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Adipex 375mg

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Buy Adipex 375mg Online – Adipex 375mg For Sale

Buy Adipex 375mg Online. Adipex-P is a prescription medicine used to treat the symptoms of obesity. Adipex-P may be used alone or with other medications. Adipex-P belongs to a class of drugs called CNS Stimulants, Anoxexiants; Stimulants; Sympathomimetic. It is not known if Adipex-P is safe and effective in children younger than 16 years of age.

What are the possible side effects of Adipex-P?

Adipex-P may cause serious side effects including:

  • feeling short of breath,
  • chest pain,
  • lightheadedness,
  • swelling in your ankles or feet,
  • pounding heartbeats,
  • fluttering in your chest,
  • tremors,
  • feeling restless,
  • trouble sleeping,
  • unusual changes in mood or behavior,
  • severe headache,
  • blurred vision,
  • pounding in your neck or ears,
  • anxiety, and
  • nosebleed

Get medical help right away, if you have any of the symptoms listed above. The most common side effects of Adipex-P include:

  • itching,
  • dizziness,
  • headache,
  • dry mouth,
  • unpleasant taste,
  • diarrhea,
  • constipation,
  • stomach pain, and
  • increased or decreased interest in sex

Tell the doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Adipex-P. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

DESCRIPTION

Phentermine hydrochloride USP is a sympathomimetic amine anorectic. It has the chemical name of α,α,- Dimethylphenethylamine hydrochloride. The structural formula is as follows:

 

 

ADIPEX-P® (phentermine hydrochloride) Structural Formula Illustration

C10H15N•HCl       M.W. 185.7

Phentermine hydrochloride is a white, odorless, crystalline, hygroscopic powder that is soluble in water and lower alcohols, just slightly soluble in chloroform, and insoluble in ether. ADIPEX-P® is a capsule or tablet containing 37.5 mg of phentermine hydrochloride and is intended for oral administration as an anorexiant (equivalent to 30 mg of phentermine base).

Black Iron Oxide, Corn Starch, D&C Red #33, FD&C Blue #1, Gelatin, Lactose Monohydrate, Magnesium Stearate, Propylene Glycol, Shellac, and Titanium Dioxide are the inactive components in ADIPEX-P® Capsules. Corn Starch, Lactose (Anhydrous), Magnesium Stearate, Microcrystalline Cellulose, Pregelatinized Starch, Sucrose, and FD&C Blue No. 1 are the inactive components in ADIPEX-P® Tablets.

1 PHARMACIES NEAR 90245 HAVE COUPONS FOR ADIPEX P (BRAND NAMES:ADIPEX-P FOR 30MG)

INDICATIONS

ADIPEX-P® is indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification, and caloric restriction for the management of exogenous obesity in patients with an initial body mass index of 30 kg/m2 or greater, or 27 kg/m2 or greater in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia).

The table below displays the body mass index (BMI) for different heights and weights. The BMI is determined by dividing the patient’s weight in kilograms by the patient’s height in meters squared. The metric conversions are: pounds 2.2 = kilograms; inches 0.0254 = meters.

 

 

Body Mass Index (BMI) - Illustration

 

The limited usefulness of agents of this class, including ADIPEX-P®, [see CLINICAL PHARMACOLOGY] should be measured against possible risk factors inherent in their use such as those described below.

DOSAGE AND ADMINISTRATION

Exogenous Obesity

Individualize the dosage in order to get a sufficient response with the lowest effective dose. For appetite suppression, the typical adult dosage is one capsule (37.5 mg) taken before breakfast or 1 to 2 hours after breakfast as suggested by a physician.

The typical adult dosage is one tablet (37.5 mg) daily, taken before breakfast or 1 to 2 hours after breakfast as advised by a physician. The patient’s dose may be changed as needed. For certain people, a daily dose of one-half tablet (18.75 mg) may be sufficient, while in other instances it may be preferable to provide half tablets (18.75 mg) twice day.

