Approved as in addition to reduce calorie diet and exercise for long-term weight management.
A combination of an anorexiant phentermine and the anti-epileptic drug topiramate.
Topiramate augments, gamma aminobutyrate activity and inhibits glutamate receptors, and works through central mechanisms to reduce appetite and increase society.
Associated with congenital malformations and infants exposed during the first trimester.
Schedule IV drug.
Phentermine is a shorter acting sympathomimetic amine approved as monotherapy as a weight management drug.
Phentermine approved for short term use of three months or less.
Greater than six months use of phentermine is associated with weight loss ranging from 2.3 to 5.5% compared to placebo.
Topiramate is a longer acting neurostabilizer approved as monotherapy for seizure disorders and migraine headaches.
Starting dosage 3.75 mg/23 mg extended release.
After 14 days the recommended dose 7.5 mg/46 mg with the top dose of 15 mg/92 mg.
PHEN/TPM ER may alt exposure to oral contraceptives causing irregular menstrual bleeding.
May potentiate CNS depressants such as alcohol.
May potentiate hypokalemia of non-potassium sparing diuretics.
Phentermine is metabolized by the liver, with most excreted by the kidneys.
Phentermine is a sympathomimetic amine that primarily increases nor epinephrine in the hypothalamus with lesser effects on dopamine and serotonin.
It is most commonly used anti-obese medication in this category of drugs.
Phentermine has a low potential for abuse.
Phentermine works through several central mechanisms to reduce appetite and increase satiety.
Topiramate is excreted mainly by the kidney.
Adverse reactions include paresthesias, dizziness, dysguesia, insomnia, constipation, and dry mouth.
Maybe associated with metabolic acidosis, elevated creatinine, and hypoglycemia.
Contraindicated in glaucoma, hyperthyroidism, within 14 days of monoamine oxidase inhibitors, and pregnancy.
Common adverse events are xerostomia (7 to 12% ) insomnia(6-11%) headache (10-12%) , and constipation (4-8%).