Phentermine

Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. It can help weight loss by making you less hungry. Or it can help you feel full longer. Phentermine is approved for use for up to 12 weeks with consideration for further treatment given. Phentermine is meant to be only part of a weight-loss plan. For example, it can be used with healthy eating, physical activity and behavior change. Phentermine is for people with obesity or overweight who haven’t been able to lose enough weight with diet and exercise alone to improve their health.

How does phentermine work?

It is not known how this medication helps people to lose weight. It may work by decreasing your appetite, increasing the amount of energy used by your body, or by affecting certain parts of the brain. This medication is an appetite suppressant and belongs to a class of drugs called sympathomimetic amines.

Who should not take phentermine?

Phentermine is one of the most prescribed weight-loss medicines. But it isn’t a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. It also isn’t for people who are pregnant, may become pregnant or are breastfeeding.

What do I need to tell my doctor BEFORE I take phentermine?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have ever had any of these health problems: Heart disease like heart failure or a heartbeat that is not normal, drug abuse, high blood pressure, or stroke.
  • If you have any of these health problems: Glaucoma, agitation, anxiety, or overactive thyroid.
  • If you have kidney disease or are on dialysis.
  • If you have taken certain drugs for depression or Parkinson’s disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
  • If you are taking any of these drugs: Fluoxetine, fluvoxamine, paroxetine, or sertraline.
  • If you are using another drug like this one. If you are not sure, ask your doctor or pharmacist.
  • If you are taking any other drug (prescription or OTC, natural product) for weight loss.
  • If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.
  • If you are breast-feeding. Do not breast-feed while you take this drug.

This is not a list of all drugs or health problems that interact with this drug.

Tell  us about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with us.

What are some things I need to know or do while I take phentermine?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • Do not take this drug for longer than you were told by your doctor.
  • If you have been taking this drug for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance. Call your doctor if this drug stops working well. Do not take more than ordered.
  • If you have been taking this drug for many weeks, talk with your doctor before stopping. You may want to slowly stop this drug.
  • This drug may be habit-forming; avoid long-term use. Tell your doctor if you have a history of drug or alcohol abuse.
  • You may need to have some heart tests before starting this drug. If you have questions, talk with your doctor.
  • Check blood pressure and heart rate as the doctor has told you.
  • If you have high blood sugar (diabetes) and take drugs to lower blood sugar, talk with your doctor. Weight loss may raise the chance of low blood sugar if you take drugs to lower blood sugar. Call your doctor right away if you have signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
  • Follow the diet and workout plan that your doctor told you about.
  • Talk with your doctor before you drink alcohol.
  • People who take drugs for weight loss like this drug may have a higher chance of having raised pressure in the lungs. This is rare but is often deadly. Talk with your doctor.
  • Do not give to a child younger than 17 years of age.
  • This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Chest pain or pressure.
  • Change in how you act.
  • Mood changes.
  • Shakiness.
  • Shortness of breath.
  • Some people taking drugs like this one have had heart valve problems. Call your doctor right away if you have dizziness, tiredness, or weakness that will not go away; fast heartbeat or a heartbeat that does not feel normal; swelling in your arms or legs; or trouble breathing.

What are some other side effects of phentermine?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Dizziness or headache.
  • Feeling nervous and excitable.
  • Diarrhea or constipation.
  • Dry mouth.
  • Trouble sleeping.
  • Bad taste in your mouth.
  • Lowered interest in sex.
  • Not able to get or keep an erection.
  • Restlessness.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep out of reach of children
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened

Semaglutide

Semaglutide injection is used along with an individualized low-calorie, low-fat diet and exercise program to help with weight loss in obese adults or overweight adults who may also have high blood pressure, diabetes, or high cholesterol. Semaglutide injection is also used along with an individualized low-calorie, low-fat diet and exercise program to help with weight loss in obese children 12 years of age or older.

How does semaglutide work?

Semaglutide injection is in a class of medications called incretin mimetics. It works by helping the pancreas to release the right amount of insulin when blood sugar levels are high. Insulin helps move sugar from the blood into other body tissues where it is used for energy. Semaglutide injection also works by slowing the movement of food through the stomach and may decrease appetite and cause weight loss.

What side effects can semaglutide cause?

Warning:

  • This drug has been shown to cause thyroid cancer in some animals. It is not known if this happens in humans. If thyroid cancer happens, it may be deadly if not found and treated early. Call your doctor right away if you have a neck mass, trouble breathing, trouble swallowing, or have hoarseness that will not go away.
  • Do not use this drug if you have a health problem called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or if you or a family member have had thyroid cancer.

