What are the potential side effects of phentermine. How does phentermine work for weight loss. What is the recommended dosage for phentermine. Who should avoid taking phentermine. How long can you safely use phentermine.

Understanding Phentermine: A Powerful Weight Loss Medication

Phentermine is a prescription medication primarily used for short-term treatment of obesity in adults. It belongs to a class of drugs called anorectics, which work by suppressing appetite. While its exact mechanism of action isn’t fully understood, phentermine is believed to increase the release of certain brain chemicals that help reduce hunger, ultimately aiding in weight loss efforts.

Available as an oral capsule, tablet, and orally disintegrating tablet, phentermine is marketed under various brand names, with Adipex-P being one of the most well-known. As a controlled substance, its use is closely monitored by healthcare providers due to its potential for misuse and dependence.

Who Can Benefit from Phentermine?

Phentermine is typically prescribed to individuals who are:

• Obese or significantly overweight
• Have a Body Mass Index (BMI) of 30 or greater
• Have weight-related health conditions such as high blood pressure, high cholesterol, or diabetes

Is phentermine suitable for everyone trying to lose weight. No, it’s not a first-line treatment for weight loss. Phentermine is generally reserved for cases where dietary changes and exercise alone have not been sufficient. It’s crucial to understand that this medication is intended for short-term use (usually a few weeks) and should be used in conjunction with a comprehensive weight loss program that includes a balanced diet, regular physical activity, and behavioral modifications.

Phentermine Dosage and Administration Guidelines

The appropriate dosage of phentermine can vary depending on individual factors such as age, weight, and medical history. However, there are general guidelines that healthcare providers typically follow:

• Starting dose: Usually 15 mg to 30 mg once daily
• Maximum dose: 37.5 mg per day
• Timing: Typically taken before breakfast or 1-2 hours after breakfast

How should phentermine be taken for optimal results. It’s generally recommended to take phentermine on an empty stomach or at least 2 hours after a meal. This helps maximize its appetite-suppressing effects. However, some individuals may experience better results by taking it with food if stomach upset occurs.

Can the dosage be adjusted. Yes, your healthcare provider may adjust your dosage based on your response to the medication and any side effects you experience. It’s crucial to follow your doctor’s instructions precisely and never adjust the dose on your own.

Potential Side Effects of Phentermine: What to Watch For

Like all medications, phentermine can cause side effects. While not everyone experiences them, it’s important to be aware of potential adverse reactions. Common side effects include:

• Dry mouth
• Insomnia or sleep disturbances
• Headache
• Constipation or diarrhea
• Increased heart rate
• Nervousness or restlessness

Are there any serious side effects associated with phentermine. Yes, while less common, phentermine can potentially cause more severe side effects that require immediate medical attention:

1. Primary Pulmonary Hypertension (PPH): A rare but potentially fatal lung disease
2. Valvular Heart Disease: Damage to heart valves affecting blood flow
3. Severe Hypertension: Dangerously high blood pressure
4. Psychiatric symptoms: Such as severe anxiety or depression
5. Cardiovascular events: Including heart palpitations or chest pain

If you experience shortness of breath, chest pain, fainting, or swelling in the legs and ankles while taking phentermine, seek medical attention immediately. These could be signs of serious cardiovascular complications.

Phentermine and Shortness of Breath: A Crucial Warning Sign

Shortness of breath is a particularly concerning side effect of phentermine that warrants special attention. It can be a symptom of several serious conditions associated with the medication:

Primary Pulmonary Hypertension (PPH)

PPH is a rare but severe condition that affects the arteries in the lungs and the right side of the heart. Symptoms of PPH include:

• Progressive shortness of breath, especially during physical activity
• Fatigue and weakness
• Dizziness or fainting spells
• Bluish tinge to the lips and skin (cyanosis)
• Swelling in the ankles and legs

Why is PPH so dangerous. PPH can lead to heart failure if left untreated. The increased pressure in the pulmonary arteries forces the right side of the heart to work harder, eventually causing it to weaken and fail.

Valvular Heart Disease

Phentermine use has been associated with heart valve problems. Symptoms may include:

• Shortness of breath, particularly when lying down or during physical activity
• Fatigue and weakness
• Swelling in the ankles and feet
• Irregular heartbeat
• Chest discomfort or pain

How does phentermine affect heart valves. The exact mechanism is not fully understood, but it’s thought that phentermine may cause changes in the heart valve tissue, leading to improper closure and leakage.

Contraindications and Precautions: When to Avoid Phentermine

While phentermine can be an effective weight loss aid for some individuals, it’s not suitable for everyone. Certain medical conditions and circumstances may increase the risk of serious side effects. Phentermine should be avoided in people with:

• History of cardiovascular disease
• Uncontrolled hypertension
• Hyperthyroidism
• Glaucoma
• History of drug abuse
• Pregnancy or breastfeeding
• Severe anxiety or agitation
• Allergies to sympathomimetic amines

Can phentermine interact with other medications. Yes, phentermine can interact with various drugs, potentially increasing the risk of side effects or reducing the effectiveness of either medication. Some notable interactions include:

1. Monoamine Oxidase Inhibitors (MAOIs): Can lead to a dangerous increase in blood pressure
2. Other weight loss medications: May increase the risk of side effects
3. Insulin and oral diabetes medications: May require dose adjustments
4. Selective Serotonin Reuptake Inhibitors (SSRIs): Can increase the risk of serotonin syndrome

Always inform your healthcare provider about all medications, supplements, and herbal products you’re taking before starting phentermine.

