What are Phentermine and topiramate?
Phentermine, along with Topiramate, can be described as a combination medication that is used in conjunction with exercise and diet to combat overweight in people aged 12 and over. Phentermine and topiramate can be utilized to help treat weight gain, which could be due to diabetes, high cholesterol, or elevated blood pressure. Phentermine and topiramate do not treat these underlying issues. Continue to take any other medication the medical professional has advised you to take. Phentermine and topiramate can be used for other purposes not covered in this medication guide.
Side effects of Phentermine and topiramate
Seek medical attention immediately when you are experiencing symptoms or warning signs of an allergic response (hives or breathing difficulties and swelling in your throat or face) or an extreme skin reaction (fever and sore throat, eye burning, irritation, and the skin is red or purple with peeling and blisters).
Inform your doctor about any new or worsening symptoms, for example: changes in your behavior or mood, anxiety, panic attacks, trouble sleeping, or if you are feeling angry, irritable, or impulsive and aggressive, anxious, or hyperactive (mental as well as physically) or depressed, or are thinking about taking your own life or harming yourself.
Phentermine and topiramate can result in serious adverse effects. Contact your doctor immediately if you suffer from:
- Unexpected changes in behavior or mood;
- Difficulty concentrating, confusion issues with speech or memory
- Rapid or pounding heartbeats when you're resting;
- A seizure;
- Indications of a kidney stone: severe discomfort in your side or lower back, pain or difficult urination, or
- Symptoms of excessive acid in your blood: loss of appetite, fatigue, and thinking issues, as well as irregular heartbeats.
Common negative side effects of phentermine as well as topiramate can include:
- Joint pain, ankle sprain;
- flu-like symptoms;
- Dizziness;
- constipation;
- Tingling sensations or numbness
- Sleep problems (insomnia);
- dry mouth, changes in your taste perception,
- Mood swings, low self-esteem mood changes, feelings of low self-esteem, a loss of interest in activities that you used to love, and thoughts of harming yourself.
This is not a comprehensive list of all side effects. Other side effects could occur. Consult your physician to seek medical advice on the effects. You may report any adverse reactions to the FDA at 1-800-FDA-1088.
Similar or related drugs
Ozempic, Wegovy, Phentermine, Semaglutide, Saxenda, and Alli
Warnings
Don't use this if you're pregnant. Phentermine and topiramate could raise the chance of developing a birth defect known as a cleft palate and lip in the newborn. Phentermine and topiramate may raise your pace of resting. Consult your physician if you notice a rapid heart rate or high-pitched beat during your rest. Topiramate can cause vision problems, which can last for a long time if not treated promptly. Consult your physician now if you experience sudden changes in your vision. There are people who have thoughts of suicide when taking topiramate. Be attentive to any changes to your mental state or the symptoms. Inform your doctor if you notice any changes or worsening symptoms.
Prior to use this drug
Don't take this medication in the event that you've taken an MAO inhibitor in the last 14 days. A potentially dangerous interaction between drugs may happen. MAO inhibitors include isocarboxazid linezolid, Methylene blue injection, rasagiline, and phenelzine, as well as tranylcypromine and others.
It is not recommended to use this medicine if you're allergic to topiramate or phentermine, or if you suffer from
- Glaucoma;
- Excessively active thyroid or
- If you are expecting or are likely to be pregnant,
It is possible that you will need to take an ultrasound test that is negative prior to commencing this treatment. Don't take phentermine or topiramate when you are expecting. Stop taking the medicine and contact your doctor immediately if you find yourself pregnant.
Topiramate can cause an increase in the likelihood of developing cleft lips and palates in newborns. This birth defect can be seen at an early stage of pregnancy and may develop before you realize that you're expecting. Loss of weight during pregnancy can affect the baby's development, regardless of whether you're obese. Utilize effective birth control methods to avoid pregnancy while taking topiramate and phentermine.
Combining this medicine with birth pills to control pregnancy can cause bleeding that is not normal (spotting). However, this isn't likely to make the birth control pills less effective at stopping pregnancy. If you experience irregular bleeding or spots, continue taking the birth control pill and speak with your physician.
Inform your doctor if you were ever diagnosed with:
- Heart conditions and high blood pressure
- A heart attack (or stroke);
- Diabetes (weight loss can result in the blood sugar dropping);
- metabolic acidosis (too much acid in your blood);
- Soft or fractured bones (osteomalacia, osteopenia, osteoporosis);
- Kidney disease: kidney stones or dialysis;
- liver disease;
- Mood disorders, depression, or suicidal or suicidal-like thoughts or actions
- An allergic reaction or sensitivity to aspirin or yellow dye (tartrazine);
- A seizure; or
- chronic diarrhea.
Topiramate may increase the amount of acid in the blood (metabolic acidosis). This could weaken your bones, lead to kidney stones, trigger growth issues for children, or harm an unborn baby. It is possible that you will need blood tests to confirm that you don't have metabolic acidosis.
