What are the guidelines for Adipex (Phentermine) usage?

From the Guidelines

Adipex (phentermine) should be used for short-term weight management in adults with obesity, with a typical dosage of 15-37.5 mg orally once daily, and treatment duration limited to 12 weeks maximum, as recommended by the AGA clinical practice guideline 1.

Key Considerations

• The medication should be used alongside diet and exercise for individuals with a BMI of 30 or higher, or 27+ with weight-related conditions like hypertension or diabetes.
• Phentermine should be avoided in patients with a history of cardiovascular disease, and blood pressure and heart rate should be monitored periodically while taking the medication 1.
• The recommended dosage of phentermine is 15–37.5 mg orally once daily, but dosage should be individualized to achieve adequate response with the lowest effective dose 1.

Potential Side Effects

• Common side effects include dry mouth, insomnia, constipation, and increased heart rate.
• Adipex should be avoided by people with heart disease, uncontrolled hypertension, hyperthyroidism, glaucoma, history of drug abuse, or during pregnancy.

Mechanism of Action

• Phentermine works by suppressing appetite through stimulating the central nervous system and increasing norepinephrine levels in the brain 1.

Monitoring and Supervision

• Regular monitoring by a healthcare provider is essential during treatment to assess effectiveness and watch for side effects.
• Never increase your dose without medical supervision, and don't stop suddenly as withdrawal symptoms may occur.

From the FDA Drug Label

Phentermine Hydrochloride is a sympathomimetic amine anorectic indicated as a short-term adjunct (a few weeks) 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 greater than or equal to 30 kg/m 2, or greater than or equal to 27 kg/m 2 in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia). Dosage should be individualized to obtain an adequate response with the lowest effective dose. The recommended dose should not be exceeded.

The guidelines for Adipex (phentermine) include:

• Indication: short-term adjunct in a regimen of weight reduction for patients with an initial body mass index greater than or equal to 30 kg/m 2, or greater than or equal to 27 kg/m 2 in the presence of other risk factors.
• Dosage: individualized to obtain an adequate response with the lowest effective dose.
• Administration: can be taken with or without food, and late evening administration should be avoided.
• Contraindications: history of cardiovascular disease, hyperthyroidism, glaucoma, agitated states, history of drug abuse, pregnancy, nursing, and known hypersensitivity to sympathomimetic amines.
• Warnings and precautions: coadministration with other drugs for weight loss is not recommended, and rare cases of primary pulmonary hypertension and serious regurgitant cardiac valvular disease have been reported 2.

From the Research

Guidelines for Adipex

Adipex, also known as phentermine, is a medication used for weight loss in obese individuals. The following guidelines are based on available research:

• Approved medications: Phentermine is one of the anti-obesity medications approved by the FDA for chronic weight management, along with orlistat, naltrexone/bupropion, and liraglutide 3.
• Efficacy: Phentermine has been shown to produce significant weight loss, with a mean difference in weight loss of 3.6 kg (CI, 0.6 to 6.0 kg) at 6 months compared to placebo 4.
• Comparison to other medications: Phentermine-topiramate has been associated with the highest odds of achieving at least 5% weight loss at 52 weeks, compared to other medications such as liraglutide, naltrexone-bupropion, lorcaserin, and orlistat 5.
• Safety: Phentermine may have adverse effects, such as potential dependency, and should be used with caution 6.
• Treatment approach: Pharmacotherapy, including phentermine, should be tailored to individual patients depending on their chronic conditions, comorbidities, and preferences, and should be used in combination with lifestyle interventions for sustainable weight management 3, 6.

Key Considerations

• Weight loss: Phentermine can produce significant weight loss, but the amount of weight lost may vary depending on the individual and the treatment regimen 4, 5.
• Adverse events: Phentermine may be associated with adverse events, such as gastrointestinal discomfort and potential dependency, and should be monitored closely 6, 5.
• Combination therapy: Phentermine may be used in combination with other medications, such as topiramate, to enhance its efficacy 5.
• Lifestyle interventions: Phentermine should be used in combination with lifestyle interventions, such as diet and exercise, for sustainable weight management 3, 6.