Phentermine

Phentermine is an appetite suppressant otherwise known as Ionamin. It belongs in a class of drugs named anorexiants, and is a prescription drug used in cases where patients have not responded to an appropriate diet and exercise routine.

Also known as; Adipex P (Immediate release) - Anoxine-AM® - Fastin® - Ionamin® (Slow Release Resin, Australia) - Duromine® (Slow Release Resin, New Zealand) - Obephen® - Obermine® - Obestin-30® - Phentrol® - Phenterex® - Phentromin® - Pro-Fast SA - Redusa - Panbesy - Phentermine Trenker - Obenix - Oby-Trim

How Does Phentermine Work?

Ionamin/Phentermine works by stimulating your hypothalamus gland and affecting your neurotransmitters to reduce your appetite. The hypothalamus is the part of the brain that controls the nervous system, appetite and body temperature, among other things. is a centrally-acting stimulant and is a constitutional isomer (not to be confused with stereoisomer) of methamphetamine. It stimulates neuron bundles to release a particular group of neurotransmitters known as catecholamines; these include dopamine, epinephrine (also known as adrenalin), and norepinephrine (noradrenaline). The anorectic activity seen with these compounds is thus likely due to their effect on the central nervous system, which is consistent with current knowledge about the central nervous system and feeding behavior. This is the same mechanism of action as other stimulant appetite suppressants such as diethylpropion and phendimetrazine. The neurotransmitters signal a fight-or-flight response in the body which, in turn, puts a halt to the hunger signal. As a result, it causes a loss in appetite because the brain does not receive the hunger message.

How do you take Phentermine?

Doctors usually recommend that you take Phentermine on an empty stomach, preferably an hour before meals. The pills must be taken whole or split in half - crushing or chewing can increase side effects and reduce Ionamin's long-lasting action. Generally, it is recommended by the Food and Drug Administration (FDA) that phentermine should be used short-term (usually interpreted as 'up to 12 weeks'), while following nonpharmacological approaches to weight loss such as healthy dieting and exercise. However, recommendations limiting its use for short-term treatment may be controversial. One reason given behind limiting its use to 12 weeks is drug tolerance, whereby phentermine loses its appetite-suppressing effects after the body adjusts to the drug. On the contrary, it has been shown that phentermine did not lose effectiveness in a 36-week trial.[2] Due to the risk of insomnia, it is generally recommended that the drug be taken either before breakfast or 1-2 hours after breakfast.

Only take as much as your doctor prescribes as there is a risk of overdose. Phentermine should also not be taken in conjunction with other diet pills. If you miss a dose then do not double-dose the next day. A dose taken late in the day may also cause insomnia.

Who should not take Phentermine

You should consult your doctor if you have any of the following conditions:

Heart disease, Arteriosclerosis, Glaucoma, Thyroid problems, Anxiety, a seizure disorder such as epilepsy, Diabetes, a history of drug/alcohol abuse.

Patients who are pregnant or breastfeeding should avoid Phentermine, as well as those who have taken a monoamine oxidase inhibitor in the last 2 weeks. Always check with your doctor first.

Phentermine Side Effects

Phentermine is habit-forming and is often qualified as addictive by doctors. Usage should be limited to only a few weeks. Users should speak to their doctors about any side effects that occur but I have listed some of the most common below.

If you notice these side effects, stop taking Phentermine immediately and call for emergency help:

Hallucinations or confused behaviour

Allergic reaction (typically swelling of the lips, tongue or throat)

High blood pressure or irregular heartbeat.

Constipation
Vomiting
Diarrhea
Other, less serious, side effects include restlessness, anxiety, insomnia, and dry mouth.

Old News:

