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20-September-2008 09:55:56 - Phentermine Phentermine Systematic IUPAC name 2-methyl-1-phenylpropan-2-amine and 2-methyl-amphetamine Identifiers CAS number 122-09-8 ATC code A08AA01 C01CA11 PubChem 4771 DrugBank APRD00093 Chemical data Formula C10H15N Mol. mass 149.233 g/mol Pharmacokinetic data Bioavailability Peak plasma levels occur within 1 to 4.5 hours. Absorption is usually complete by 4 to 6 hours Protein binding Approximately 96.3% Metabolism hepatic Half life 16 to 31 hours Excretion Urinary elimination Therapeutic considerations Pregnancy cat. CUS Legal status Schedule IVUS Routes Oral Phentermine, a contraction for phenyl-tertiary-butylamine, is an appetite suppressant of the amphetamine and phenethylamine class. It is approved as an appetite suppressant to help reduce weight in obese patients when used short-term and combined with exercise, diet, and behavioral modification. It is typically prescribed for individuals who are at increased medical risk because of their weight and works by helping to release certain chemicals in the brain that control appetite. Contents 1 Commercial trade names 2 History 3 Mechanism of action 4 Dosing and administration 5 Contraindications and warnings 6 Side effects 6.1 More common symptoms 6.2 Less common symptoms 7 References 8 External links Commercial trade names Adipex P Immediate release Avaprex Immediate release Anoxine-AM Fastin discontinued Ionamin Slow Release Resin, Australia, discontinued in the US Duromine Slow Release Resin, New Zealand Australia Mirapront Obephen Obermine Obestin-30 Phentrol Phenterex Phentromine Pro-Fast SA Redusa Panbesy Phentermine Trenker Obenix Oby-Trim Teramine Zantryl Sinpet MX Supremin PH Umine NZ Weltmine KP History In 1959 phentermine first received approval from the FDA as an appetite suppressing drug. Phentermine hydrochloride then became available in the early 1970s. It was previously sold as Fastin from King Pharmaceuticals for SmithKline Beecham, however in 1998 it was removed from the market. Medeva Pharmaceuticals sells the name brand of phentermine called Ionamin and Gate Pharmaceuticals sells it as Adipex-P. Phentermine is also currently sold as a generic. Since the drug was approved in 1959 there have been almost no clinical studies performed. The most recent study was in 1990 which combined phentermine with fenfluramine or dexfenfluramine and became known as Fen-Phen.citation needed A study was published in 1992 that Fen-Phen was more effective than diet and exercise with few side effects.citation needed However, in 1997 after 24 cases of heart valve disease in Fen-Phen users, fenfluramine and dexfenfluramine were voluntarily taken off the market at the request of the FDA. Studies later proved that nearly 30% of people taking fenfluramine or dexfenfluramine had abnormal valve findings. The FDA did not ask manufacturers to remove phentermine from the market.citation needed Phentermine is still available by itself in most countries, including the U.S. However, because it is similar to amphetamines, individuals may develop an addiction to it. Hence, it is classified as a controlled substance in many countries. Internationally, phentermine is a schedule IV drug under the Convention on Psychotropic Substances.1 In the United States, it is classified as a Schedule IV controlled substance under the Controlled Substances Act. Mechanism of action Phentermine, like many other prescription drugs, works with neurotransmitters in the brain. It is a centrally-acting stimulant and is a constitutional isomer not to be confused with stereoisomer of methamphetamine. It stimulates neuron bundles to release a particular group of neurotransmitters known as catecholamines; these include dopamine, epinephrine also known as adrenaline, and norepinephrine noradrenaline. The anorectic activity seen with these compounds is thus likely due to their effect on the central nervous system, which is consistent