If obesity is impacting your fertility or reproductive health, or if you have a specific condition that affects weight (such as PCOS), your gynecologist may consider prescribing phentermine as a short-term weight management strategy. These include, but are not limited to:Whether the care and treatment of obese patients and weight management is new to the APRNs existing practice, and whether this aspect of practice is within the APRNs national certification and patient population specialty, meeting the scope of practice requirements in Section 4723.43, ORC. When breastfeeding, the drug may enter the breast milk and travel into the nursing babys body, which may cause harm to them. Other brands of this drug include Suprenza, Phentercot, Acxion, Elvenir, Terflamex, Panbesy, Duromine, Fentermina, Phentermin, PHentermine and Lomaira. endstream endobj startxref Chapter 4731-11 - Ohio Administrative Code | Ohio Laws Drug information provided by: IBM Micromedex. 2 It is contraindicated for patients with current or past: cardiovascular disease (heart problems), hyperthyroidism, glaucoma, agitated states, drug/alcohol abuse, or reactions to sympathomimetic amines. All rights reserved. Mayo Clinic Proceedings. United Nations Office on Drugs and Crime. (1) The prescriber shall assess the patient, at a minimum, once in the first three months of utilization of controlled substances for weight reduction, and shall record in the patient record information demonstrating the patient's continuing efforts to lose weight, the patient's dedication to the treatment program and response to treatment, and Yes, you need a prescription for phentermine. The natural history of obesity is measured over several years, whereas the studies cited are restricted to a few weeks duration; thus, the total impact of drug-induced weight loss over that of diet alone must be considered clinically limited. Some patients need to take the drug an hour before they eat breakfast, while others are advised to take it approximately one to two hours after breakfast. The dose of this medicine will be different for different patients. Ohio has some of the strictest rules in the country and. Make sure your hands are dry before touching the tablet. Please consult with your physician before you make any decisions regarding your health. Although phentermine is the agent-of-choice among physicians specializing in obesity treatment, the use of this drug for obesity treatment by other physicians has long been curtailed because misapprehensions regarding phentermine safety. LZ(6&JQKU5@5_M.~#p = yLgzP"Z90* v~1iu0pV (s:J&Q,. } }& 8}q>u@y)dO|fRmknw huA0@6-%&k-1qI6fSt4#>=sHMk>8fztq9_ nw:>NxHfib Lx.c QEWg\@y@ ~[*+-Dze~Ej+%.E`|IdW#o~#` MM The possible role of Phentermine in the etiology of these valvulopathies has not been established and their course in individuals after the drugs are stopped is not known. Press Releases. This was often referred to as Rainbow Pills as all four drugs were often provided to a patient at the same time. If not, additional education or an additional certification may be needed. Phentermine is a schedule IV drug that requires a consultation with the doctor and a prescription. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo subjects and tends to decrease in succeeding weeks. ). Some of these include: As with many other prescription drugs, Phentermine can also interact with certain medications. After the tablet has melted, swallow or take a sip of water. Review/update the In addition, Section 4723.431(A), ORC, requires the APRNs collaborating physician to be practicing in Ohio in a specialty that is the same or similar to the nurses nursing specialty.Section 4723.481(B), ORC, prohibits the prescriptive authority of the CTP holder from exceeding the prescriptive authority of the collaborating physician. But regarding phentermine monotherapy, phentermine hydrochloride (HCl) is a sympathomimetic Drug Enforcement Agency (DEA) scheduled IV drug approved as an anti-obesity medication and marketed in the US since 1959 (See Table 1).The reported weight reduction efficacy of phentermine [10] derived from . Click here for an email preview. In most cases, the drug is prescribed to users in periods of 12 weeks. Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Many physicians who currently receive the reports have found that the reports help them better understand, and possibly alter, their prescribing practices. This content does not have an Arabic version. Patients should be advised to report immediately any deterioration in exercise tolerance. information submitted for this request. %PDF-1.3 They help the body produce a larger amount of energy from fat cells, which further reduces body fat percentage. The possibility of abuse of Phentermine should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. Primary Pulmonary Hypertension (PPH) a rare, frequently fatal disease of the lungs has been reported to occur in patients receiving a combination