Many people are contemplating suicide when taking topiramate. Your doctor should monitor your progress on a regular basis during appointments. Family members or other caregivers should be on the lookout for changes in your symptoms or mood. It is recommended not to breastfeed when taking this medication.
How to take Topiramate and phentermine?
Follow the directions on the prescription label and go through all medication guides or instructions sheets. Make sure you use the medication precisely as directed. Use phentermine and topiramate every morning, either with or without food. Drink plenty of fluids throughout the day to avoid loss of water as well as kidney stones when you're taking phentermine and topiramate.
Your doctor might alter the dosage or instruct the patient to discontinue taking this medication in the event that you haven't lost some weight in your first twelve weeks. Follow the doctor's instructions for dosage extremely carefully. Also, you must adhere to a calorie-restricted diet. Don't stop taking topiramate or phentermine abruptly, or you may experience seizures (convulsions). Follow the instructions of your physician regarding the tapering of your dose.
Topiramate and phentermine can both raise your heart rate at rest. Your doctor should examine your heart's function. Keep it at room temperature, free of heat and moisture. Phentermine could be addictive. Usage can trigger an addiction, an overdose, or even death. Keep the medication in a safe place so that others aren't able to access it. Giving away or selling the medication is against the law.
Details on dosage
Usual Adult Dose for Weight Loss:
All doses expressed as phentermine/topiramate XR:
Initial dosage: 3.75 mg/23 mg orally every day for 14 days, and then 7.5 mg/46 mg taken orally twice per day.
After 12 weeks of treatment in the range of 7.5 mg/46 mg twice a day, assess weight loss. If the weight loss is less than three percent of the weight at baseline, stop therapy or increase the dosage.
Dose increase: 11.25 mg/69 mg orally daily during 14 consecutive days, and then 15 mg/92 mg orally twice per day.
After 12 weeks of treatment in 15 mg/92mg doses, once every day, evaluate the loss of weight and, if weight loss is lower than 5 percent of base weight, stop therapy.
Dosage for maintenance: 7.5 mg/46 mg OR 15 mg/92 mg taken orally, once per day.
Doses in the range of 3.75 mg/23 mg or 11.25 mg/69 mg should be used for titration purposes only.
Comments:
Dosing should be done early in the morning (with or without meals) to prevent the possibility of sleeping.
Doses should be adjusted and weight loss assessed in the manner described above. If the weight loss percentage isn't attained by the stated timeframe, it is highly unlikely that patients will be able to achieve and maintain clinically significant weight loss, so stopping is advised.
Removal from dosage at 15 mg/92mg twice per day must be gradually reduced to every other day for at most one week before discontinuing treatment.
It is used as an addition to a diet that is low in calories and more physical activity for the management of weight in patients who suffer from chronic illness.
With a weight index (BMI) that is 30 kg/m2 or higher (obese),
With a BMI that is 27 kg/m2 or more (overweight) and at least one comorbidity relating to weight like hypertension or diabetes mellitus, type 2, diabetes mellitus, or dyslipidemia
What happens if I miss the dose?
Do not miss the missed dose, and take the next dose at your regular time. Do not take two doses at once.
What happens if I overdose?
For medical emergencies, seek emergency treatment or contact the Poison Help Line at 1-800-222-1222. A high dose of topiramate and phentermine can cause death.
The signs of a drug overdose could include hallucinations, confusion, anxiety, personality changes, and tremors. It can also cause a restless feeling, followed by extreme tiredness, nausea, vomiting, stomach cramps, diarrhea, an irregular heartbeat, rapid breathing, seizures, or a coma.
What should be avoided?
Do not use any other weight-loss products without consulting your physician. The ketogenic (also known as "ketosis") diets that are rich in fat and low in carbohydrates may increase the risk of developing metabolic acidosis. Beware of these diets when you are taking phentermine or topiramate.
Consuming alcohol while taking this medication may cause unwanted side effects. Avoid driving and other hazardous activities until you are aware of the effects this medication will have on your body. Your reaction could be affected. Avoid becoming too hot or dehydrated during hot temperatures. This medicine may reduce sweating and raise the body temperature, resulting in dangerous dehydration.
Interaction with other drugs
Phentermine and topiramate may cause irregular vaginal bleeding when you're taking a birth control pill. It shouldn't make them less efficient at stopping pregnancy.
Combining this medication with other drugs that cause you to feel drowsy may make this worse. Consult your physician before taking an opioid drug, a sleeping pill such as a muscle relaxer, or medication to treat anxiety or seizures.
Discuss with your doctor your other medications, particularly:
- Acetazolamide;
- Methazolamide;
- Zonisamide;
- Valproic acid or divalproex sodium (Depakene or Depakote)
- Birth control pill;
- Diuretic, also known as a "water pill"; or
- Insulin, or oral diabetes medication.
This list isn't complete. Other medications can affect the effects of phentermine and topiramate. These include prescription and over-the-counter medicines, vitamins, and herbal products. There are many possible interactions between drugs, which are included here.