with current knowledge about the central nervous system and feeding behavior. This is the same mechanism of action as other stimulant appetite suppressants such as diethylpropion and phendimetrazine. The neurotransmitters signal a fight-or-flight response in the body which, in turn, puts a halt to the hunger signal. As a result, it causes a loss in appetite because the brain does not receive the hunger message.citation needed Dosing and administration Generally, it is recommended by the Food and Drug Administration FDA that phentermine should be used short-term usually interpreted as 'up to 12 weeks', while following nonpharmacological approaches to weight loss such as healthy dieting and exercise.citation needed Contraindications and warnings Patients with the following should not use Phentermine: An allergy to any ingredient in Phentermine or other sympathomimetics eg, pseudoephedrine Are also taking dexfenfluramine, fenfluramine, furazolidone, guanadrel, guanethidine, or have taken a monoamine oxidase inhibitor MAOI eg, phenelzine in the last 14 days Have severe high blood pressure, an overactive thyroid, glaucoma, heart or blood vessel disease, or severe narrowing of the blood vessels Are in an agitated state, or have a history of substance abuse Some medical conditions may interact with Phentermine, patients with the following should consult with their doctor before using phentermine: Are pregnant, planning to become pregnant, or are breast-feeding Are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement Have allergies to medicines, foods, or other substances Have a brain or spinal cord disorder, hardening of the arteries, high blood pressure, diabetes, or high cholesterol or lipid levels Some medicines may interact with phentermine, such as the following: Dexfenfluramine, fenfluramine, furazolidone, or MAOIs eg, phenelzine because the risk of serious side effects, such as increasing headache, high blood pressure, slow heart rate, elevated temperature, or possibly fatal lung problems, may be increased Serotonin specific reuptake inhibitors citalopram Celexa, escitalopram Lexapro, fluoxetine Prozac, Sarafem, fluvoxamine Luvox, paroxetine Paxil, or sertraline Zoloft because the risk of their side effects may be increased by Phentermine GuanadrelHylorel or guanethidineIsmelin because their effectiveness may be decreased by phentermine Antacids: Antacids may decrease the excretion of phentermine. 2 Carbonic anhydrase inhibitors acetazolamide, dichlorphenamide, methazolamide: Carbonic anhydrase inhibitors may decrease the excretion of phentermine.2 Side effects Generally, phentermine appears to be relatively well tolerated.3 It can produce side effects consistent with its catecholamine-releasing properties, e.g., tachycardia increased heart rate and elevated blood pressure, but the incidence and magnitude of these appear to be less than with the amphetamines. Because phentermine acts through sympathomimetic pathways, the drug may increase blood pressure and heart rate. It may also cause palpitations, restlessness, and insomnia. Additionally, phentermine has the potential to cause physical and psychological dependence. More common symptoms Insomnia Increased blood pressure Irritability Nervousness Sense of well-being Dry mouth Unpleasant taste Blurred vision Heartburn/Acid reflux Change in sexual desire Clumsiness Confusion Diarrhea Dizziness Headache Irregular heartbeat Nausea or vomiting Psychosis Skin rash or itching Stomach pain Tiredness Less common symptoms Convulsions seizures Dizziness Fever Hallucinations Hostility with urge to attack Irregular blood pressure Lightheadedness or fainting Mental depression, following a period of excitement Tremors, trembling or shaking Overactive reflexes Panic Restlessness Severe nausea, vomiting or diarrhea Stomach cramps Tiredness or weakness References ^ Incb.org PDF file ^ a b Phentermine. Merck Co., Inc. 2008. Retrieved on 2008-05-15. ^ Nelson DL, Gehlert DR. 2006. Central nervous system biogenic amine targets for control of appetite and energy expenditure. HTML. Endocrine. 