American Home Products Corp. resolved one of the biggest product liability cases ever Thursday by agreeing to pay up to $4.83 billion to settle claims that the fen-phen diet drug combination caused dangerous heart valve problems. The settlement covers thousands of lawsuits filed nationwide and any of the roughly 6 million people who took the now-recalled drugs, even if they didn't sue. If a judge approves the settlement, people with serious health problems blamed on fen-phen will get as much as $1.5 million each. Healthy former users will be able to get such benefits as $30 prescription refunds and free checkups. Payments will begin this year and continue for about 16 years. The settlement contains $2.32 billion to pay for injuries, $1 billion for medical monitoring and drug refunds, and $429 million in plaintiffs' attorney fees. The company also agreed to pay $25 million for heart disease research. Under the settlement, American Home will put $3.75 billion aside. With interest, the total amount could be $4.83 billion, easily surpassing such other large product-liability settlements as Dow Corning's $3.2 billion payment to women with silicone breast implants. The settlement ``offers peace of mind to those who used the drugs and permits the company to move beyond the uncertainty and distractions of litigation,'' said John R. Stafford, American Home's chairman, chief executive and president. But the settlement's proposed $1.5 million lid may not be enough for some plaintiffs with serious injuries, according to Joshua Katz, a Santa Rosa attorney with the Lanahan and Reilley law firm the represents about 60 of the plaintiffs. Katz cited a Humboldt County woman with two heart valves replaced and with severe hypertension whose case is set for trial in February as one example where the plaintiff may not agree to the settlement. About half of Katz's 60 claims live in North Coast counties, while the others live in the Sacramento Valley. ``The settlement could be good for people whose injuries are not as severe, but for her that amount of money is simply not adequate,'' Katz said. ``The company put profits ahead of people's health.'' It was American Home's second big settlement in recent months. Subsidiary Wyeth-Ayerst Laboratories agreed to pay more than $50 million to 36,000 women to settle claims that the implantable contraceptive Norplant caused headaches, irregular menstrual bleeding, nausea and depression. The company admitted no wrongdoing. American Home, which also sells the pain reliever Advil and Robitussin cough medicine, made fenfluramine, the ``fen'' in the fen-phen combination, and sold it as Pondimin. It also made a similar drug called Redux, which is covered by the settlement. Doctors prescribed Pondimin along with phentermine, or ``phen'' for short, but in 1997, the Food and Drug Administration persuaded the company to stop selling the drugs after a Mayo Clinic study linked fen-phen to potentially fatal heart valve damage. Phentermine, which is made by another company, was never linked to any illnesses when taken alone and remains on the market. Louis L. Hoynes, American Home's general counsel, reiterated the company's position that the drugs, which make the brain trick the stomach into feeling full, were safe for most people. ``The scientific studies conducted to date and clinical experience indicate that the health of the overwhelming majority of people who took Redux or Pondimin has not been adversely affected,'' he said. On news of the settlement, American Home stock rose $3.56-1/4, or 8 percent, to $48.68-3/4 on the New York Stock Exchange. The company had revenue of about $13 billion last year and profits of $2.5 billion. American Home, based in Madison, N.J., said it faces about 6,500 suits over the drugs. Individuals can opt out of the settlement and still sue. However, if American Home believes too many people have refused to participate, it can terminate the deal. In the only verdict in any fenphen lawsuit, a jury awarded a 36-year-old Texas woman $23.3 million in July for heart damage she claimed to have suffered after taking fen-phen for more than three months. Last month, the company settled for about $2 million, her attorney Kip Petroff said. Under the settlement, she would have received only about $21,000, Petroff said. He represents about 150 other fen-phen clients and is advising them not to participate in the settlement. ``It's just a bunch of garbage,'' he said. ``It's way too little money. The people under that settlement would get just a small fraction of what they could get in court.'' Juanita Spear, who took the diet pills for five months in 1997 and said she suffered heart valve damage, said the settlement will be easier than going to court herself. ``I still feel as if they should never have put the drug out there,'' said Spear, 50, of Anchorage, Alaska. ``No matter what the amount is, it doesn't change the fact that I don't have the energy that I once did.'' A trial had been under way in New Jersey over whether the company should pay for medical monitoring for 94,000 healthy exfen-phen users. The trial was suspended this week when the settlement appeared near. The settlement does not cover patients who say they suffer from primary pulmonary hypertension, a rare but serious lung disorder. The company said it decided to deal with those cases separately because there are so few of them. It also noted that fen-phen's label included a warning about the disorder.

