Phentermine Side Effects
For the Consumer
Applies to phentermine: oral capsule, oral capsule extended release, oral tablet, oral tablet disintegrating
As well as its needed effects, phentermine may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking phentermine, check with your doctor immediately:Rare
- Seeing, hearing, or feeling things that are not there
- severe mental changes
- Chest pain
- decreased ability to exercise
- fast, irregular, pounding, or racing heartbeat or pulse
- numbness or tingling in the arms or legs
- swelling of the feet or lower legs
- trembling or shaking of the legs, arms, hands, or feet
- trouble breathing
- trouble with thinking, speaking, or walking
Some phentermine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:Incidence not known
- Decreased interest in sexual intercourse
- difficulty having a bowel movement (stool)
- dry mouth
- false or unusual sense of well-being
- hives or welts
- inability to have or keep an erection
- increased in sexual ability, desire, drive, or performance
- increased interest in sexual intercourse
- loss in sexual ability, desire, drive, or performance
- redness of the skin
- skin rash
- unpleasant taste
For Healthcare Professionals
Applies to phentermine: compounding powder, oral capsule, oral capsule extended release, oral tablet, oral tablet disintegrating
Cardiovascular adverse effects may be associated with phentermine. Palpitations, tachycardia, elevation of blood pressure, ischemic event have been reported. Primary pulmonary hypertension and valvular heart disease has been reported in patients taking phentermine in combination with fenfluramine or dexfenfluramine and in rare cases in patients who have taken phentermine alone. Analysis of available data suggests that fenfluramine and dexfenfluramine are the causal agents, and both drugs have been withdrawn from the market as of September 15, 1997.[Ref]
A 37-year-old woman was admitted to the hospital after an episode of ventricular fibrillation. The patient was being treated for moderate obesity and had been taking phentermine hydrochloride, thyroid (USP), and trichlormethiazide. Her previous medical history had been unremarkable. It was suspected that one or more of her medications contributed to the nearly fatal arrhythmia.
Two case reports describe patients using phentermine (one in combination with phendimetrazine) who later developed ischemic cerebrovascular disease. One suffered a cerebral infarct with angiographic evidence of vasculopathy involving multiple vascular beds. The other patient developed headache and a hemisensory disturbance of seven days duration.
A case of fatal pulmonary hypertension has also been reported in a 29-year-old woman 8 months following the use of fenfluramine (of which dexfenfluramine is the dextro isomer) and phentermine for only 23 days. Histopathological findings upon autopsy indicated severe pulmonary hypertension. She did not smoke and had no family history of pulmonary hypertension. No obvious risk factors other than obesity were present, although preexisting disease was not ruled out.
A case of restrictive cardiomyopathy due to endocardial fibrosis after short term use of fenteramine in combination with phentermine has been reported.[Ref]
Phentermine produces nervous system stimulation, which may result in tremor, anxiety, restlessness, dizziness, insomnia, euphoria, dysphoria, and headache.[Ref]
Fifty women with refractory obesity received phentermine resinate for a period of 20 weeks. Three defaulted from the study due to incapacitating headaches without significant change in blood pressure. Two additional patients defaulted due to complaints of irritability.
A double-blind clinical trial of phentermine and fenfluramine involving 81 people with simple obesity reported several CNS complaints from patients taking phentermine resin during the study (twenty six complaints during the first 6 weeks of the study). The number of complaints diminished with time over the course of the study. Only seven complaints of CNS effects were reported at 20 weeks. Complaints reported by patients include sleep difficulties, nervousness, depression, fatigue and increased dreaming.[Ref]
Rarely psychotic episodes have been reported at recommended doses with some sympathomimetic drugs.[Ref]
Gastrointestinal adverse effects may include dryness of the mouth, unpleasant taste, diarrhea, and constipation.[Ref]
An allergic reaction resulting in urticaria may occur.[Ref]
Endocrine effects such as impotence and changes in libido may occur in patients taking phentermine.[Ref]
1. "Product Information. Ionamin (phentermine)." Rhone-Poulenc Rorer, Collegeville, PA.
2. Kokkinos J, Levine SR "Possible association of ischemic stroke with phentermine." Stroke 24 (1993): 310-3
3. U.S. Food and Drug Administration, Center for Drug Evaluation and Research "Reports of valvular heart disease in patients receiving concomitant fenfluramine and phentermine. Available from URL: http://www.fda.gov//cder/news/phenfen.htm." ([1997 Jul 8]):
4. Mark EJ, Patalas ED, Change HT, Evans RJ, Kessler SC "Fatal pulmonary hypertension associated with short-term use of fenfluramine and phentermine." N Engl J Med 337 (1997): 602-6
5. Connolly HM, Crary JL, McGoon MD, et al. "Valvular heart disease associated with fenfluramine-phentermine." N Engl J Med 337 (1997): 581-8
6. U.S. Food and Drug Administration, Center for Drug Evaluation and Research ""Fen-phen" update. Available from: URL: http://www.fda.gov//cder/fenphenupdate.htm." ([1997 Aug]):
7. "Product Information. Fastin (phentermine)." SmithKline Beecham, Philadelphia, PA.
8. "Product Information. Suprenza (phentermine)." Akrimax Pharmaceuticals, Cranford, NJ.
9. U.S. Food and Drug Administration, Center for Drug Evaluation and Research "FDA announces withdrawal fenfluramine and dexfenfluramine (Fen-Phen). Available from: URL: URL: http://www.fda.gov//cder/news/fenphenpr81597.htm." ([1997 Sept]):
10. Graham DJ, Green L "Further cases of valvular heart disease associated with fenfluramine-phentermine." N Engl J Med 337 (1997): 635
11. Gibbs HR "Diet pills and sudden death." N Engl J Med 318 (1988): 1127
12. Douglas A, Douglas JG, Robertson CE, Munro JF "Plasma phentermine levels, weight loss and side-effects." Int J Obes 7 (1983): 591-5
13. Weintraub M, Hasday JD, Mushlin AI, Lockwood DH "A double-blind clinical trial in weight control. Use of fenfluramine and phentermine alone and in combination." Arch Intern Med 144 (1984): 1143-8
It is possible that some side effects of phentermine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.
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