of Phentermine with fenfluramine or dexfenfluramine. Carefully follow the dosing instructions for the form you are using. PDF PA Prescriptive Authority Guidance Document - Ohio As much as 33% of the U.S. adult population are considered to be obese. A physician is the only person who can prescribe phentermine. information highlighted below and resubmit the form. The drug is classified under a certain chemical class known as amphetamine as it has a similar pharmacology value to other drugs classified in the class. The overdose symptoms include: The side effects of Phentermine can lead to several symptoms that may impair certain functions in the patients body. , 0 I hold a DEA cert. ohio.gov under the Practice APRN link.Although the Formulary allows CTP holders to prescribe these three drugs under the circumstances documented by their respective standard care arrangement, there are other factors that must be considered by the CTP holder prior to initiating Qsymin, Belviq or Contrave prescriptions for patients. These are two schedule- IV medications, phentermine/topiramate (Qsymia), and locaserin (Belviq), as well as non-controlled naltrexone hydrochloride/ buproprion hydrochloride (Contrave). Lomaira: One tablet three times a day, taken 30 minutes before meals. Therefore, coadministration of Phentermine and these drug products is not recommended. Get the best fitness, food, and weight loss tips to succeed on your journey! Duromine is not funded by Pharmac, so patients pay $160-$200 per month when they present a standard prescription of 30mg daily - in addition to the GP consultation fee. Take 1 tablet or capsule once a day before breakfast or 1-2 hours after breakfast. United States of America, Drug Enforcement Administration, Federal Register. Phentermine may decrease the hypotensive effect of adrenergic neuron blocking drugs. Long-term efficacy and safety of anti-obesity treatment: Where do we stand? If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus. HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use . A physician will usually start with a physical examination to determine if the patients health is in a state that will not be negatively affected when taking this drug. The limited usefulness of agents of this class, including Phentermine, [see Clinical Pharmacology (12.1, 12.2)] should be measured against possible risk factors inherent in their use such as those described below. ]^Ng8\!HqX 'nR l# w! {A6.q=0G: S:nR-`\ |%Tx F5z :^EU\)|\eyt0F In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2), limit the dosage of Phentermine to 15 mg daily [see Dosage and Administration (2.2)]. It should melt quickly. The CPG determination is specific to Qsymin, Belviq and Contrave only. More, these sites also operate pharmacies that are not VIPPS-accredited, so you may also be putting your personal information and or money at-risk ( At January's meeting, the board discussed the rules and elected to investigate what other states are doing to regulate weight loss medication. Won Son J, et al. The CPG determination is specific to Qsymin, Belviq and Contrave only. Your doctor may prescribe both of these drugs separately, or choose to prescribe Qsymia, which is another medication that combines Phentermine and Topamax. Phentermine also is offered combined with topiramate for weight loss (Qsymia). Last updated on Mar 22, 2022. Use caution when administering Phentermine to patients with renal impairment. 100 TABLETS Some patients experience an increase in sexual interest, while others notice that they have a lower libido. It is illegal & unsafe to buy phentermine online consider Phen Caps instead! Search: PHENTERMINE BMI GUIDELINES Metabolism Phentermine has two metabolic pathways; hydroxylation and oxidation. Do not crush, break, or chew it. It is obvious that these symptoms can make the entire program useless. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. ). Rx only. %%EOF This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. the unsubscribe link in the e-mail. The FDA in the United States first approved the use of Amphetamine as a drug that can be used to suppress a patients appetite in 1959. include protected health information. Today, Phentermine can still be obtained through the doctors prescription in the majority of countries around the world. Adults and children 17 years of age and older. Overstimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, psychosis. Special Populations Geriatric Patients Select dosage with caution, starting at lower end of dosage range. This site complies with the HONcode standard for trustworthy health information: verify here. This is a label given to drugs that can be misused. Phendimetrazine tartrate is a white, odorless crystalline powder. HVMs8WQl eLg*&{dd $_;lm |NggK6,M]gu\.BNB. Diabetes & Metabolism Journal. The safety and efficacy of combination therapy with Phentermine and any other drug products for weight loss including prescribed