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Weight loss drug
Description
Sympathomimetic appetite suppressants are used in the short-term treatment of obesity.
Their appetite-reducing effect tends to decrease after a few weeks. Because of this, these
medicines are useful only during the first few weeks of a weight-loss program. The
sympathomimetic appetite suppressants can help you to lose weight while you are learning
new ways to eat and to exercise. Changes in eating habits and activity level must be
developed and continued long-term in order for you to continue losing weight and to keep
the lost weight from returning.
These medicines are available only with your doctor's
prescription, in the following dosage forms:
Oral
- Benzphetamine
- Diethylpropion
- Tablets (U.S. and Canada)
- Extended-release tablets (U.S. and Canada)
- Mazindol
- Tablets (U.S. and Canada)
- Phendimetrazine
- Extended-release capsules (U.S.)
- Tablets (U.S.)
- Phentermine
- Capsules (U.S.)
- Resin capsules (U.S. and Canada)
- Tablets (U.S.)
Proper Use of This Medicine
In order to prevent trouble in sleeping, if you are taking:
- One dose of this medicine a day, take it about 10 to 14
hours before bedtime.
- More than one dose of this medicine a day, take the last
dose of the day about 4 to 6 hours before bedtime.
For patients taking a long-acting form of this
medicine:
- Swallow these capsules or tablets whole. Do not break,
crush, or chew before swallowing.
For patients taking mazindol:
- This medicine may be taken with food, if needed, to prevent
stomach upset.
Take this medicine only as directed by your doctor .
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. If too much is taken, it may cause unwanted effects or become
habit-forming.
If you think this medicine is not working properly after
you have taken it for a few weeks, do not increase the dose. Instead, check with
your doctor.
Dosing - The dose of appetite suppressants will be
different for different patients. Follow your doctor's orders or the directions on the
label. The following information includes only the average doses of appetite
suppressants. If your dose is different, do not change it unless your doctor tells
you to do so.
For benzphetamine
- For oral dosage form (tablets):
- For appetite suppression:
- AdultsAt first, 25 to 50 milligrams (mg) once a day, taken
in midmorning or midafternoon. Your doctor may need to adjust your dose.
- Children up to 16 years of ageUse is not recommended.
For diethylpropion
- For oral dosage form (tablets):
- For appetite suppression:
- Adults25 milligrams (mg) three times a day, taken one hour
before meals.
- Children up to 16 years of ageUse is not recommended.
- For long-acting oral dosage form (extended-release
tablets):
- For appetite suppression:
- Adults75 mg once a day, taken in midmorning.
- Children up to 16 years of ageUse is not recommended.
For mazindol
- For oral dosage form (tablets):
- For appetite suppression:
- AdultsAt first, 1 milligram (mg) once a day. Your doctor may
need to adjust your dose.
- Children up to 16 years of ageUse is not recommended.
For phendimetrazine
- For long-acting oral dosage form (extended-release
capsules):
- For appetite suppression:
- Adults105 mg once a day, taken thirty to sixty minutes
before the morning meal.
- Children up to 16 years of ageUse is not recommended.
- For oral dosage form (tablets):
- For appetite suppression:
- Adults17.5 to 35 mg two or three times a day, taken one hour
before meals.
- Children up to 16 years of ageUse is not recommended.
For phentermine
- For oral dosage form (capsules):
- For appetite suppression:
- Adults15 to 37.5 milligrams (mg) once a day, taken before
breakfast or one to two hours after breakfast.
- Children up to 16 years of ageUse is not recommended.
- For oral dosage form (tablets):
- For appetite suppression:
- Adults15 to 37.5 mg once a day, taken before breakfast or
one to two hours after breakfast. Instead of taking it once a day, your doctor may tell
you to take smaller doses thirty minutes before meals.
- Children up to 16 years of ageUse is not recommended.
- For oral resin dosage form (capsules):
- For appetite suppression:
- Adults15 to 30 mg once a day, taken before breakfast.
- Children up to 16 years of ageUse is not recommended.
Missed dose - If you miss a dose of this medicine,
skip the missed dose and continue with your regular dosing schedule. Do not double doses.
Storage - To store this medicine:
- Keep out of the reach of children.
- Store away from heat and direct light.
- Do not store in the bathroom, near the kitchen sink, or in
other damp places. Heat or moisture may cause the medicine to break down.
- Do not keep outdated medicine or medicine no longer needed.
Be sure that any discarded medicine is out of the reach of children.