ADIPEX-P® is not advised for usage in children less than or equal to 16 years old. Late-evening medicine should be avoided due to its potential to induce sleeplessness.

Dosage In Patients With Renal Impairment

The recommended maximum dosage of ADIPEX-P® is 15 mg daily for patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73 m2 ). Avoid use of ADIPEX-P® in patients with eGFR less than 15 mL/min/1.73 m2 or end-stage renal disease requiring dialysis [see Use In Specific Populations and CLINICAL PHARMACOLOGY].

HOW SUPPLIED

Dosage Forms And Strengths

Capsules containing 37.5 mg phentermine hydrochloride (equivalent to 30 mg phentermine base). Tablets containing 37.5 mg phentermine hydrochloride (equivalent to 30 mg phentermine base).

Storage And Handling

Available in tablets and capsules containing 37.5 mg phentermine hydrochloride (equivalent to 30 mg phentermine base). Each blue and white, oblong, speckled, scored tablet is debossed with “ADIPEX-P” and “9”-“9”. The #3 capsule has an opaque white body and an opaque bright blue cap. Each capsule is imprinted with “ADIPEX-P” – “37.5” on the cap and two stripes on the body using dark blue ink.

  • Tablets are packaged in bottles of 30 (NDC 57844-009-56); 100 (NDC 57844-009-01); and 1000 (NDC 57844-009-10).
  • Capsules are packaged in bottles of 100 (NDC 57844-019-01).
  • Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].
  • Dispense in a tight container as defined in the USP, with a child-resistant closure (as required).
  • KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN.
  • Manufactured By: Pliva Hrvats ka d.o.o. Zagreb, Croatia. Revised: March 2017

SIDE EFFECTS

The following adverse reactions are described, or described in greater detail, in other sections:

The following adverse reactions to phentermine have been identified:

Cardiovascular

Primary pulmonary hypertension and/or regurgitant cardiac valvular disease, palpitation, tachycardia, elevation of blood pressure, ischemic events.

Central Nervous System

Overstimulation, restlessness, dizziness, insomnia, euphoriadysphoriatremor, headache, psychosis.

Gastrointestinal

Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances.

Allergic

Urticaria.

Endocrine

Impotence, changes in libido.

DRUG INTERACTIONS

Monoamine Oxidase Inhibitors

Use of ADIPEX-P® is contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors because of the risk of hypertensive crisis.

Alcohol

Concomitant use of alcohol with ADIPEX-P® may result in an adverse drug reaction.

Insulin And Oral Hypoglycemic Medications

Requirements may be altered [see WARNINGS AND PRECAUTIONS].

Adrenergic Neuron Blocking Drugs

ADIPEX-P® may decrease the hypotensive effect of adrenergic neuron blocking drugs.

Drug Abuse And Dependence

Controlled Substance

Phentermine is a Schedule IV controlled substance.

Abuse

Phentermine is related chemically and pharmacologically to the amphetamines. Amphetamines and other stimulant drugs have been extensively abused and the possibility of abuse of phentermine should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program.

Dependence

Abuse of amphetamines and related drugs may be associated with intense psychological dependence and severe social dysfunction. There are reports of patients who have increased the dosage of these drugs to many times that recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. A severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia.

WARNINGS

Included as part of the “PRECAUTIONS” Section

PRECAUTIONS

Coadministration With Other Drug Products For Weight Loss

ADIPEX-P® is indicated only as short-term (a few weeks ) monotherapy for the management of exogenous obesity. The safety and efficacy of combination therapy with ADIPEX-P® and any other drug products for weight loss including prescribed drugs, over-the-counter preparations, and herbal products, or serotonergic agents such as selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, fluvoxamine, paroxetine), have not been established. Therefore, coadministration of ADIPEX-P® and these drug products is not recommended.