Monitoring and Follow-up: Ensuring Safe and Effective Use of Phentermine

Given the potential risks associated with phentermine, close medical supervision is essential throughout the course of treatment. Regular monitoring typically includes:

• Blood pressure checks
• Heart rate monitoring
• Assessment of weight loss progress
• Evaluation of side effects
• Periodic blood tests to check liver and kidney function

How often should follow-up appointments be scheduled. The frequency of check-ups can vary based on individual circumstances, but most healthcare providers recommend monthly visits while on phentermine. These appointments allow for dosage adjustments if needed and ensure the benefits of the medication continue to outweigh any potential risks.

Is long-term use of phentermine safe. Phentermine is approved for short-term use only, typically up to 12 weeks. Prolonged use can increase the risk of dependence and serious side effects. If weight loss goals are not achieved within this timeframe, alternative strategies should be considered.

Lifestyle Modifications: Maximizing the Benefits of Phentermine

While phentermine can be an effective tool for weight loss, it’s most successful when combined with comprehensive lifestyle changes. To optimize results and maintain weight loss long-term, consider implementing the following strategies:

Balanced Nutrition

A nutrient-dense, calorie-controlled diet is crucial for sustainable weight loss. Focus on:

• Plenty of fruits and vegetables
• Lean proteins
• Whole grains
• Healthy fats in moderation
• Limiting processed foods and added sugars

Regular Physical Activity

Incorporating exercise into your routine can enhance weight loss efforts and improve overall health. Aim for:

• At least 150 minutes of moderate-intensity aerobic activity per week
• Strength training exercises 2-3 times per week
• Increased daily movement (e.g., taking stairs, walking more)

Behavioral Changes

Addressing the psychological aspects of weight management is essential for long-term success. Consider:

• Keeping a food and activity journal
• Practicing mindful eating
• Developing stress management techniques
• Seeking support from friends, family, or support groups

Can lifestyle changes alone be as effective as phentermine. In many cases, yes. While phentermine can provide a helpful boost, particularly for those with significant weight to lose, sustainable weight management ultimately relies on lasting lifestyle modifications. Some individuals may find that these changes alone are sufficient to achieve their weight loss goals without the need for medication.

Alternatives to Phentermine: Exploring Other Weight Loss Options

For individuals who are not suitable candidates for phentermine or prefer to explore other options, several alternatives are available:

Other FDA-Approved Weight Loss Medications

• Orlistat (Xenical, Alli): Works by blocking fat absorption in the intestines
• Liraglutide (Saxenda): A injectable medication that mimics a hormone that regulates appetite
• Naltrexone-bupropion (Contrave): Combines two drugs to reduce appetite and control cravings
• Phentermine-topiramate (Qsymia): A combination medication that suppresses appetite and increases feelings of fullness

Non-Pharmacological Approaches

• Cognitive Behavioral Therapy (CBT): Helps address underlying thought patterns and behaviors related to eating and weight
• Meal replacement programs: Structured plans that replace some or all meals with specially formulated products
• Commercial weight loss programs: Offer support, guidance, and structured meal plans
• Bariatric surgery: For individuals with severe obesity who have not responded to other interventions

Are natural supplements effective for weight loss. While many natural supplements claim to aid weight loss, scientific evidence supporting their effectiveness is often limited. Some, like green tea extract or conjugated linoleic acid (CLA), may offer modest benefits. However, it’s crucial to approach these products with caution and consult a healthcare provider before use, as they can interact with medications and may have side effects.

The journey to sustainable weight loss is often complex and multifaceted. While medications like phentermine can play a role in jump-starting weight loss for some individuals, they are not a magic solution. Long-term success typically requires a combination of strategies, including dietary changes, increased physical activity, behavioral modifications, and ongoing support. By working closely with healthcare providers and remaining committed to lifestyle changes, individuals can achieve their weight loss goals and improve overall health and well-being.

Side Effects, Dosage, Uses, and More

Highlights for phentermine

1. Phentermine oral capsule is available as a brand-name drug and as a generic drug. Brand name: Adipex-P.
2. Phentermine comes in three forms: an oral capsule, an oral tablet, and an orally disintegrating tablet.
3. Phentermine oral capsule is used to treat obesity.

• Primary pulmonary hypertension (PPH) warning: This drug can cause PPH. This is a rare lung disease that may be fatal (cause death). PPH is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. Symptoms can include shortness of breath, heart palpitations (fast, fluttering heartbeat), dizziness, bluish color to your lips and skin, tiredness, and edema (swelling of your legs and ankles).
• Valvular heart disease warning: This drug may harm your heart valves. Your valves may not be able to close properly and may leak. This may interrupt the blood flow through your heart to your body. Symptoms can include fatigue and weakness, shortness of breath during activity or when you lie down, swollen ankles and feet, chest pain, and an irregular or fast heartbeat.
• Misuse and dependence warning: This drug may be habit-forming. You shouldn’t take it long-term. Tell your doctor if you have a history of drug or alcohol misuse before starting this drug.

Phentermine is a prescription drug. It comes as an oral capsule, an oral tablet, and an orally disintegrating tablet.