drugs, over-the-counter preparations, and herbal products, or serotonergic agents such as selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, fluvoxamine, paroxetine), have not been established. Avoid use of Phentermine in patients with eGFR less than 15 mL/min/1.73m2 or end-stage renal disease requiring dialysis [see Use in Specific Populations (8.6) and Clinical Pharmacology (12.3)]. After 12 weeks, the patient needs to take a break from the product as it may lead to physical dependence. Implementation of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. The most common brand of Phentermine is a product known as Adipex, but officially called Adipex-P. 4 5 Each tablet contains the following inactive ingredients: starch, lactose anhydrous, microcrystalline cellulose, colloidal silicon dioxide, stearic acid, magnesium stearate and blue sugar spheres. However, weight loss clinics are not the perfect solution. 4 0 obj 2021; doi:10.1007/s13679-020-00422-w. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Biliopancreatic diversion with duodenal switch (BPD/DS), Endoscopic Sleeve Gastroplasty (Gastric Sleeve), Biliopancreatic diversion with duodenal switch. If we combine this information with your protected PDF Reference ID: 3115694 - Food and Drug Administration Phen Caps is recommended by over 30,000 people like you who want to lose weight fast and effectively without the drawbacks of prescription medications. Obesity pillars roundtable: Phentermine - Past, present, and future Some brands use a dissolving tablet that is placed under the tongue, which allows the body to absorb the chemicals in the drug faster. Phentermine Hydrochloride Tablets are indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index 30 kg/m 2, or 27 kg/m 2 in the presence of other risk factors (e.g., Patients must be instructed on how much Phentermine to take, and when and how to take it [see Dosage and Administration (2)]. The drug is mainly an appetite suppressant, thus making a patient feel fuller after (and between) meals and making the patient more likely to consume foods that have lower amounts of calories. Patients who have been on a Phentermine program should not suddenly stop using the drug. This includes Chapter 4731-11, OAC, Controlled Substances pertaining to the prescribing of schedule II, III, and IV medications for purposes of weight loss. Many patients find that if their doctor gradually lowers their dose, for example from 37.5mg per day down to 15mg per day for the last few days, they experience fewer withdrawal symptoms and are able to keep the weight off later. Some preparations of the formula, however, have been classified as schedule II drugs. Specializes in Cardiology, Research, Family Practice. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. As phentermine is similar to amphetamine, it is a controlled drug (class C5) and has the potential for abuse. Contraindications History of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive heart failure, uncontrolled hypertension) During or within 14 days following the administration of monoamine oxidase inhibitors Hyperthyroidism It is both dangerous and potentially illegal to use an online phentermine doctor. Read more here: How much does phentermine cost? the unsubscribe link in the e-mail. Perreault L. Obesity in adults: Drug therapy. Dosage form: tablet The magnitude of increased weight loss of drug-treated patients over placebo-treated patients is only a fraction of a pound a week. See Drug Abuse and Dependence (9) and Overdosage (10). Mid-Level Practitioners Authorization by State Pursuant to Title 21, Code of Federal Regulations, Section 1300.01(b28), the term mid-level practitioner means an individual If your dose is different, do not change it unless your doctor tells you to do so. As a reminder, Ohio law requires physicians who prescribe any controlled substances, not just opioids, to submit an ICD-10 code with that prescription. It has the chemical name of ,,-Dimethylphenethylamine hydrochloride. Phentermine doctors network. The medical board would like to work with the pharmacy board to make OARRS reports more available and helpful to physicians. The FDA has categorized this drug as X for pregnancy, which means it should not be used during pregnancy under any circumstances. endstream endobj 1531 0 obj <>/Metadata 26 0 R/Pages 1528 0 R/StructTreeRoot 41 0 R/Type/Catalog>> endobj 1532 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/TrimBox[0.0 0.0 630.0 702.0]/Type/Page>> endobj 1533 0 obj <>stream Phentermine may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle; the patient should therefore be cautioned accordingly. Your email address will not be published. Phentermine is pregnancy category X, so it should never be taken while pregnant or nursing ( While the drug is considered to be relatively safe for individuals who are older than 16, the recommended age is 18. 