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against
the good it may do. This is a decision you and your doctor will make. For sympathomimetic
appetite suppressants, the following should be considered:
Allergies - Tell your doctor if you have ever had
any unusual or allergic reaction to this medicine or amphetamine, dextroamphetamine,
ephedrine, epinephrine, isoproterenol, metaproterenol, methamphetamine, norepinephrine,
phenylephrine, phenylpropanolamine, pseudoephedrine, terbutaline, or other appetite
suppressants. Also tell your health care professional if you are allergic to any other
substances, such as foods, preservatives, or dyes.
Diet - You must follow a reduced-calorie diet while
using an appetite suppressant in order to lose weight. Also, in order to keep the lost
weight from returning, changes in diet and exercise must be continued after the weight has
been lost.
Pregnancy - If a pregnant woman takes this medicine
in high doses or more often than the doctor has directed, it may cause withdrawal symptoms
in the newborn baby. Also, medicines similar to sympathomimetic appetite suppressants can
cause birth defects in the newborn baby if a pregnant woman takes them in high doses.
Before taking this medicine, make sure your doctor knows if you are pregnant or if you may
become pregnant.
Breast-feeding - Diethylpropion and benzphetamine
pass into breast milk. It is not known if other sympathomimetic appetite suppressants pass
into breast milk. However, use of sympathomimetic appetite suppressants during
breast-feeding is not recommended, because it may cause unwanted effects in nursing
babies.
Children - Studies on these medicines have been done
only in adult patients, and there is no specific information comparing use of
sympathomimetic appetite suppressants in children with use in other age groups. The use of
these medicines by children younger than 16 years of age is not recommended.
Older adults - Many medicines have not been studied
specifically in older people. Therefore, it may not be known whether they work exactly the
same way they do in younger adults or if they cause different side effects or problems in
older people. There is no specific information comparing use of appetite suppressants in
the elderly with use in other age groups.
Other medicines - Although certain medicines should
not be used together at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may want to change the
dose, or other precautions may be necessary. When you are taking appetite suppressants, it
is especially important that your health care professional know if you are taking any of
the following:
- Amantadine (e.g., Symmetrel) or
- Amphetamines or
- Caffeine (e.g., NoDoz) or
- Chlophedianol (e.g., Ulone) or
- Cocaine or
- Medicine for asthma or other breathing problems or
- Medicine for colds, sinus problems, or hay fever or other
allergies (including nose drops or sprays) or
- Methylphenidate (e.g., Ritalin) or
- Nabilone (e.g., Cesamet) or
- Pemoline (e.g., Cylert)Using these medicines with
sympathomimetic appetite suppressants may increase the central nervous system (CNS)
stimulant effects, such as irritability, nervousness, trembling or shaking, or trouble in
sleeping
- Appetite suppressants (diet pills), other or
- Selective serotonin reuptake inhibitors (citalopram [e.g.,
Celexa], fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil],
sertraline [e.g., Zoloft])It is not known whether using two different appetite
suppressants together or using a sympathomimetic appetite suppressant with a selective
serotonin reuptake inhibitor is safe and effective. There have been some serious unwanted
effects on the hearts of people who used two different appetite suppressants together
- Monoamine oxidase (MAO) inhibitor activity (isocarboxazid
[e.g., Marplan], isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine
[e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])Do not
take an appetite suppressant while you are taking or less than 14 days after taking a
monoamine oxidase (MAO) inhibitor. If you do, you may develop sudden extremely high
blood pressure
- Tricyclic antidepressants (amitriptyline [e.g., Elavil],
amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane],
doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl],
protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])Using these medicines with
sympathomimetic appetite suppressants may cause high blood pressure or irregular heartbeat
Other medical problems - The presence of other
medical problems may affect the use of appetite suppressants. Make sure you tell your
doctor if you have any other medical problems, especially:
- Alcohol abuse (or history of) or
- Drug abuse or dependence (or history of)Dependence on
appetite suppressants may be more likely to develop
- Diabetes mellitus (sugar diabetes)The amount of insulin or
oral antidiabetic medicine that you need to take may change
- EpilepsyDiethylpropion may increase the risk of having
seizures
- Family history of mental illnessMental depression or other
mental illness may be more likely to occur
- Glaucoma or
- Heart or blood vessel disease or
- High blood pressure or
- Mental illness or
- Overactive thyroidAppetite suppressants may make the
condition worse
- Kidney diseaseHigher blood levels of the appetite
suppressant may occur, increasing the chance of serious side effects
Precautions While Using This Medicine
Your doctor should check your progress at regular visits to make sure that this medicine
does not cause unwanted effects.
If you think this medicine is not working properly after
you have taken it for a few weeks, do not increase the dose. Instead, check with
your doctor.
Do not take an appetite suppressant with or less than 14
days after taking a monoamine oxidase (MAO) inhibitor. If you do, you may very
suddenly develop extremely high blood pressure.
Taking a sympathomimetic appetite suppressant may cause a
positive result in urine screening tests for amphetamines.