Phentermine oral capsule is available as the brand-name drug Adipex-P. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Phentermine is a controlled substance. Your use of this drug will be closely monitored by your doctor.

Why it’s used

Phentermine oral capsule is only used short-term (for a few weeks) to treat obesity. This drug aids in weight loss in very obese and overweight people with certain health risk factors. These risk factors include high blood pressure, high cholesterol, and diabetes. This drug is used along with exercise, a low-calorie diet, and other behavior changes to lose weight.

How it works

Phentermine belongs to a class of drugs called anorectics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It isn’t known exactly how phentermine works to help you lose weight. It may work by increasing the release of chemicals in your brain that help reduce your appetite. This may help you eat less, which would aid in weight loss.

Phentermine oral capsule doesn’t cause drowsiness, but it can cause trouble sleeping. It can also cause other side effects.

More common side effects

The more common side effects of phentermine can include:

• bad taste in your mouth
• constipation
• diarrhea
• dry mouth
• headache
• vomiting

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Primary pulmonary hypertension (PPH). This is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. Symptoms can include:
  • shortness of breath
  • heart palpitations (fast, fluttering heartbeat)
  • dizziness
  • cyanosis (bluish color to your lips and skin)
  • tiredness
  • edema (swelling of your legs and ankles)
  • angina (chest pain)
• Valvular heart disease. This drug may harm your heart valves so they can’t close properly and may leak. Symptoms can include:
  • fatigue and weakness, especially when you increase your activity level
  • shortness of breath during activity or when you lie down
  • edema (swelling of your legs and ankles)
  • angina (chest pain), chest discomfort or tightness that often gets worse during exercise
  • lightheadedness or fainting
  • arrhythmia (irregular heartbeat)
  • heart murmur
  • heart palpitations (fast, fluttering heartbeat)
• Hypertension (high blood pressure)
• Restlessness
• Tremors (uncontrollable rhythmic movement in one part of your body)
• Insomnia (trouble sleeping)
• Erectile dysfunction in men (trouble getting or keeping an erection)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Phentermine oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with phentermine are listed below.

Drugs you shouldn’t take

Taking certain drugs with phentermine may cause serious side effects. Don’t take these drugs with phentermine. Examples of these drugs include:

• Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid, phenelzine, rasagiline, selegiline, and tranylcypromine. You shouldn’t take phentermine within 14 days of starting or stopping an MAOI. Taking these drugs together can cause a hypertensive crisis (a dangerous increase in blood pressure).
• Other drugs for weight loss, such as amphetamine, benzphetamine, dextroamphetamine, diethylpropion, and phendimetrazine. Taking these drugs together may cause increased side effects. These include hypertensive crisis (a dangerous increase in blood pressure) or arrhythmia (a serious abnormal heart rhythm).
• Serotonin reuptake inhibitors (SSRIs), such as fluoxetine, sertraline, fluvoxamine, paroxetine, citalopram, escitalopram and nefazodone. Taking these drugs together can cause a hypertensive crisis (a dangerous increase in blood pressure).

Interactions that cause more side effects

Taking phentermine with certain medications may cause more side effects. Examples of these drugs include:

• Insulin and oral diabetes drugs, such as nateglinide, pioglitazone, repaglinide, rosiglitazone, metformin, glimepiride, glipizide, sitagliptin, saxagliptin, linagliptin, exenatide, and liraglutide. Taking these drugs together may cause a significant drop in your blood sugar levels. Your doctor may lower your dosage of your diabetes drugs. You may also need to monitor your blood sugar levels closely.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Phentermine can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it or phendimetrazine tartrate. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol can increase your risk of side effects from phentermine. These side effects can include dizziness, feeling nervous and excitable, headache, hard stools or diarrhea, dry mouth, and not being able to sleep. They can also include decreased interest in sex or change in ability to have sex.

If you drink alcohol, talk to your doctor. You may need to be more closely monitored for side effects.

Warnings for people with certain health conditions

For people with history of primary pulmonary hypertension (PPH): You shouldn’t take phentermine. Phentermine may make your PPH worse.

For people with history of heart disease: You shouldn’t take this drug if you have a history of heart problems. These include stroke, arrhythmia (irregular heartbeat), heart failure, coronary artery disease, valve disease, and uncontrolled high blood pressure. Phentermine may cause a serious increase in your blood pressure. This may make your heart work harder. The extra stress on your heart may make your heart disease worse.

For people with history of hyperthyroidism: Tell your doctor if you have hyperthyroidism (an overactive thyroid). Phentermine may increase your thyroid activity. This may raise your thyroid levels even further.

For people with glaucoma: This drug may increase your eye pressure even more. This may cause permanent damage to your vision. Tell your doctor if you have glaucoma.

For people with diabetes: You may be able to control your diabetes better as you lose weight while you’re on this drug. Your doctor may lower the dosage of your diabetes drugs.

For people with a history of drug misuse: This drug may be habit-forming. You shouldn’t take this medication long-term. Tell your doctor if you have a history of drug or alcohol misuse.

For people with agitation: This drug may cause restlessness and anxiety and may make your agitation worse. You shouldn’t take phentermine if you’re agitated.

Warnings for other groups

For pregnant women: Phentermine is a category X pregnancy drug. That means two things:

1. Category X drugs should never be used during pregnancy.
2. Women of childbearing age should use reliable birth control while taking this drug.

Stop taking phentermine and call your doctor right away if you become pregnant while taking this drug.

When to call the doctor

• Call your doctor if you’re not losing weight, even though you’re exercising, eating a low-calorie diet, and taking this drug. Keep in mind that it may take a few weeks for this drug to work.

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For women who are breastfeeding: Phentermine may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This medication hasn’t been studied in children. It shouldn’t be used in people younger than 16 years.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Generic: Phentermine

• Form: oral capsule
• Strengths: 15 mg, 30 mg, 37. 5 mg

Brand: Adipex-P

• Form: oral capsule
• Strengths: 37.5 mg

Dosage for obesity

Adult dosage (ages 18–64 years)

• Adipex-P and generic phentermine 37.5-mg capsule:
  • Typical starting dosage: One 37.5-mg capsule each day. Take it in the morning before breakfast, or 1–2 hours after breakfast.
  • Maximum dosage: 37.5 mg per day
• Phentermine 15-mg and 30-mg capsules:
  • Typical starting dosage: One 15-mg or 30-mg capsule each day. Take it in the morning, 2 hours after breakfast.
  • Dosage increases: If your doctor started you on 15-mg dose, they may increase your dose based on your weight loss and how well you tolerate the drug.
  • Maximum dosage: 30 mg per day.

Child dosage (age 16–17 years)

• Adipex-P and generic phentermine 37. 5-mg capsule:
  • Typical starting dosage: One 37.5-mg capsule each day. Take it in the morning before breakfast, or 1–2 hours after breakfast.
  • Maximum dosage: 37.5 mg per day.
• Phentermine 15-mg and 30-mg capsules:
  • Typical starting dosage: One 15-mg or 30-mg capsule each day. Take it in the morning, 2 hours after breakfast.
  • Dosage increases: If your doctor started you on a 15-mg dose, they may increase your dose based on your weight loss and how well you tolerate the drug.
  • Maximum dosage: 30 mg per day.

Child dosage (ages 0–16 years)

It hasn’t been confirmed that this drug is safe and effective for use in children younger than 16 years. It shouldn’t be used in children in this age range.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Phentermine oral capsule is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: You may not lose weight. If you take this drug for a long period of time and stop it suddenly, you may have extreme fatigue and depression.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• restlessness
• tremor
• confusion
• fast breathing
• hallucinations (seeing or hearing something that isn’t there)
• arrhythmia (irregular heartbeat)
• hypertension (high blood pressure)
• heart palpitations (fast, fluttering heartbeat)
• nausea
• vomiting
• diarrhea

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You should lose weight.

Keep these considerations in mind if your doctor prescribes phentermine for you.

General

• You can take phentermine with or without food.
• Take phentermine once per day in the morning. Taking phentermine late in the day may cause trouble sleeping.
• Don’t cut or crush the oral capsule.

Storage

• Store phentermine at room temperature. Keep it at a temperature between 68°F and 77°F (20°C and 25°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor will have you participate in an exercise program and follow a reduced-calorie diet while you’re taking this drug. This should help you lose weight. Your doctor may also ask you to keep a journal of your food intake, exercise, and weight. This will help track your weight loss progress.

Clinical monitoring

Your weight and waist circumference will be monitored while you’re taking this drug. This will tell you and your doctor if the medication is working to help you lose weight.

During your treatment, you and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include blood pressure.

Your diet

You should follow a reduced-calorie diet as directed by your doctor while taking this drug. This should help you lose weight.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Side Effects, Dosage, Uses, and More

Highlights for phentermine

1. Phentermine oral capsule is available as a brand-name drug and as a generic drug. Brand name: Adipex-P.
2. Phentermine comes in three forms: an oral capsule, an oral tablet, and an orally disintegrating tablet.
3. Phentermine oral capsule is used to treat obesity.

• Primary pulmonary hypertension (PPH) warning: This drug can cause PPH. This is a rare lung disease that may be fatal (cause death). PPH is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. Symptoms can include shortness of breath, heart palpitations (fast, fluttering heartbeat), dizziness, bluish color to your lips and skin, tiredness, and edema (swelling of your legs and ankles).
• Valvular heart disease warning: This drug may harm your heart valves. Your valves may not be able to close properly and may leak. This may interrupt the blood flow through your heart to your body. Symptoms can include fatigue and weakness, shortness of breath during activity or when you lie down, swollen ankles and feet, chest pain, and an irregular or fast heartbeat.
• Misuse and dependence warning: This drug may be habit-forming. You shouldn’t take it long-term. Tell your doctor if you have a history of drug or alcohol misuse before starting this drug.

Phentermine is a prescription drug. It comes as an oral capsule, an oral tablet, and an orally disintegrating tablet.

Phentermine oral capsule is available as the brand-name drug Adipex-P. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Phentermine is a controlled substance. Your use of this drug will be closely monitored by your doctor.

Why it’s used

Phentermine oral capsule is only used short-term (for a few weeks) to treat obesity. This drug aids in weight loss in very obese and overweight people with certain health risk factors. These risk factors include high blood pressure, high cholesterol, and diabetes. This drug is used along with exercise, a low-calorie diet, and other behavior changes to lose weight.

How it works

Phentermine belongs to a class of drugs called anorectics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It isn’t known exactly how phentermine works to help you lose weight. It may work by increasing the release of chemicals in your brain that help reduce your appetite. This may help you eat less, which would aid in weight loss.

Phentermine oral capsule doesn’t cause drowsiness, but it can cause trouble sleeping. It can also cause other side effects.

More common side effects

The more common side effects of phentermine can include:

• bad taste in your mouth
• constipation
• diarrhea
• dry mouth
• headache
• vomiting

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Primary pulmonary hypertension (PPH). This is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. Symptoms can include:
  • shortness of breath
  • heart palpitations (fast, fluttering heartbeat)
  • dizziness
  • cyanosis (bluish color to your lips and skin)
  • tiredness
  • edema (swelling of your legs and ankles)
  • angina (chest pain)
• Valvular heart disease. This drug may harm your heart valves so they can’t close properly and may leak. Symptoms can include:
  • fatigue and weakness, especially when you increase your activity level
  • shortness of breath during activity or when you lie down
  • edema (swelling of your legs and ankles)
  • angina (chest pain), chest discomfort or tightness that often gets worse during exercise
  • lightheadedness or fainting
  • arrhythmia (irregular heartbeat)
  • heart murmur
  • heart palpitations (fast, fluttering heartbeat)
• Hypertension (high blood pressure)
• Restlessness
• Tremors (uncontrollable rhythmic movement in one part of your body)
• Insomnia (trouble sleeping)
• Erectile dysfunction in men (trouble getting or keeping an erection)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Phentermine oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with phentermine are listed below.

Drugs you shouldn’t take

Taking certain drugs with phentermine may cause serious side effects. Don’t take these drugs with phentermine. Examples of these drugs include:

• Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid, phenelzine, rasagiline, selegiline, and tranylcypromine. You shouldn’t take phentermine within 14 days of starting or stopping an MAOI. Taking these drugs together can cause a hypertensive crisis (a dangerous increase in blood pressure).
• Other drugs for weight loss, such as amphetamine, benzphetamine, dextroamphetamine, diethylpropion, and phendimetrazine. Taking these drugs together may cause increased side effects. These include hypertensive crisis (a dangerous increase in blood pressure) or arrhythmia (a serious abnormal heart rhythm).
• Serotonin reuptake inhibitors (SSRIs), such as fluoxetine, sertraline, fluvoxamine, paroxetine, citalopram, escitalopram and nefazodone. Taking these drugs together can cause a hypertensive crisis (a dangerous increase in blood pressure).

Interactions that cause more side effects

Taking phentermine with certain medications may cause more side effects. Examples of these drugs include:

• Insulin and oral diabetes drugs, such as nateglinide, pioglitazone, repaglinide, rosiglitazone, metformin, glimepiride, glipizide, sitagliptin, saxagliptin, linagliptin, exenatide, and liraglutide. Taking these drugs together may cause a significant drop in your blood sugar levels. Your doctor may lower your dosage of your diabetes drugs. You may also need to monitor your blood sugar levels closely.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Phentermine can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it or phendimetrazine tartrate. Taking it again could be fatal (cause death).

Alcohol interaction warning

The use of drinks that contain alcohol can increase your risk of side effects from phentermine. These side effects can include dizziness, feeling nervous and excitable, headache, hard stools or diarrhea, dry mouth, and not being able to sleep. They can also include decreased interest in sex or change in ability to have sex.

If you drink alcohol, talk to your doctor. You may need to be more closely monitored for side effects.

Warnings for people with certain health conditions

For people with history of primary pulmonary hypertension (PPH): You shouldn’t take phentermine. Phentermine may make your PPH worse.

For people with history of heart disease: You shouldn’t take this drug if you have a history of heart problems. These include stroke, arrhythmia (irregular heartbeat), heart failure, coronary artery disease, valve disease, and uncontrolled high blood pressure. Phentermine may cause a serious increase in your blood pressure. This may make your heart work harder. The extra stress on your heart may make your heart disease worse.

For people with history of hyperthyroidism: Tell your doctor if you have hyperthyroidism (an overactive thyroid). Phentermine may increase your thyroid activity. This may raise your thyroid levels even further.

For people with glaucoma: This drug may increase your eye pressure even more. This may cause permanent damage to your vision. Tell your doctor if you have glaucoma.

For people with diabetes: You may be able to control your diabetes better as you lose weight while you’re on this drug. Your doctor may lower the dosage of your diabetes drugs.

For people with a history of drug misuse: This drug may be habit-forming. You shouldn’t take this medication long-term. Tell your doctor if you have a history of drug or alcohol misuse.

For people with agitation: This drug may cause restlessness and anxiety and may make your agitation worse. You shouldn’t take phentermine if you’re agitated.

Warnings for other groups

For pregnant women: Phentermine is a category X pregnancy drug. That means two things:

1. Category X drugs should never be used during pregnancy.
2. Women of childbearing age should use reliable birth control while taking this drug.

Stop taking phentermine and call your doctor right away if you become pregnant while taking this drug.

When to call the doctor

• Call your doctor if you’re not losing weight, even though you’re exercising, eating a low-calorie diet, and taking this drug. Keep in mind that it may take a few weeks for this drug to work.

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For women who are breastfeeding: Phentermine may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This medication hasn’t been studied in children. It shouldn’t be used in people younger than 16 years.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Generic: Phentermine

• Form: oral capsule
• Strengths: 15 mg, 30 mg, 37. 5 mg

Brand: Adipex-P

• Form: oral capsule
• Strengths: 37.5 mg

Dosage for obesity

Adult dosage (ages 18–64 years)

• Adipex-P and generic phentermine 37.5-mg capsule:
  • Typical starting dosage: One 37.5-mg capsule each day. Take it in the morning before breakfast, or 1–2 hours after breakfast.
  • Maximum dosage: 37.5 mg per day
• Phentermine 15-mg and 30-mg capsules:
  • Typical starting dosage: One 15-mg or 30-mg capsule each day. Take it in the morning, 2 hours after breakfast.
  • Dosage increases: If your doctor started you on 15-mg dose, they may increase your dose based on your weight loss and how well you tolerate the drug.
  • Maximum dosage: 30 mg per day.

Child dosage (age 16–17 years)

• Adipex-P and generic phentermine 37. 5-mg capsule:
  • Typical starting dosage: One 37.5-mg capsule each day. Take it in the morning before breakfast, or 1–2 hours after breakfast.
  • Maximum dosage: 37.5 mg per day.
• Phentermine 15-mg and 30-mg capsules:
  • Typical starting dosage: One 15-mg or 30-mg capsule each day. Take it in the morning, 2 hours after breakfast.
  • Dosage increases: If your doctor started you on a 15-mg dose, they may increase your dose based on your weight loss and how well you tolerate the drug.
  • Maximum dosage: 30 mg per day.

Child dosage (ages 0–16 years)

It hasn’t been confirmed that this drug is safe and effective for use in children younger than 16 years. It shouldn’t be used in children in this age range.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Phentermine oral capsule is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: You may not lose weight. If you take this drug for a long period of time and stop it suddenly, you may have extreme fatigue and depression.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• restlessness
• tremor
• confusion
• fast breathing
• hallucinations (seeing or hearing something that isn’t there)
• arrhythmia (irregular heartbeat)
• hypertension (high blood pressure)
• heart palpitations (fast, fluttering heartbeat)
• nausea
• vomiting
• diarrhea

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You should lose weight.

Keep these considerations in mind if your doctor prescribes phentermine for you.

General

• You can take phentermine with or without food.
• Take phentermine once per day in the morning. Taking phentermine late in the day may cause trouble sleeping.
• Don’t cut or crush the oral capsule.

Storage

• Store phentermine at room temperature. Keep it at a temperature between 68°F and 77°F (20°C and 25°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor will have you participate in an exercise program and follow a reduced-calorie diet while you’re taking this drug. This should help you lose weight. Your doctor may also ask you to keep a journal of your food intake, exercise, and weight. This will help track your weight loss progress.

Clinical monitoring

Your weight and waist circumference will be monitored while you’re taking this drug. This will tell you and your doctor if the medication is working to help you lose weight.

During your treatment, you and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include blood pressure.

Your diet

You should follow a reduced-calorie diet as directed by your doctor while taking this drug. This should help you lose weight.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Phentermine – side effects, action of the drug

Psychostimulants of synthetic origin, as a rule, medical preparations, are very popular among a part of the population who cannot live without doping. Due to the strong effect on the central nervous system, psychotropics accelerate thought processes, significantly increase mental performance , cause a powerful burst of energy. “Phentermine” is a drug that is also in the field of view of drug addicts, as it is a derivative of amphetamine. Therefore, it “explodes the brain” in almost the same way as the “hair dryer”.

Description

Phentermine was developed to treat overweight and obesity . The drug belongs to the representatives of the central sympathomimetic anorectics, providing both adrenergic and serotonergic effects. Appetite is reduced by the release of the neurotransmitter norepinephrine.

The drug is a white crystalline powder, which is available in the form of capsules or tablets (rapid effect). And in Australia and New Zealand it is sold in the form of resins with a prolonged action under the brand name “Ionamin®”, “Duromine®”. Oral (by mouth). The effect on weight loss does not depend on course or continuous use.

Sometimes sports doctors, under strict supervision, include it in the weight loss diet of bodybuilders and boxers. “Drying” the muscles and a surge of energy provide better results in training.

Please note! In a number of countries, including Russia, “Phentermine” is little known as a dietary remedy. It is of greater interest to fans of the “expansion of consciousness” as a psychotropic. In the Russian Federation, the drug is included in the list of substances subject to a ban (manufacturing, prescription, purchase, sale). In the US, anoretic treatment is strictly under medical supervision.

Phentermine is allowed in some states only because it causes less euphoria than amphetamine.

Specificity of action

For drug addicts, the drug is of increased interest due to the fact that the main agent of the drug “fen” provokes the release of neurotransmitters into the blood (norepinephrine to a greater extent, dopamine and serotonin – to a lesser extent).

Drug intoxication literally works miracles with a person: he is full of strength, energetic, self-confident, generates ideas. The world for him is colored with new colors. But after the depletion of the natural mental and physical reserves of the body comes known to all drug addicts “otkhodnyak” (withdrawal syndrome) .

Signs of the use of sympathomimetics (substances based on ephedrine):

• Rapid, often slurred speech.
• High motor activity, sometimes with impaired coordination of movements (“drunk gait”).
• Dilated pupils (mydriasis).
• Pale skin due to low blood pressure.
• Sudden change of mood. Drug intoxication first causes stormy joy, and then unreasonable aggression towards others.

