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Expert Q&A

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Does phentermine interact badly with any drugs?

Asked by Miriam, North Carolina

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Is phentermine safe to use? What drugs does it have a negative interaction with?

Expert Bio Picture

Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer

Phentermine, a stimulant similar to amphetamines, acts on the central nervous system to suppress appetite. It is one of the few drugs approved by the Food and Drug Administration to treat obesity. Its use should be limited to people with a BMI greater than 30 or greater than 27 with obesity associated medical conditions such as diabetes, high blood pressure or high cholesterol. It is approved only for the short-term treatment of obesity. While phentermine is safe according to FDA standards, it has numerous drug interactions and side effects. You should not take phentermine if you are taking a class of drugs known as MAO inhibitors, and you should consult with your doctor if you are taking anti-depressants including Prozac, Zoloft, Lexapro or Wellbutrin. Side effects include anxiety, insomnia, dry mouth, diarrhea or constipation, elevated blood pressure, palpitations and arrhythmias. In addition, you may experience symptoms of withdrawal including anxiety and depression when stopping the medication. It should not be taken by patients with glaucoma.

While research has shown phentermine to modestly improve weight loss when combined with a healthy diet and exercise, the drug effects may begin to decrease after six to eight weeks and appetite levels may return. For this reason, I am not a big fan of appetite-suppressing medications, as I feel that they teach people how not to eat rather than how to eat to control appetite better naturally, which is a much more effective long-term strategy. However, many of my colleagues who manage obesity on a regular basis use this medication to help patients kick-start their diet program, particularly if they have problems with appetite control. If you do decide to take this medication, it is critical that you take it under the supervision of a licensed physician and combine it with healthy diet and lifestyle changes for long-term weight maintenance.

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