121 0 obj <>/Filter/FlateDecode/ID[<5D80FCFEE48BF540827EEA7155FB4128>]/Index[104 35]/Info 103 0 R/Length 85/Prev 180155/Root 105 0 R/Size 139/Type/XRef/W[1 2 1]>>stream Nationwide Efforts to Combat the Problem Questions To Discuss At the completion of this block of instruction you will be able to answer the following questions: 1. PDF Phentermine Patient Information - American Association of Clinical Le81g Of Rdb-YR!bLEbfYo9(e The Topamax is added to Phentermine in order to intensify its effects and to help patients lose weight faster. APRNs Prescribing Weight Loss Medications. A link to Chapter 4731-11, OAC, is also provided on page 15 of the Formulary.The nursing law and rules are available for review on the Boards website www.nursing.ohio.gov under the Law and Rules link.The website for State Medical Board of Ohio is: www.med.ohio.gov. Due to its status as a controlled substance, the sale, distribution, and possession of this drug is tightly regulated by the DEA and international regulatory authorities ( By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. Phentermine is not recommended for use in pediatric patients 16 years of age. Following the administration of Phentermine, Phentermine reaches peak concentrations (Cmax) after 3 to 4.4 hours. See DrugAbuse and Dependence (9.3). ). HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use ADIPEX-P safely and effectively. How to Get a Prescription for Phentermine - Phentermine.com Moreover, it is strongly recommended to avoid or limit the alcohol intake. The drug is classified under a certain chemical class known as amphetamine as it has a similar pharmacology value to other drugs classified in the class. The possibility of an association between PPH and the use of Phentermine alone cannot be ruled out; there have been rare cases of PPH in patients who reportedly have taken Phentermine alone. Some weight loss clinics also insist that patients take additional supplements, such as vitamin B12 shots and 5-HTP, to boost phentermine despite the supplements unproven effectiveness. Rule 4731-11-14 - Ohio Administrative Code | Ohio Laws Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide. More specifically, this medication is an option for people with a body mass index (BMI): Greater than 30 kg/m2 Greater than 27 kg/m2 + one or more weight-related condition All rights reserved. It helps patients lose weight by suppressing their appetite and boosting their energy levels, thus leading to a more active lifestyle and greater calorie burn. Plus, the doctors are not familiar with your overall health status, instead relying entirely on self-reported information, which is often incomplete or inaccurate. Phentermine Hydrochloride Tablets are indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index 30 kg/m2, or 27 kg/m2 in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia). Do not keep outdated medicine or medicine no longer needed. This search engine indexes the Drug Enforcement Administration Diversion Control Program Web Site (www.deadiversion.usdoj.gov) only. % Phentermine hydrochloride USP is a sympathomimetic amine anorectic. The patient brings in a prescription for the same drug on November 1, 2013. Should the collaborating physician have restrictions on his/her ability to prescribe controlled substances including controlled substance weight loss medications, the CTP holder would be limited by the same restrictions.The administrative rules, Advanced Practice Registered Nurse Certification and Practice, contained in Chapter 4723-8, of Ohio Administrative Code (OAC), require all APRNs to utilize and incorporate into the nurses practice knowledge of Chapter 4731.,ORC, and rules adopted under that chapter by the State Medical Board that govern the practice of the nurses collaborating physician. Initial U.S. Approval: 1959 -----INDICATIONS AND USAGE----- Suprenza is a sympathomimetic amine anorectic indicated as a short-term adjunct (a few weeks) in a regimen of . 104 0 obj <> endobj . allnurses is a Nursing Career & Support site for Nurses and Students. This site complies with the HONcode standard for trustworthy health information: verify here. The usual duration of treatment is 12 weeks or less. Even after the period that the drug has been prescribed for, the doctor will often recommend to gradually stop using the Phentermine to avoid the withdrawal symptoms. The dosage may be adjusted to the patients need. Concomitant use of alcohol with Phentermine may result in an adverse drug reaction. Take this medicine only as directed by your doctor. If the time is too close to the next dose, it is recommended to skip the dose they have missed. Why is phentermine a controlled substance? Opioid Prescribing Guidelines - Ohio Highlighted below are the topics discussed at the meeting that OSMA is closely following. Phentermine should never be taken after 6 pm in the afternoon as it causes insomnia. Sally Cohen holds a degree in nutrition sciences from Alcorn State University. This study guide will help you focus your time on what's most important. In some cases, the doctor may prescribe Phentermine in smaller doses and advise the patient to take it up to three times in a single day. Rule 4731-11-04 | Controlled substances: Utilization of short term anorexiants for weight reduction. If your primary care physician thinks you are a good candidate for phentermine but does not want to (or cannot) prescribe it, he or she may refer you to a specialist. In relatively short-term clinical trials, adult obese subjects instructed in dietary management and treated with anorectic drugs lost more weight on the average than those treated with placebo and diet. hbbd``b`z$@D`]"@DeX- Bb V ``LA\F*? Advertising revenue supports our not-for-profit mission. (5) A treatment plan based upon the clinical information obtained, to include all of the following components: (a) Diagnosis; (b) Objective goals for treatment; (c) Rationale for the medication choice and dosage; and (d) Planned duration of treatment and steps for further assessment and follow-up. However, phentermine is not appropriate or safe for everyone. Drug classes: Anorexiants, CNS stimulants. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This website is a resource which lists doctors and clinics who may offer phentermine or appetite suppressants for patients they deem qualified. Ohio has some of the strictest rules in the country andthe current rules place time limitations on prescriptions that, many times, force physicians to stop a medication that is showing positive weight loss results. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class in which these phenomena have been looked for. JC. However, the medication does have a considerable street value. Facts & Comparisons eAnswers. x8FvuN3il&_t%(af?uE7wRu\BbK. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Swallow the extended-release capsule whole. This combination of ingredients was branded as Fen-Phen. iQJG\If6CuoG^|&qXegM,+vmC [To w{`F@kMxVBrH7.1g B;H _BfHPXK#Q Swallow the tablet whole. Learn about phentermine and succeed in your weight loss journey. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. The Formulary can be accessed on the Board of Nursing website: www.nursing. Adipex-P: Package Insert / Prescribing Information - Drugs.com It is advised to stay in strict adherence with the instructions and dosage information a doctor prescribes to the patient in order to avoid dangerous side effects. Children 16 years of age and youngerUse is not recommended. LiverTox National Institutes of Health. Adipex-P (phentermine hydrochloride) capsules label, Greater than 27 kg/m2 + one or more weight-related condition, Vitals (heart rate, blood pressure, etc. 0 Phentermine is a popular prescription drug that is often used to treat obesity. The State Medical Board of Ohio met on January 13, 2021. It also isn't for people who are pregnant, may become pregnant or are breastfeeding. 2019; doi:10.1016/j.mayocp.2018.11.020. However, it caused a chronic condition known as pulmonary hypertension, which led to the death of many patients. information highlighted below and resubmit the form. %%EOF Comprehensive review of current and upcoming anti-obesity drugs. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Below is a chart of body mass index (BMI) based on various heights and weights. Start with your primary care doctor and schedule an appointment to discuss weight. (2019). The risks include, but are not limited to: See also, for example, Adverse Reactions (6) and Use in SpecificPopulations (8). = I wonder whose pockets got lined with that one. Phentermine is for people with obesity or overweight who haven't been able to lose enough weight with diet and exercise alone to improve their health. Since Phentermine is a drug that contains chemical compounds, it is important to know about all of the risks that are involved with its use and precautions a person should be aware of before the consumption. Systemic exposure of Phentermine may increase up to 91%, 45%, and 22% in patients with severe, moderate, and mild renal impairment, respectively [see Dosage and Administration (2.2) and Use in Specific Populations (8.6)]. Based on Ohio's opioid prescribing guidelines, we developed an opioid prescribing rule that applies to all BWC-certified prescribers. Phentermine is 17.5% plasma protein-bound, while topiramate is 15 - 41% plasma protein-bound when the blood concentration range is 0.5 to 250 g/mL. Accessed Oct. 11, 2022. Phentermine has been linked to many complications; knowing these details will help patients minimize their risk of experiencing such unwanted scenarios. PDF ADI-40091 Adipex-P PI v2 The weight loss experts who OSMA has consulted with have indicated that misuse of phentermine is unlikely. Even patients who are overweight and pregnant at the same time are not allowed to use this product. Burguera B, et al. Later on, between 1940 and 1960, Phentermine was combined with other medications to improve its effectiveness.