As the action of toxins decreases, after about 5 hours, the patient begins to experience withdrawal symptoms. The severity of symptoms depends on several factors:

• General health and age of the drug addict . A person with a history of chronic diseases (hypertension, failures in the cardiovascular system, VVD, etc. ) endures “withdrawal” more difficult.
• From mental health . As a rule, people who resort to doping suffer from emotional instability and are prone to depression.
• Product quality . Illegal “Phentermine” is often diluted by “black alchemists” with cheap analogues of “hair dryer”. Toxic impurities reduce the cost of sympathomimetics, but increase their toxic properties.
• Experience and dosage . Since doping causes not only physiological, but also psychological dependence, and tolerance to “synthetics” increases, each time an increasing amount of “medicine” is required.

The main signs of “withdrawal”

In most cases, patients experience the following symptoms:

• A sharp increase in blood pressure, up to a hypertensive crisis.
• Arrhythmia (abnormal heart rhythm). They have an increased heart rate (tachycardia).
• Shortness of breath even at rest. Due to the low supply of oxygen to the body, cerebral hypoxia may develop.
• Pain in the hypochondrium (intercostal neuralgia)
• Periodic numbness in the upper and lower extremities.
• Profuse sweating.
• Chill.
• Insomnia. Rare lapses into oblivion are accompanied by nightmares. The addict cannot find a comfortable lying position because his muscles are cramping.
• Visual and auditory hallucinations.
• Loss of visual acuity. Objects look blurry, “flies” flash in the eyes.
• Painful reactions to light and loud noises.
• Gastrointestinal tract may cause nausea, vomiting, bloody diarrhea. And, as a result, dehydration of the body.
• Infrequent urination leads to the accumulation in the kidneys and bladder of the decay products of the “hair dryer”, so the development of pyelonephritis is possible.
• At the initial stage of “expansion of the worldview” a person, in addition to everything, feels a surge of sexual energy, then during withdrawal he is threatened with impotence (in men), and the extinction of libido (in women).

With severe intoxication, there is a loss of consciousness, and even clinical death.

Please note! Since “Phentermine” was originally intended to suppress the feeling of hunger, after repeated use of unacceptable doses, the drug addict loses interest in food. This can lead to sudden weight loss and anorexia.

Since CNS lesions are diagnosed, people become nervous, irritable and prone to aggression . To a greater extent, it manifests itself when a drug addict cannot get another portion of the “high”. Therefore, in search of a dose, according to the statistics of the Ministry of Internal Affairs, drug addicts commit the most crimes in “breaking”. This also applies to self-mutilation and suicide of the patient himself, as he is “covered” by panic attacks, and, as already mentioned, haunted by hallucinations with “voices and visions” calling to other worlds.

If the patient managed (in the early stages of drug use) to independently get out of the acute phase of “withdrawal”, he may feel constant thirst, very strong weakness, lethargy in the muscles (“cotton muscle”), pain in the joints, cramps of the extremities .

From the side of the central nervous system there is drowsiness, apathy, inability to concentrate on any activity. Dysthymia (from other Greek – “despondency, depression, sadness”), as a rule, lasts for several days.

Pay attention! In this state, the patient should never be left alone. He may have thoughts of suicide, or a desire to get the drug.

How to relieve withdrawal symptoms at home

If there is no possibility of a quick appeal to a narcologist, a person can be helped in several ways: Decoctions of herbs help well (chamomile, thyme, motherwort, valerian roots), sour fruit drinks, weak black tea with sugar (glucose helps to restore strength).

The person must be in a well-ventilated room with constant access to fresh air. Periodically, his face and chest should be wiped with a towel dipped in cool water.

Please note! No soul-saving conversations are allowed at this stage. This can only increase the guilt of the drug addict and push him to rash acts.

The ideal way out of this situation is to urgently seek drug treatment. But you can not be limited to a one-time visit of a specialist to the house. A person, after physiotherapy procedures, will be able to decide that he is healthy, and therefore again take up “the old way”. But in drug addicts, sooner rather than later, an overdose occurs, ending in disability and death.

Only in hospital the patient will be provided with qualified physical and psychological support during a long course of treatment.

References:

1. Samorodskaya, Irina Vladimirovna. / Obesity – St. Petersburg: SpecLit, 2016.
2. Damage to the cardiovascular system during therapy with drugs that affect appetite and body weight / Chazova I. E., Ilyina E.V., Tereshchenko S.N. / 2010 / Systemic hypertension.
3. Obesity pharmacotherapy: what’s new? / Troshina Ekaterina Anatolyevna, Ershova Ekaterina Vladimirovna / 2018 / Problems of endocrinology

Five things to know about pulmonary arterial hypertension

Pulmonary Hypertension

Normal Artery in Cross Section (Magnification x100) H&E stain

Five things to know about pulmonary arterial hypertension

9 0009 Pulmonary arterial hypertension (PAH ) is a deadly disease, but with timely diagnosis, you can live with it. We’ll cover the latest PAH research, including warning signs and who’s at risk.

High blood pressure, also known as hypertension, is very common, affecting nearly one in three American adults. Perhaps one of your friends. Or even yourself.

Pulmonary arterial hypertension is much less common but has a much higher mortality rate.