Semaglutide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • diarrhea
  • abdominal pain
  • constipation
  • heartburn
  • burping

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:

  • ongoing pain that begins in the upper left or middle of the stomach but may spread to the back, with or without vomiting
  • rash; itching; swelling of the eyes, face, mouth, tongue, or throat; or difficulty breathing or swallowing
  • decreased urination; or swelling of legs, ankles, or feet
  • vision changes
  • fainting or dizziness
  • pain in upper stomach; yellowing of skin or eyes; fever; or clay-colored stools (in those receiving semaglutide [Wegovy] for management of weight loss)
  • rapid heartbeat
  • dizziness, light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety or irritability or mood changes, hunger, weakness, or feeling jittery
  • Semaglutide injection may increase the risk that you will develop tumors of the thyroid gland, including medullary thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given semaglutide developed tumors, but it is not known if this medication increases the risk of tumors in humans. Tell your doctor if you or anyone in your family has or has ever had MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2; condition that causes tumors in more than one gland in the body). If so, your doctor will probably tell you not to use semaglutide injection. If you experience any of the following symptoms, call your doctor immediately: a lump or swelling in the neck; hoarseness; difficulty swallowing; or shortness of breath

What special precautions should I follow?

Before taking semaglutide injection,

  • tell your doctor and pharmacist if you are allergic to semaglutide (Rybelsus, Ozempic, Wegovy), albiglutide (Tanzeum; no longer available in the US), dulaglutide (Trulicity), exenatide (Bydureon, Byetta), liraglutide (Saxenda, Victoza), lixisenatide (Adlyxin, in Soliqua), any other medications, or any of the ingredients in semaglutide injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. It is especially important to tell your doctor about all the medications you take by mouth because semaglutide may change the way your body absorbs these medications.
  • tell your doctor if you have or have ever had pancreatitis (inflammation of the pancreas), diabetic retinopathy (damage to the eyes caused by diabetes), gallbladder disease, or kidney disease. Also tell your doctor if you have recently had diarrhea, nausea, or vomiting or if you cannot drink liquids by mouth, which may cause dehydration (loss of a large amount of body fluids).
  • tell your doctor if you plan to become pregnant. Your doctor may tell you to stop using semaglutide injection for 2 months before a planned pregnancy.
  • tell your doctor if you are pregnant or are breastfeeding. If you become pregnant while using semaglutide injection, call your doctor.
  • ask your doctor what to do if there is a large change in your diet, exercise, or weight; or if you get sick, develop an infection or fever, experience unusual stress, or are injured. These changes and conditions can affect your blood sugar and the amount of semaglutide injection you may need.
  • you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are using semaglutide injection for weight loss. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: depression; talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

How should semaglutide be used?

Semaglutide injection comes as a solution (liquid) in a prefilled dosing pen to inject subcutaneously (under the skin). You can inject semaglutide in your upper arm, thigh, or stomach area. Change (rotate) the injection site with each injection. You can inject semaglutide and insulin in the same body area, but you should not give the injections right next to each other. Allow the pen to warm to room temperature before injecting if the pen was stored in the refrigerator. It is usually injected once a week without regard to meals. Use semaglutide injection on the same day each week at any time of day. You may change the day of the week that you use semaglutide as long as it has been 2 or more days (48 or more hours) since you used your last dose. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use semaglutide injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

What special dietary instructions should I follow?

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian.

What should I do if I forget a dose?

If you are using semaglutide injection (Ozempic), inject the missed dose as soon as you remember it. However, if more than 5 days passed since the missed dose, skip the missed dose and continue your regular dosing schedule. Do not inject a double dose to make up for a missed one.

If you are using semaglutide injection (Wegovy) and the next dose is more than 2 days away (48 hours), use the missed dose as soon as possible. If you miss a dose of semaglutide injection (Wegovy) and the next scheduled dose is less than 2 days away (48 hours), skip the missed dose and continue your regular dosing schedule. If you miss a dose of semaglutide injection (Wegovy) for more than 2 weeks, call your doctor or pharmacist.

How do I store/and or throw out semaglutide?

Keep this medication in the container it came in and out of reach of children. Store it away from light and heat, with the pen cap on.

Store unused semaglutide pens (Ozempic) in the refrigerator (36°F to 46°F [2°C to 8°C]) but do not place them near the refrigerator cooling element. Once a semaglutide pen is in use you can store it at room temperature (59°F to 86°F [15°C to 30°C]) or in the refrigerator. Do not freeze. Do not use semaglutide if it has been frozen. When traveling, pens that are in use can be stored at room temperature (59°F to 86°F [15°C to 30°C]) (not in a car glove compartment or other hot place). Make a note of the date you first use a semaglutide pen, and dispose of the pen after 56 days, even if there is some solution left in the pen.

