The most common side effects involve the central nervous system, which are expressed in the form of headache, feelings of anxiety, insomnia, euphoria, and hand tremor. We get hungry, and throw caution to the wind. Some physicians recommend splitting the daily Phentermine I have been on Phentermine for 2 months now. So how do we remedy this problem? 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. Jul 23, Messages:
: Phentermine maximum dose
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The maximum dose of Duromine is 40mg per day. This dose is used to treat obesity in adult patients who poorly respond to use of lower doses of this drug. In order to reduce appetite and feeling of hunger, Duromine 40mg capsules are taken in the morning, during breakfast. It should be borne in mind that the capsules should not be opened or chewed. This lead to disruption of their action. Anorectic effect exerted by the maximum dose of Duromine lasts at the average within 25 hours, although it may exceed this duration in some patients.
Despite the fact that clinical studies have shown that Duromine is well tolerated by obese patients, the drug is not devoid of side effects like other anorectics. Risk of adverse reactions increases when using the maximum dose of Duromine. The most common side effects involve the central nervous system, which are expressed in the form of headache, feelings of anxiety, insomnia, euphoria, and hand tremor. In addition to these side effects, the maximum dose of Duromine increases the risk of serious cardiovascular side effects.
Therefore, at the first pain in the chest or heart, stop using Duromine and consult the doctor. Although the maximum dose of Duromine helps to achieve an optimal appetite suppression and contributes to a rapid loss of excess weight, it is very important to follow the recommended treatment regimen. 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. The possibility of an association between valvular heart disease and the use of Phentermine alone cannot be ruled out; there have been rare cases of valvular heart disease in patients who reportedly have taken Phentermine alone.
When tolerance to the anorectant effect develops, the recommended dose should not be exceeded in an attempt to increase the effect; rather, the drug should be discontinued. 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.
Phentermine is related chemically and pharmacologically to amphetamine d- and dll-amphetamine and other related stimulant drugs have been extensively abused. 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. See Drug Abuse and Dependence 9 and Overdosage The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage.
Concomitant use of alcohol with Phentermine may result in an adverse drug reaction. Use caution in prescribing Phentermine for patients with even mild hypertension risk of increase in blood pressure. A reduction in insulin or oral hypoglycemic medications in patients with diabetes mellitus may be required. The following adverse reactions are described, or described in greater detail, in other sections:.
Overstimulation, restlessness, dizziness, insomnia, euphoria, dysphoria, tremor, headache, psychosis. Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Use of Phentermine is contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors because of the risk of hypertensive crisis. Requirements may be altered [ see Warnings and Precautions 5.
Phentermine may decrease the hypotensive effect of adrenergic neuron blocking drugs. Phentermine is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. A minimum weight gain, and no weight loss, is currently recommended for all pregnant women, including those who are already overweight or obese, due to obligatory weight gain that occurs in maternal tissues during pregnancy.
Phentermine has pharmacologic activity similar to amphetamine d- and dll-amphetamine [ see Clinical Pharmacology Animal reproduction studies have not been conducted with Phentermine. 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. It is not known if Phentermine is excreted in human milk; however, other amphetamines are present in human 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, taking into account the importance of the drug to the mother. Safety and effectiveness in pediatric patients have not been established. Because pediatric obesity is a chronic condition requiring long-term treatment, the use of this product, approved for short-term therapy, is not recommended.
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
Based on the reported excretion of Phentermine in urine, exposure increases can be expected in patients with renal impairment [ see Clinical Pharmacology Use caution when administering Phentermine to patients with renal impairment. Phentermine is related chemically and pharmacologically to the amphetamines. Amphetamines and other stimulant drugs have been extensively abused and 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.
Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. There are reports of patients who have increased the dosage of these drugs to many times than recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG.
Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. A severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia. Manifestations of acute overdosage include restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, and panic states.
Fatigue and depression usually follow the central stimulation. Cardiovascular effects include arrhythmia, hypertension or hypotension, and circulatory collapse. Gastrointestinal symptoms include nausea, vomiting, diarrhea and abdominal cramps. Overdosage of pharmacologically similar compounds has resulted in fatal poisoning usually terminates in convulsions and coma.
Management of acute Phentermine hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendations in this regard. Acidification of the urine increases Phentermine excretion. The most severe manifestation of chronic intoxications is psychosis, often clinically indistinguishable from schizophrenia. See Drug Abuse and Dependence 9. Phentermine hydrochloride USP is a sympathomimetic amine anorectic.
The structural formula is as follows:. Phentermine hydrochloride is a white, odorless, hygroscopic, crystalline powder which is soluble in water and lower alcohols, slightly soluble in chloroform and insoluble in ether. Phentermine hydrochloride, an anorectic agent for oral administration, is available as a tablet containing