2006 Feb;291:49-60. PubMed. Retrieved on 6 May 2006. External links MedLine Plus - Phentermine International Programme on Chemical Safety - Phentermine TOXNET DrugBank:Phentermine v d e Phenethylamines 2C-B 2C-C 2C-D 2C-E 2C-I 2C-N 2C-T-2 2C-T-21 2C-T-4 2C-T-7 2C-T-8 3C-E 4-FMP Bupropion Cathine Cathinone Clenbuterol DESOXY Dextroamphetamine Methamphetamine Diethylcathinone Dimethylcathinone DOC DOB DOI DOM bk-MBDB Dopamine Br-DFLY Ephedrine Epinephrine Escaline Etafedrine Fenfluramine Levosalbutamol Levmetamfetamine MBDB MDA MDMA MDMC MDEA MDPV Mescaline Methcathinone Norepinephrine Phentermine Salbutamol Tyramine Venlafaxine v d e Stimulants Alkylamines Cyclopentamine Geranamine Isometheptene Octodrine Propylhexedrine Tuamine Alphapyrrolidinylalkiophenones α-PPP MDPPP MDPV MPBP MPHP MPPP MOPPP Pyrovalerone Cholinergics ABT-089 ABT-418 Anabasine Arecoline Cotinine Cytisine Dianicline Epibatidine Epiboxidine GTS-21 Ispronicline Nicotine Rivanicline Tebanicline Varenicline Convulsants Bicuculline DMCM Gabazine Pentetrazol Picrotoxin Strychnine Thujone Eugeroics Adrafinil Armodafinil Carphedon Modafinil Phenethylamines 4-Bromomethcathinone 4-Fluoroamphetamine 4-Fluoromethamphetamine 4-Fluoromethcathinone 4-Methylmethcathinone 4-MTA Aletamine Amfepentorex Amphechloral Amphetamine Dextroamphetamine, Adderall Amphetaminil Benzphetamine Bupropion Cathinone Chlorphentermine Clenbuterol Clobenzorex Clortermine Diethylpropion Dimethoxyamphetamine Dimethylamphetamine Dimethylcathinone Ephedrine Epinephrine Ethcathinone Ethylamphetamine Fenethylline Fenfluramine Fenproporex Fludorex Furfenorex Levomethamphetamine Lisdexamfetamine MDMA Mefenorex Methamphetamine Methcathinone Methoxyphedrine Methylone Octopamine Ortetamine Parahydroxyamphetamine PCA PIA PMA PMEA PMMA PPAP Phendimetrazine Phenmetrazine Phentermine Phenylephrine Phenylpropanolamine Propylamphetamine Pseudoephedrine Selegiline Synephrine Tiflorex Xylopropamine Phenylaminooxazoles 4-Methyl-aminorex Aminorex Clominorex Fenozolone Fluminorex Pemoline Thozalinone Piperazines 2C-B-BZP BZP GBR-12783 GBR-12935 GBR-13069 GBR-13098 GBR-13119 MeOPP MBZP Vanoxerine Piperidines 2-Benzylpiperidine Desoxypipradrol Diphemethoxidine Ethylphenidate HDMP-28 --Methyl-1-methyl-4β-2-naphthylpiperidine-3β-carboxylate Methylphenidate Dexmethylphenidate Nocaine Phacetoperane Pipradrol Tropanes 3α-Bis-4-fluorophenylmethoxytropane 3α-4-Chlorophenylphenylmethoxytropane 3-Pseudotropyl-4-fluorobenzoate Altropane IACFT Brasofensine CFT WIN 35,428 β-CIT RTI-55 Cocaethylene Cocaine β-CPPIT Dichloropane RTI-111 Difluoropine FE-β-CPPIT FP-β-CPPIT PIT PTT RTI-31 RTI-32 RTI-51 RTI-112 RTI-113 RTI-121 IPCIT RTI-126 RTI-150 RTI-171 RTI-177 RTI-336 Tesofensine Troparil β-CPT, WIN 35,065-2 WF-23 WF-33 WF-60 Xanthines Aminophylline Caffeine Dimethazan Paraxanthine Theobromine Theophylline Others Amineptine Bemegride Benzydamine BPAP Bromantane BTQ Clofenciclan Cypenamine Cyprodenate Diclofensine Dimethocaine Diphenyl prolinol Ethamivan Fencamfamine Feprosidnine Gilutensin GYKI-52895 Hexacyclonate Indanorex Indatraline LR-5182 Mazindol Mesocarb Naphthylisopropylamine Nikethamide Nomifensine Phthalimidopropiophenone Prolintane Sibutramine Yohimbine Zylofuramine See also Sympathomimetic amines v d e Antiobesity preparations A08 -- see also anorectic Centrally acting Phentermine - Fenfluramine - Amfepramone - Dexfenfluramine - Mazindol - Cathine - Clobenzorex - Sibutramine - cannabinoids Rimonabant, Taranabant Peripherally acting Orlistat Retrieved from http://en..org/wiki/Phentermine Categories: Anorectics | Phenethylamines | StimulantsHidden categories: All articles with statements | Articles with statements since May 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Français Polski РуÑ?Ñ?кий Suomi This page was last modified on 20 August 2008, at 09:19
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