The US Department of Health and Human Services recommends getting at least 150 minutes per week of moderate aerobic exercise, such as brisk walking or running.
• Get more sleep. Although individual needs vary, try to get 7-9 hours of sleep per night.
• Do your best to manage your stress levels. Stress management may help reduce emotional eating and inflammation. You can try strategies such as taking medication, walking, talking to friends and family, or talking to a qualified professional.
• Try behavioral strategies. Behavioral changes that may be helpful include self-monitoring of food intake, physical activity, and weight, and making adjustments as needed.

These lifestyle changes can be challenging and you don’t have to do everything at once. Instead, slowly introduce new healthy behaviors over time. This will contribute to long-term, sustainable results.

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General Information: Lifestyle and behavior modifications are the cornerstones of successful weight loss and maintenance.

Summary

Phentermine is a prescription-only appetite suppressant and diet pill approved for short-term use.

The combination of phentermine and topiramate is even more effective than phentermine alone and is approved for long-term use. It may also help reduce drinking episodes in people with BED.

Common side effects include dry mouth, dizziness, fatigue, irritability, and constipation.