From the Guidelines
Phentermine is contraindicated in patients with anxiety disorders, history of heart disease, uncontrolled hypertension, seizure, MAOIs, pregnancy and breastfeeding, hyperthyroidism, glaucoma, history of drug abuse, and sympathomimetic amines.
Key Contraindications
- Anxiety disorders (agitated states)
- History of heart disease, uncontrolled hypertension
- Seizure
- MAOIs
- Pregnancy and breastfeeding
- Hyperthyroidism
- Glaucoma
- History of drug abuse
- Sympathomimetic amines These contraindications are based on the potential for phentermine to exacerbate existing conditions or interact with other medications, as noted in studies such as 1 and 1.
Additional Considerations
- Phentermine should be avoided in patients with a history of cardiovascular disease, and blood pressure and heart rate should be monitored periodically while taking phentermine, as suggested by 1 and 1.
- Patients who have anxiety or insomnia might feel their condition is exacerbated by phentermine, and would not be ideal candidates, as mentioned in 1.
- Phentermine is a Schedule IV medication, and while it is associated with low risk of dependency or abuse, it should be used with caution in patients with a history of substance use disorder, as noted in 1.
From the FDA Drug Label
Use of Phentermine is contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors because of the risk of hypertensive crisis. Phentermine is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm
The contraindications of phentermine (Adipex) are:
- Use during or within 14 days following the administration of monoamine oxidase inhibitors due to the risk of hypertensive crisis 2
- Pregnancy, as weight loss offers no potential benefit to a pregnant woman and may result in fetal harm 2
From the Research
Contraindications of Phentermine
The contraindications of phentermine (Adipex) include:
- Use in patients with cardiovascular disease or patients with uncontrolled hypertension, as stated in the study 3
- Phentermine is also contraindicated in patients with a history of substance abuse, although there is no evidence of phentermine addiction, as reported in the study 4
- Potential drug-drug interactions with phentermine among long-term phentermine consumers, which may result in adverse drug reactions, as discussed in the study 5
Special Considerations
- Phentermine should be used with caution in patients with a history of palpitations or atrial fibrillation, as it may exacerbate these conditions, as reported in the case study 6
- Clinicians should be aware of the potential for phentermine to interact with other medications, including dextromethorphan, tramadol, and phenylpropanolamine, as identified in the study 5
Precautions
- Phentermine is approved for short-term treatment of obesity, and its use should be carefully monitored to minimize the risk of adverse effects, as stated in the study 3
- Clinicians should consider the potential risks and benefits of phentermine treatment, particularly in patients with cardiovascular disease or other comorbidities, as discussed in the review 7