Sympathomimetic appetite suppressants may cause dryness of
the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your
mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more
than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth
may increase the chance of developing dental disease, including tooth decay, gum disease,
and fungus infections.
This medicine may cause some people to feel a false sense
of well-being or to become dizzy, lightheaded, drowsy, or less alert than they are
normally. Make sure you know how you react to this medicine before you drive, use
machines, or do anything else that could be dangerous if you are dizzy or are not alert.
Before having any kind of surgery, dental treatment, or
emergency treatment, tell the medical doctor or dentist in charge that you are using this
medicine. Taking appetite suppressants together with medicines that are used during
surgery or dental or emergency treatments may cause serious side effects.
Check with your doctor immediately if you notice a
decrease in your ability to exercise, if you faint, or if you have chest pain, swelling of
your feet or lower legs, or trouble in breathing. These may be symptoms of very
serious heart or lung problems.
If you have been taking this medicine for a long time or in
large doses and you think you may have become mentally or physically dependent on it,
check with your doctor.
- Some signs of dependence on appetite suppressants are:
- a strong desire or need to continue taking the medicine.
- a need to increase the dose to receive the effects of the
medicine.
- withdrawal side effects (for example, mental depression,
nausea or vomiting, stomach cramps or pain, trembling, unusual tiredness or weakness) when
you stop taking the medicine.
For patients with diabetes:
- This medicine may affect blood sugar levels. If you notice a
change in the results of your urine or blood sugar test or if you have any questions,
check with your doctor.
If you have been taking this medicine in large doses or for
a long time, do not stop taking it without first checking with your doctor. Your
doctor may want you to reduce gradually the amount you are taking before stopping
completely. This will help prevent withdrawal side effects.
Side Effects of This Medicine
Appetite suppressants may cause some serious side effects, including heart and lung
problems. You and your doctor should discuss the good this medicine may do as well as
the risks of taking it. Along with its needed effects, a medicine may cause some
unwanted effects. Although not all of these side effects may occur, if they do occur they
may need medical attention.
Check with your doctor as soon as possible if any of the
following side effects occur:
Less common or rare
Difficult or painful urination, fast or irregular
heartbeat, feeling that others can hear your thoughts, feeling that others are watching
you or controlling your behavior, hallucinations (feeling, seeing, or hearing things that
are not there), headache (severe), mental depression, numbness, especially on one side of
the face or body, skin rash or hives, sore throat and fever (with diethylpropion) ,
talking, feeling, and acting with excitement and activity you cannot control, unusual
bleeding or bruising (with diethylpropion)
Symptoms of overdose
Abdominal or stomach cramps, coma, confusion, convulsions
(seizures), diarrhea (severe), dizziness, lightheadedness, or fainting, fast breathing,
feeling of panic, fever, hallucinations (seeing, hearing or feeling things that are not
there), high or low blood pressure, hostility with urge to attack, irregular heartbeat,
nausea or vomiting (severe), overactive reflexes, restlessness, trembling or shaking,
tiredness, weakness, and mental depression following effects of excitement
Abuse of a sympathomimetic appetite suppressant (taking the
medicine in larger doses or taking it more frequently or for a longer time than the doctor
ordered) can cause the following side effects:
Changes in personality, excessive, excited activity,
irritability (severe), mental illness (severe), similar to schizophrenia, skin disease,
trouble in sleeping (severe)
Other side effects may occur that usually do not need
medical attention. These side effects may go away during treatment as your body adjusts to
the medicine. However, check with your doctor if any of the following side effects
continue or are bothersome:
More common
Constipation, dizziness or lightheadedness , dryness of
mouth, false sense of well-being, headache, irritability, nausea or vomiting, nervousness
or restlessness, stomach cramps or pain , trembling or shaking, trouble in sleeping
After the stimulant effects have worn off, drowsiness,
unusual tiredness or weakness, or mental depression may occur.
Less common or rare
Blurred vision, changes in sexual desire or decreased
sexual ability, diarrhea, drowsiness, frequent urge to urinate or increased urination,
increased sweating, unpleasant taste
Although not all of the side effects listed above have been
reported for all of these medicines, they have been reported for at least one of them.
However, since all of the sympathomimetic appetite suppressants are similar, any of the
above side effects may occur with any of these medicines.
After you stop using this medicine, your body may need time
to adjust. The length of time this takes depends on the amount of medicine you were using
and how long you used it. During this time check with your doctor if you notice any of the
following side effects:
Extreme tiredness or weakness, mental depression, nausea or
vomiting, stomach cramps or pain, trembling, trouble in sleeping or nightmares
Other side effects not listed above may also occur in some
patients. If you notice any other effects, check with your doctor.
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