Primary Pulmonary Hypertension

Primary Pulmonary Hypertension (PPH) – a rare, frequently fatal disease of the lungs – has been reported to occur in patients receiving a combination of phentermine with fenfluramine or dexfenfluramine. The possibility of an association between PPH and the use of ADIPEX-P® alone cannot be ruled out; there have been rare cases of PPH in patients who reportedly have taken phentermine alone. The initial symptom of PPH is usually dyspnea. Other initial symptoms may include angina pectorissyncope or lower extremity edema. Patients should be advised to report immediately any deterioration in exercise tolerance. Treatment should be discontinued in patients who develop new, unexplained symptoms of dyspnea, angina pectoris, syncope or lower extremity edema, and patients should be evaluated for the possible presence of pulmonary hypertension.

Valvular Heart Disease

Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic and/or tricus pid valves, has been reported in otherwise healthy persons who had taken a combination of phentermine with fenfluramine or dexfenfluramine for weight loss. The possible role of phentermine in the etiology of these valvulopathies has not been established and their course in individuals after the drugs are stopped is not known. The possibility of an association between valvular heart disease and the use of ADIPEX-P® alone cannot be ruled out; there have been rare cases of valvular heart disease in patients who reportedly have taken phentermine alone.

Development Of Tolerance, Discontinuation In Case Of Tolerance

When tolerance to the anorectant effect develops, the recommended dose should not be exceeded in an attempt to increase the effect; rather, the drug should be discontinued.

Effect On The Ability To Engage In Potentially Hazardous Tasks

ADIPEX-P® may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle; the patient should therefore be cautioned accordingly.

Risk Of Abuse And Dependence

ADIPEX-P® is related chemically and pharmacologically to amphetamine (d- and dll-amphetamine) and to other related stimulant drugs that have been extensively abused. The possibility of abuse of ADIPEX-P® should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. See Drug Abuse And Dependence and OVERDOSE.

The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage.

Usage With Alcohol

Concomitant use of alcohol with ADIPEX-P® may result in an adverse drug reaction.

Use In Patients With Hypertension

Use caution in prescribing ADIPEX-P® for patients with even mild hypertension (risk of increase in blood pressure).

Use In Patients On Insulin Or Oral Hypoglycemic Medications For Diabetes Mellitus

A reduction in insulin or oral hypoglycemic medications in patients with diabetes mellitus may be required.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment Of Fertility

Studies have not been performed with phentermine to determine the potential for carcinogenesis, mutagenesis or impairment of fertility.

Use In Specific Populations

Pregnancy

Pregnancy Category X

ADIPEX-P® is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. A minimum weight gain, and no weight loss, is currently recommended for all pregnant women, including those who are already overweight or obese, due to obligatory weight gain that occurs in maternal tissues during pregnancy. Phentermine has pharmacologic activity similar to amphetamine (d- and dll-amphetamine) [see CLINICAL PHARMACOLOGY ]. Animal reproduction studies have not been conducted with phentermine. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus.

Nursing Mothers

It is not known if ADIPEX-P® is excreted in human milk; however, other amphetamines are present in human milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established. Because pediatric obesity is a chronic condition requiring long-term treatment, the use of this product, approved for short-term therapy, is not recommended.

Geriatric Use

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

Renal Impairment

Based on the reported excretion of phentermine in urine, exposure increases can be expected in patients with renal impairment [see CLINICAL PHARMACOLOGY].

Use caution when administering ADIPEX-P® to patients with renal impairment. In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73 m2 ), limit the dosage of ADIPEX-P® to 15 mg daily [see DOSAGE AND ADMINISTRATION]. ADIPEX-P® has not been studied in patients with eGFR less than 15 mL/min/1.73 m2, including end-stage renal disease requiring dialysis; avoid use in these populations.

OVERDOSE

The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage.

Acute Overdosage

Acute overdose symptoms include agitation, tremor, hyperreflexia, fast breathing, bewilderment, aggression, hallucinations, and panic attacks. Typically, fatigue and sadness follow cerebral stimulation. Cardiovascular consequences include tachycardia, arrhythmia, high or low blood pressure, and circulatory collapse. Symptoms of gastrointestinal disorders include nausea, vomiting, diarrhea, and abdominal pain. A lethal overdose of pharmacologically similar substances is often characterized by convulsions and unconsciousness.