When a person is diagnosed with regular (systemic) hypertension, it means that the force of blood pressure on the walls of the arteries is too high, which increases the risk of heart attack and stroke.

Pulmonary hypertension is a form of high blood pressure in the lungs. It can be caused by many factors, including sleep apnea and chronic obstructive pulmonary disease (COPD). Pulmonary arterial hypertension (PAH) is a type of pulmonary hypertension in which the walls of the arteries leading from the right side of the heart to the lungs narrow. As a result, pressure in the lungs rises, leading to symptoms such as fatigue and shortness of breath.

Although PAH is a rare disease (its exact prevalence is still unknown, but it is estimated to affect 50-100 people per million), correct diagnosis and treatment is vital for patients, as PAH worsens over time, and currently There is currently no cure for this disease.

If you are at risk or want to learn more about this deadly disease, read the basic facts about PAH.

1. The exact cause of PAH is unknown, but physiological changes underlie its development and progression.

PAH is diagnosed when the mean blood pressure in an artery on the right side of the heart is greater than 25 mmHg. Art. No one knows exactly what triggers the chain of factors that leads to PAH, but experts do know how the disease progresses.

“The disease begins with vasoconstriction and leads to remodeling of the vascular wall,” says Alessandro Maresta, Physician, Vice President and Head of Global Medical Affairs at Actelion Pharmaceuticals, a Swiss biotechnology company that Johnson & Johnson acquired in June 2017. When the walls of blood vessels thicken, the lumen (the space through which blood flows) shrinks, resulting in increased pressure. As the disease progresses, the pressure continues to rise, but the right ventricle of the heart is not designed to pump blood at such a high pressure.”

“Patients tend to get tired quickly and have difficulty breathing,” says Nazzareno Galié, MD, Professor of Cardiology, Head of the Department of Cardiology at the University of Bologna (Italy). “Some people notice an increased heart rate or chest pressure, especially during exercise.”

2. There are four types of PAH.

According to Galier, most species are considered idiopathic, meaning they have no known cause or underlying precipitating factor.

About six percent of cases are inherited. This is presumably due to a mutation in the receptor for a protein that affects tissue growth. “If you are a carrier of this gene, this does not mean that you will definitely develop PAH, but you are at risk,” explains Maresta. “We believe that more than one initiating factor, such as a pre-existing disease, is required for the development of a disease.”

Idiopathic and hereditary forms of PAH are twice as common in women as in men. PAH is most commonly diagnosed in women aged
30 to 60 years old.

In some cases, the development of PAH is due to exposure to certain medications. The best-known PAH drug is called Fen-fen (Fenfluramine, Phentermine), a weight loss drug that was popular in the 60s and 70s but is no longer available.

Finally, associated cases of a disease are observed when it occurs in parallel with an already existing disease, such as HIV, congenital heart disease or scleroderma.

All four types – idiopathic, hereditary, drug-induced and associated – are treated in the same way, but the prognosis depends on the type of disease.

Maresta notes that patients with associated PAH and scleroderma are more prone to kidney failure, gastrointestinal complications and heart complications. “This can affect overall life expectancy,” adds Maresta.

3. PAH is more common among women.

According to the Pulmonary Hypertension Association, idiopathic and hereditary forms of PAH are twice as common in women as in men. PAH is most commonly diagnosed in women between 30 and 60 years of age.

It is not currently known why women are more vulnerable, but the role of estrogen, the changes (including hormonal) that occur during pregnancy, and the association with autoimmune diseases, which are also more common in women, are being studied.

4. PAH is difficult to diagnose.

This is a rare disease, therefore. when a patient complains of symptoms such as fatigue and difficulty breathing, the doctor usually checks for asthma and congestive heart failure first.

While this makes sense (these diseases are much more common than PAH), it also means that it takes time to diagnose PAH, Galier explains.

“You can see a GP, then an asthma specialist, then another specialist, etc., before you see a pulmonologist or cardiologist who diagnoses PAH,” Maresta adds. “Typically, it takes a year from the onset of symptoms to the correct and definitive diagnosis of PAH.”

In addition, Galier points out, before making a diagnosis of PAH, the physician must also rule out other forms of pulmonary hypertension.

But fortunately, the rate of PAH diagnosis is starting to increase. “Things are gradually changing as more doctors know what PAH is and how to detect it,” says Maresta.

If your doctor suspects PAH, a specialist (cardiologist or pulmonologist) will do a series of tests that may include a chest x-ray, a lung function test, and an exercise tolerance test. If the test results still show signs of PAH, you will probably need a right heart catheterization, which will allow you to measure the pressure inside the pulmonary arteries.

5. Although there is no cure for PAH, there are effective treatments for the disease .

At the physiological level, there are several biological mechanisms known as metabolic pathways associated with blood vessel function that are thought to play a role in the progression of PAH.

“Regulations strongly recommend that patients with PAH be given a combination of drugs that target two different pathways,” says Maresta. “First, you can get one drug, and then take a second drug for six months.” Maresta adds that the results of current research show that choosing three paths at once can lead to better results.

“Mean survival [from diagnosis] was once two and a half years. Now most patients live from 7 to 10 years, and some live up to 20 years.”

Alessandro Maresta, MD,

Vice President and Head of Global Medical Affairs at Actelion Pharmaceuticals

Although there is no cure for PAH now, the typical prognosis is much better than it was 25 years ago.