The recall of two popular weight-loss pills has triggered calls and inquiries to local physicians, pharmacies and health food stores as anxious dieters wonder what to do now that the drugs have been taken off the market. One of the drugs was half of the double-whammy ``fen-phen'' mix that became an international weight-loss craze three years ago and still was popular among dieters and physicians until the recall a week ago. On Saturday, people still were calling in their prescription refills for fenfluramine (Pondimin) and dexfenfluramine (Redux), said several area pharmacists. Those customers were told about the recall and warned not to take any of their remaining pills. ``I don't know what I'm going to do now,'' said one 62-year-old Healdsburg woman, who asked not to be named. She said she lost 70 pounds during the two years she was on ``fen-phens.'' At 190 pounds, she still is overweight and needs to lose more to help control her diabetes. The recall was announced last Monday, following controversy and critical debate among the scientific and medical communities. The Federal Drug Administration requested the drugs be removed from the market due to the discovery of heart valve abnormalities among 92 of 291 patients participating in a study of the ``fen-phen'' combination. The combination mixes phentermine with the now-banned fenfluramine. A half-dozen former fen-phen users in Sonoma County said they had experienced serious side effects from using the drugs. ``I'd tried everything, Nutra System, Weight Watchers, you name it,'' said a 43-year-old Santa Rosa woman. ``I'd lose weight slowly, then put it back on, plus some extra. I weighed 180 pounds and I'm only 5 five feet tall. When I heard about `fen-phens,' I asked my doctor for the pills.'' The drugs helped her to drop down to 124 pounds, but she also developed flu-like symptoms, pneumonia and shortness of breath, she said. ``Now I've been told that I need new valves for my heart.'' Another woman, one of three Sonoma County residents participating in a class-action lawsuit demanding the drug manufacturers pay for ongoing health monitoring, said she has switched to a ``natural'' fen-phen. ``Herbal Phen-Fen'' has become a hot item in the past few days, said Josh Durrin, a sales clerk at General Nutrition Center in Santa Rosa Plaza. ``Herbal Phen-Fen is totally different than the synthetic ``fenphen'' prescription drugs,'' Durrin said. ``Herbal Phen-Fen is just the combination of two herbs, St. John's Wort extract and Mahuang extract ... This herbal combination works well with Guarana, which is an herbal caffeine that'll boost your metabolism and burn fat.'' A number of grocery stores polled Saturday reported increased sales of diet products. Customers in the past few days have been buying more Slim Fast, Lean Cuisine and other products labeled either ``low-fat'' or ``fat free,'' as well as over-the-counter weight-loss pills such as Dexatrim. Some women say their lives were turned around by weight loss from the fen-phen combination and say they have had none of the negative side effects. One 40-year-old Sebastopol woman who has been on Redux a year and a half said she will take the pills she still has. ``I don't have any symptoms and I'm perfectly healthy. I'll take them until I'm out and then I'll scrounge what I can get from my friends who have stopped taking it.'' That's not advisable, warn physicians, and it's the reason the drug manufacturers are willing to buy back any remaining pills dieters have in their possession. Wyeth-Ayerst Laboratories has provided a toll-free number for information: (800) 892-2718

A Santa Rosa doctor who has been a proponent of diet drugs in treating obese diabetic patients applauded their recall. ``I think it's appropriate they take it off the shelf if the risks are not rare or trivial, and this information certainly indicates that is not the case,'' endocrinologist David Price said, referring to new data on the drugs -- fenfluramine, sold as Pondimin, and dexfenfluramine, sold as Redux. ``I've been proactive in prescribing these drugs and I was even on the lecture series for Redux,'' Price said. ``Until now, I haven't seen anything that argued against them. In fact, in July I sent out questionnaires to cardiologists all over Northern California asking them if they'd encountered any problems, especially valvular problems. I only heard of one possible problem.'' Removing the drugs from the market will not put an end to the problem or to litigation, said Arnold Laub, a San Francisco attorney who filed a class action suit in federal court against the manufacturers of fenfluramine, dexfenfluramine and phentermine -- another diet drug that with fenfluramine formed the second half of the fen-phen combination. ``The problems associated with the cardiovascular system are just the tip of the iceberg,'' Laub said Monday. ``What about tests that have shown brain damage? What about people on these drugs who commit suicide? What about pulmonary disease?'' The lawsuit, filed last month on behalf of many patients, including two unnamed residents of Sonoma County, seeks compensation as well as the establishment of a medical monitoring fund to keep tabs on patients who have taken the diet drugs.

Imagine a disease, called Disease X, which affects 35 percent of the population and its incidence is increasing at an alarming rate. It is a major risk factor for premature coronary disease, uterine cancer, breast cancer, prostate cancer, diabetes, hypertension, cholesterol problems, gallstones, arthritis and depression. Disease X has no established successful therapy and most patients who do respond to treatment suffer a high recidivism rate. Recently, some medications have offered hope to patients who suffer from Disease X. Although not all patients respond to these medications, many do, some dramatically. Side effects are usually mild and transient, although there is a very rare (one in 20,000 to 50,000 people per year) fatal complication resulting in heart and lung failure. An association between these drugs and valve damage in the heart was just reported and is thought to be exceptionally rare, if it exists at all. Appropriately prescribed with medical follow up, these complications occur no more often than do potentially fatal side effects from other medication. Disease X is obesity, and the medications described include phentermine/fenfluramine and dexfenfluramine. The disease, obesity, contributes to 300,000 deaths each year in the United States and for the very obese, or those less obese with medical complications, the benefits of treatment with these medications far outweigh the risks of not treating obesity, or the minuscule risk reported to these drugs.

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