Acute phentermine hydrochloride poisoning is mostly treated symptomatically with lavage and barbiturate sedation. Insufficient experience with hemodialysis or peritoneal dialysis exists to allow for suggestions in this area. Urine acidification enhances phentermine excretion. On the basis of pharmacologic considerations, intravenous phentolamine (Regitine®, CIBA) has been proposed for the treatment of acute, severe hypertension, if it results from an overdose.

Chronic Intoxication

Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. The most severe manifestation of chronic intoxications is psychosis, often clinically indistinguishable from schizophrenia. See Drug Abuse And Dependence .

CONTRAINDICATIONS

CLINICAL PHARMACOLOGY

Mechanism Of Action

ADIPEX-P® is a sympathomimetic amine with pharmacologic activity similar to the prototype drugs of this class used in obesityamphetamine (d- and dll-amphetamine). Drugs of this class used in obesity are commonly known as “anorectics” or “anorexigenics.” It has not been established that the primary action of such drugs in treating obesity is one of appetite suppression since other central nervous system actions, or metabolic effects, may also be involved.

Pharmacodynamics

Typical actions of amphetamines include central nervous system stimulation and elevation of blood pressure. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class in which these phenomena have been looked for.

Pharmacokinetics

Following the administration of phentermine, phentermine reaches peak concentrations (C ) after 3.0 to 4.4 hours.

Drug Interactions

In a single-dose study comparing the exposures after oral administration of a combination capsule of 15 mg phentermine and 92 mg topiramate to the exposures after oral administration of a 15 mg phentermine capsule or a 92 mg topiramate capsule, there is no significant topiramate exposure change in the presence of phentermine. However in the presence of topiramate, phentermine C and AUC increase 13% and 42%, respectively.

Specific Populations

Renal Impairment

Cumulative urinary excretion of phentermine under uncontrolled urinary pH conditions was 62% to 85%.

Systemic exposure of phentermine may increase up to 91%, 45%, and 22% in patients with severe, moderate, and mild renal impairment, respectively [see DOSAGE AND ADMINISTRATION and Use In Specific Populations].

Clinical Studies

No clinical investigations with ADIPEX-P® have been undertaken. In very brief clinical studies, obese adults who were taught in food management and treated with “anorectic” medications lost, on average, more weight than those treated with placebo and diet alone. Compared to placebo-treated individuals, drug-treated patients lose a fraction of a pound per week more weight. In both drug-treated and placebo-treated participants, the rate of weight loss is highest during the first weeks of treatment and tends to decrease in subsequent weeks.

The probable causes of the increased weight loss attributable to the different medication effects remain unidentified. The degree of weight loss linked with the use of a “anorectic” medicine varies from study to study, and the enhanced weight loss seems to be somewhat attributable to characteristics other than the pharmaceuticals administered, such as the physician investigator, the population treated, and the diet advised. There are no conclusive studies regarding the relative relevance of pharmacological and non-drug variables in weight reduction.

The natural history of obesity is assessed over many years, but the length of the reported research is limited to a few weeks; hence, the overall effect of drug-induced weight reduction over diet alone must be regarded clinically limited.

PATIENT INFORMATION

Patients must be told that phentermine should not be coadministered with other weight-loss medicines [see INDICATIONS AND USAGE and WARNINGS].

Patients must be informed on the dosage, timing, and administration of ADIPEX-P®. Women who are pregnant or breastfeeding should not take ADIPEX-P®. Patients must be advised about the risks associated with the use of phentermine (including those indicated in Warnings and Precautions), the signs of possible adverse reactions, and when to call a physician and/or take other appropriate action. The dangers include, without limitation:

See also, for example, ADVERSE REACTIONS and Use In Specific Populations .

The patients must also be informed about

Tell patients to keep ADIPEX-P® in a safe place to prevent theft, accidental overdose, misuse or abuse. Selling or giving away ADIPEX-P® may harm others and is against the law.

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