Store semaglutide pens (Wegovy) in the refrigerator (36°F to 46°F [2°C to 8°C]). Before removing the cap, it can be stored or from 46°F to 86°F [8°C to 30°C]) in the original carton for up to 28 days. Do not freeze. Do not use semaglutide if it has been frozen.

It is important to keep all medication out of sight and reach of children, pets, and other people cannot consume them. However, you should not flush this medication down the toilet. 

Tirzepatide

The U.S. Food and Drug Administration (FDA) approved Eli Lilly and Company’s (NYSE: LLY) Zepbound™ (tirzepatide) injection, the first and only obesity treatment of its kind that activates both GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) hormone receptors. Zepbound is indicated for adults with obesity (with a BMI of 30 kg/m2 or greater), or those who are overweight (with a BMI of 27 kg/m2 or greater) and also have weight-related medical problems such as hypertension, dyslipidemia, type 2 diabetes mellitus, obstructive sleep apnea or cardiovascular disease, to lose weight and keep it off. It should be used with a reduced-calorie diet and increased physical activity.

How does tirzepatide work?

Tirzepatide mimics the actions of two hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones work together to stimulate insulin secretion and slow stomach emptying extending the sensation of fullness following a meal. This helps regulate blood sugar levels and cause weight loss.

What are some things I need to know or do while I take tirzepatide?

Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. Wear disease medical alert ID (identification). Follow the diet and workout plan that your doctor told you about. Check your blood sugar as you have been told by your doctor. Do not drive if your blood sugar has been low. There is a greater chance of you having a crash. Birth control pills may not work as well to prevent pregnancy. If you take birth control pills, you may need to switch to another type of hormone based birth control like a vaginal ring if your doctor tells you to. If another type of hormone-based birth control is not an option, use some other kind of birth control also, like a condom. Do this for 4 weeks after Tirzepatide 2/8 starting this drug and for 4 weeks each time the dose is raised. This drug may prevent other drugs taken by mouth from getting into the body. If you take other drugs by mouth, you may need to take them at some other time than this drug. Talk with your doctor. It may be harder to control blood sugar during times of stress such as fever, infection, injury, or surgery. A change in physical activity, exercise, or diet may also affect blood sugar. Talk with your doctor before you drink alcohol. Do not share with another person even if the needle has been changed. Sharing your tray or pen may pass infections from one person to another. This includes infections you may not know you have. If you cannot drink liquids by mouth or if you have an upset stomach, throwing up, or diarrhea that does not go away; you need to avoid getting dehydrated. Contact your doctor to find out what to do. Dehydration may lead to low blood pressure or to new or worse kidney problems. A severe and sometimes deadly pancreas problem (pancreatitis) has happened with other drugs like this one. Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

What are some side effects that I need to call my doctor about right away?

Warning: This drug has been shown to cause thyroid cancer in some animals. It is not known if this happens in humans. If thyroid cancer happens, it may be deadly if not found and treated early. Call your doctor right away if you have a neck mass, trouble breathing, trouble swallowing, or have hoarseness that will not go away. Do not use this drug if you have a health problem called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or if you or a family member have had thyroid cancer.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; yellow skin or eyes; fever with chills; bloating; or very upset stomach or throwing up.
  • Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
  • Dizziness or passing out.
  • A fast heartbeat.
  • Change in eyesight.
  • Low blood sugar can happen when this drug is used with other drugs for diabetes. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. 

    Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.

What are some other side effects of tirzepatide?

  • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
  • Heartburn.

These are not all of the side effects that may occur. If you have questions about side effects, call us.

What do I need to tell my doctor BEFORE I take tirzepatide?

If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had. If you have type 1 diabetes. Do not use this drug to treat type 1 diabetes. If you have ever had pancreatitis. If you have stomach or bowel problems. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with us.

How is tirzepatide best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely. It is given as a shot into the fatty part of the skin on the top of the thigh, belly area, or upper arm. If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot. Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well. Take the same day each week. Move site where you give the shot each time. Take with or without food. Wash your hands before and after use. Do not use if the solution is leaking or has particles. This drug is colorless to a faint yellow. Do not use if the solution changes color. If you are also using insulin, you may inject this drug and the insulin in the same area of the body but not right next to each other. Do not mix this drug in the same syringe with insulin. Do not move this drug from the pen to a syringe. Each pen or vial is for 1 use only. Throw away any part of the used pen after the dose is given. Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.

What do I do if I miss a dose?

If it is within 4 days after the missed dose, take the missed dose and go back to your normal day. If it has been more than 4 days since the missed dose, skip the missed dose and go back to your normal day. Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out tirzepatide?

Store in a refrigerator. Do not freeze. Do not use if it has been frozen. If needed, each pen or vial may be stored at room temperature for up to 21 days. If you store at room temperature, throw away any part not used after 21 days. Protect from heat. Store in the original container to protect from light. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs.