The clinical significance of this change is unknown. Although phentermine is one of the most commonly prescribed weight-loss medications, it has some potentially serious drawbacks. Monitor therapeutic response; the dosage requirements of amlodipine may be increased. Minor The metabolism of dapsone may be accelerated when administered concurrently with topiramate, a known inducer of CYP3A4. One drug information reference suggests that cyclic antidepressants potentiate the pharmacologic effects of direct-acting sympathomimetics, but decrease the pressor response to indirect-acting sympathomimetics, however, the data are not consistent. Energy is drafted by this, ii suitable in vitro dissolution testing of all advantages, and iii proportional.
Coadministration with alcohol or CNS depressants drugs with phentermine or topiramate may potentiate CNS depression or other centrally mediated effects of these agents eg, dizziness, cognitive adverse reactions, drowsiness, light-headedness, impaired coordination, somnolence. Kidney stone formation reported; topiramate inhibits carbonic anhydrase activity and promotes kidney stone formation by reducing urinary citrate excretion and increasing urine pH; avoid coadministration with other carbonic anhydrase inhibitors; use in patients on a ketogenic diet may also increase this risk; increase fluid intake to decrease risk.
Can cause changes in laboratory values; can increase the risk of hypokalemia through its inhibition of carbonic anhydrase activity; caution with coadministration of drug that cause hypokalemia eg, furosemide, hydrochlorothiazide. Obtain blood chemistry profile that includes bicarbonate, creatinine, potassium, and glucose at baseline and periodically during treatment. Available epidemiologic data indicate an increased risk in oral clefts of 9. The effect of topiramate-induced metabolic acidosis has not been studied in pregnancy; however, metabolic acidosis in pregnancy due to other causes can cause decreased fetal growth, decreased fetal oxygenation, and fetal death, and may affect the fetus???
Qsymia Pregnancy Surveillance Program to monitor maternal-fetal outcomes of pregnancies that occur during therapy Distributed in breast milk; because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug. Controlled studies in pregnant women show no evidence of fetal risk. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. Positive evidence of human fetal risk. Do not use in pregnancy. Risks involved outweigh potential benefits. Sympathomimetic amine; induces anorectic effect via release of norepinephrine in the hypothalamus causing appetite suppression by increasing blood leptin concentration; exact mechanism of action unknown.
Adding plans allows you to compare formulary status to other drugs in the same class. To view formulary information first create a list of plans. Your list will be saved and can be edited at any time. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. By clicking send, you acknowledge that you have permission to email the recipient with this information.
Sign Up It's Free! If you log out, you will be required to enter your username and password the next time you visit. Brand and Other Names: Share Email Print Feedback Close. Not to exceed 7. Hepatic impairment Mild Child-Pugh No dose adjustment required Moderate Child-Pugh Significant - Monitor Closely. All Interactions Sort By: Postmarketing Reports Phentermine Allergic: Increased blood pressure, ischemic events CNS: Euphoria, psychosis, tremor Reproductive: Changes in libido, impotence.
Topiramate Central nervous system: Suicidal behavior and ideation Dermatologic: Bullous skin reactions eg, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis , pemphigus Gastrointestinal: Hepatic failure including fatalities , hepatitis Metabolic: Maculopathy, angle closure glaucoma, increased intraocular pressure. Warnings Contraindications Hypersensitivity or idiosyncrasy to sympathomimetic amines Pregnancy Glaucoma Hyperthyroidism Use of phentermine is contraindicated during or within 14 days following MAOIs due to risk for hypertensive crisis.
X Can cause fetal harm and weight loss offers no potential benefit to a pregnant woman Available epidemiologic data indicate an increased risk in oral clefts of 9. Distributed in breast milk; because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug Pregnancy Categories A: Pharmacology Mechanism of Action Phentermine: Core chapter content centers on the drugs that advanced practitioner prescribers will see most commonly in clinical practice.
This new text is built on the My library Help Advanced Book Search. Buy eBook - EUR Elsevier Health Sciences Amazon. Laura Rosenthal , Jacqueline Burchum. Elsevier Health Sciences , Feb 17, - pages. Introductory chapters tailored to the specific needs of advanced practice prescribers cover topics such as prescriptive authority, rational drug selection and prescription writing, and promoting positive outcomes of drug therapy.
Carefully focused pharmacotherapeutic content reflects the drugs most commonly seen and used by advanced practice prescribers, with emphasis not on the first drug discovered or developed in each class but on the agents most often used today. Primary care drugs are addressed first in each chapter as appropriate, followed by and acute care drugs. Prescriber-focused pedagogical aids further reinforce the most important information for advanced practice prescribers.
Black Box Warnings alert you to special warnings and precautions related to particular drugs.