phentermine prescribing guidelines ohio

Phentermine is 17.5% plasma protein-bound, while topiramate is 15 - 41% plasma protein-bound when the blood concentration range is 0.5 to 250 g/mL. The drug is mainly an appetite suppressant, thus making a patient feel fuller after (and between) meals and making the patient more likely to consume foods that have lower amounts of calories. Animal reproduction studies have not been conducted with Phentermine. Phentermine also has many potential drug interactions (e.g., with MAOIs), so the prescribing doctor and pharmacist know about ALL other medications and supplements taken within the last two weeks. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Follow your doctor's orders or the directions on the label. The doctor may advise the patient to complete the remaining period of the program or help him/her end the program safely. ADIPEX-P (phentermine hydrochloride) tablets, for oral use CIV ADIPEX-P (phentermine hydrochloride) capsules, for oral use CIV Initial U.S. Approval: 1959 Carefully follow your doctor's instructions for a reduced-calorie diet plan and regular exercise. After 12 weeks, the patient needs to take a break from the product as it may lead to physical dependence. %%EOF Tak YJ, et al. Take the disintegrating tablet with or without food. Wait, so NPs may prescribe Qsymia, but not phentermine? Copyright 2023 IBM Watson Health. Doctors often prescribe a dose of 5-HTP and vitamin B12 with a Phentermine prescription in order to enhance its effects and to relieve some side effects. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). 2020; doi:10.4093/dmj.2020.0258. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo subjects and tends to decrease in succeeding weeks. It should melt quickly. See full prescribing information for ADIPEX-P. 2 The dose of this medicine will be different for different patients. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. The medical board would like to work with the pharmacy board to make OARRS reports more available and helpful to physicians. OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. More specifically, this medication is an option for people with a body mass index (BMI): Weight-related conditions that may qualify a lower-BMI patient for phentermine include: type 2 diabetes, high cholesterol (hyperlipidemia), and controlled high blood pressure (hypertension) ( information and will only use or disclose that information as set forth in our notice of 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. 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. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. privacy practices. State Medical Board of Ohio On Wednesday, February 8, the board voted to adopt new telehealth rules. The usual duration of treatment is 12 weeks or less. Create well-written care plans that meets your patient's health goals. LiverTox National Institutes of Health. NDC 42806-810-01 The weight loss experts who OSMA has consulted with have indicated that misuse of phentermine is unlikely. Phentermine (Adipex-P, Lomaira) is a prescription medicine used to lessen appetite. If obesity is impacting your fertility or reproductive health, or if you have a specific condition that affects weight (such as PCOS), your gynecologist may consider prescribing phentermine as a short-term weight management strategy. 100 TABLETS Adipex-P (phentermine hydrochloride) capsules label, Greater than 27 kg/m2 + one or more weight-related condition, Vitals (heart rate, blood pressure, etc. The possible origins of the increased weight loss due to the various drug effects are not established. The board expressed concerns that removing the prescribing restrictions could lead to misuse of weight loss drugs such as phentermine. If you miss a dose of this medicine, take it as soon as possible. This website is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Click here for an email preview. This does not only include prescription drugs but also: Common drugs that are known to interact with Phentermine include Dopamine, Venlafaxine, Linezolid, Ephedrine, Isoproterenol, Epinephrine, Norepinephrine and a Phenylephrine injection. Accessed Oct. 11, 2022. BMI is calculated by taking the patients weight, in kilograms (kg), divided by the patients height, in meters (m), squared. He or she may prescribe the medication him/herself if you are an appropriate candidate, or he/she may choose to refer you to a specialist for further evaluation and follow-up. 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. Implementation of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. The FDA has categorized this drug as X for pregnancy, which means it should not be used during pregnancy under any circumstances. For example, it can be be used with healthy eating, physical activity and behavior change. According to the medical board, at this time, only physicians who prescribe opioids are receiving benchmark style reports and the board thinks that all prescribers who report into OARRS should receive the same information. Patients must be instructed on how much Phentermine to take, and when and how to take it [see Dosage and Administration (2)]. Phentermine is a popular prescription drug that is often used to treat obesity. It has the chemical name of ,,-Dimethylphenethylamine hydrochloride. With respect to the care and treatment of patients with obesity, APRNs are required to incorporate the State Medical Board rules applicable to physicians and prescribing practices. Phentermine Hydrochloride Tablets are indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index 30 kg/m 2, or 27 kg/m 2 in the presence of other risk factors (e.g., It is vital to talk with the doctor before using Phentermine with other products. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Especially considering Ohios ability to track the prescribing and dispensing of the drug in Ohios drug database, OARRS. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use . Columbus, Ohio 43215 Phone: (614) 466-3934 Web: www.med.ohio.gov State Medical Board of Ohio 30 E . Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Dr. Lazarus, we will discuss combination phentermine therapy later in this roundtable discussion. The drug is classified under a certain chemical class known as amphetamine as it has a similar pharmacology value to other drugs classified in the class. To provide you with the most relevant and helpful information, and understand which 1591 0 obj <>stream Phendimetrazine tartrate is a white, odorless crystalline powder. Phentermine also is offered combined with topiramate for weight loss (Qsymia). Medically reviewed by Drugs.com. Use of Phentermine is contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors because of the risk of hypertensive crisis. Since Phentermine is a drug that contains chemical compounds, it is important to know about all of the risks that are involved with its use and precautions a person should be aware of before the consumption. OSMA has historically had concerns with the limitations that these rules place on physicians who treat patients with obesity. Metabolism Phentermine has two metabolic pathways; hydroxylation and oxidation. Other brands of this drug include Suprenza, Phentercot, Acxion, Elvenir, Terflamex, Panbesy, Duromine, Fentermina, Phentermin, PHentermine and Lomaira. There is a problem with Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. 0 See DrugAbuse and Dependence (9.3). Tablets containing 37.5 mg Phentermine hydrochloride (equivalent to 30 mg Phentermine base). privacy practices. Advise pregnant women and nursing mothers not to use Phentermine [see Use in Specific Populations (8.1, 8.3)]. endstream endobj startxref 138 0 obj <>stream The patient could have had the prescription for the month of October filled at another pharmacy. Broad St., 3 rd Floor GUIDANCE DOCUMENT: Physician Assistant Prescriptive Authority Effective 10/15/15 The following information is provided as guidance, and may not reference all statutes and rules Phentermine, an amphetamine congener, is the most widely used anti-obesity drug in the U.S. Phentermine has been linked to many complications; knowing these details will help patients minimize their risk of experiencing such unwanted scenarios. They help the body produce a larger amount of energy from fat cells, which further reduces body fat percentage. Phentermine hydrochloride, an anorectic agent for oral administration, is available as a tablet containing 37.5 mg of Phentermine hydrochloride (equivalent to 30 mg of Phentermine base). Many physicians who currently receive the reports have found that the reports help them better understand, and possibly alter, their prescribing practices. A physician will usually start with a physical examination to determine if the patients health is in a state that will not be negatively affected when taking this drug. ]^Ng8\!HqX 'nR l# w! {A6.q=0G: S:nR-`\ |%Tx F5z :^EU\)|\eyt0F However, the medication does have a considerable street value. Patients must be informed that Phentermine hydrochloride is a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity, and that coadministration of Phentermine with other drugs for weight loss is not recommended [see Indications and Usage (1) and Warnings and Precautions (5.1)]. Along with Ohio's telehealth law in Sub. APRNs Prescribing Weight Loss Medications. This was often referred to as Rainbow Pills as all four drugs were often provided to a patient at the same time. Weight Loss Prescribing Rules Ohio Administrative Code 4731-11-04 and 4731-11-04.1 The medical board is currently reviewing its long-standing rules regarding prescribing controlled substances for the treatment of obesity. U.S. Food and Drug Administration. (5) A treatment plan based upon the clinical information obtained, to include all of the following components: (a) Diagnosis; (b) Objective goals for treatment; (c) Rationale for the medication choice and dosage; and (d) Planned duration of treatment and steps for further assessment and follow-up. Ohio Administrative Code 4731-11-04 and 4731-11-04.1. This site complies with the HONcode standard for trustworthy health information: verify here. iQJG\If6CuoG^|&qXegM,+vmC [To w{`[email protected] B;H _BfHPXK#Q (1) The prescriber shall assess the patient, at a minimum, once in the first three months of utilization of controlled substances for weight reduction, and shall record in the patient record information demonstrating the patient's continuing efforts to lose weight, the patient's dedication to the treatment program and response to treatment, and If the drug is taken too late in the day, it may also cause insomnia. Yes, you need a prescription for phentermine. Last updated on Mar 22, 2022. Late evening medication should be avoided because of the possibility of resulting insomnia. In some cases, especially when the health concern is not too serious, the doctor may prescribe the drug at lower doses spread throughout the day, instead of advising the patient to take one single dose every day. The natural history of obesity is measured over several years, whereas the studies cited are restricted to a few weeks duration; thus, the total impact of drug-induced weight loss over that of diet alone must be considered clinically limited. Do not crush, break, or chew it. The promotion of this brand as a diet pill started in 1990. << /Length 5 0 R /Filter /FlateDecode >> This includes Chapter 4731-11, OAC, Controlled Substances pertaining to the prescribing of schedule II, III, and IV medications for purposes of weight loss. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. hWmo8+jE'"m{F Even after the period that the drug has been prescribed for, the doctor will often recommend to gradually stop using the Phentermine to avoid the withdrawal symptoms. Since it may lead to such symptoms, it also has the potential to cause severe withdrawal symptoms, especially when a patient goes cold turkey. This brand is manufacturedby Teva Pharmaceuticals (formerly GATE Pharmaceuticals). Should the collaborating physician have restrictions on his/her ability to prescribe controlled substances including controlled substance weight loss medications, the CTP holder would be limited by the same restrictions.The administrative rules, Advanced Practice Registered Nurse Certification and Practice, contained in Chapter 4723-8, of Ohio Administrative Code (OAC), require all APRNs to utilize and incorporate into the nurses practice knowledge of Chapter 4731.,ORC, and rules adopted under that chapter by the State Medical Board that govern the practice of the nurses collaborating physician. (2019, May 03). The least amount feasible should be prescribed or dispensed at one time in order to minimize the possibility of overdosage. It is important to follow these instructions religiously. It helps patients lose weight by suppressing their appetite and boosting their energy levels, thus leading to a more active lifestyle and greater calorie burn. RPYcn@b[%XYK'Q %[.()GTkJ WCf.-i>n-oIzE*D40f#Gp'LcddmE8;>u?X"tO 1]M={4,ReC8E8Z Q1Lt$-XpFCrTJ In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2), limit the dosage of Phentermine to 15 mg daily [see Dosage and Administration (2.2)]. It is impossible for them to complete the necessary physical evaluation (and follow-up) that is required to ensure that phentermine will not cause you undue harm. Unfortunately, the answer is no in most cases. %PDF-1.6 % 1-612-816-8773. As a result, they may be more open to the idea of prescribing phentermine. information highlighted below and resubmit the form. health information, we will treat all of that information as protected health Rx only. https://med.ohio.gov/LinkClick.aspx?fileticket=Q2JmI7o-3HI%3d&portalid=0. Phentermine is one of the substances that have been researched thoroughly, thus its effects have been proven effective and the claims that are made about this drug are backed by scientific evidence. Ideally, patients should take it on an empty stomach. hb``````>X,K10wdjdZ(`l Ro4' b2h>$:-9.AKL1}c$vEP;-@c=en`Y %YQh` &^ At January's meeting, the board discussed the rules and elected to investigate what other states are doing to regulate weight loss medication. In most cases, the drug is prescribed to users in periods of 12 weeks. Doctors used it to help patients who experience certain health issues caused by obesity to lose weight and improve the symptoms they are experiencing. Learn about the most popular weight loss medications. It is an appetite suppressant with the added ability to help the body produce more energy from fat cells. If you are a good candidate for the medication, but your doctor does not prescribe phentermine, ask for a referral. Some people also receive a phentermine prescription from their gynecologist (OB-GYN). They inhibit the activity of an entire enzyme family known as monoamine oxidase. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class in which these phenomena have been looked for. In addition, Section 4723.431(A), ORC, requires the APRNs collaborating physician to be practicing in Ohio in a specialty that is the same or similar to the nurses nursing specialty.Section 4723.481(B), ORC, prohibits the prescriptive authority of the CTP holder from exceeding the prescriptive authority of the collaborating physician. The State Medical Board of Ohio met on January 13, 2021. Some patients experience an increase in sexual interest, while others notice that they have a lower libido. The MAO inhibitors (Monoamine Oxidase Inhibitors) are used to treat depression, especially a specific type called atypical depression. 2021; doi:10.1007/s13679-020-00422-w. The Ohio Emergency and Acute Care Facility Opioids and Other Controlled Substances Prescribing Guidelines offer clinical guidance for the acute care environment where there is no established patient-doctor relationship. Requirements may be altered [see Warnings and Precautions (5.9)]. Phentermine Hydrochloride Tablets, USP 37.5 mg are white oval shaped bisected tablet with blue specs, debossed with 810 on bisected side. Keep from freezing. National Association of Boards of Pharmacy. Unpublished raw data. https://www.micromedexsolutions.com. health information, we will treat all of that information as protected health In some cases, the use of this drug in combination with other pills may cause the effects of other drugs to increase. ohio.gov under the Practice APRN link.Although the Formulary allows CTP holders to prescribe these three drugs under the circumstances documented by their respective standard care arrangement, there are other factors that must be considered by the CTP holder prior to initiating Qsymin, Belviq or Contrave prescriptions for patients. Even patients who are overweight and pregnant at the same time are not allowed to use this product. Learn about phentermine and succeed in your weight loss journey. If you take too much of this medicine, it may become habit-forming (causing mental or physical dependence). Diabetes & Metabolism Journal. Phentermine is a popular prescription drug that is often used to treat obesity. Clinics specializing in weight loss often employ bariatric specialists who have additional training in obesity management. other information we have about you. Patients are advised to report any symptoms or diseases they may have before the doctor prescribes the drug this may include high blood pressure and kidney problems, as well as any type of diabetes and thyroid disorders. Sign-up for our weekly newsletter! - 7 However, weight loss clinics are not the perfect solution. Your email address will not be published. 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. Cumulative urinary excretion of Phentermine under uncontrolled urinary pH conditions was 62% to 85%. Cardiovascular effects include arrhythmia, hypertension or hypotension, and circulatory collapse. Review/update the This content does not have an Arabic version. For some patients, half tablet (18.75 mg) daily may be adequate, while in some cases it may be desirable to give half tablets (18.75 mg) two times a day. The following information includes only the average doses of this medicine. The structural formula is as follows: Phentermine hydrochloride is a white, odorless, hygroscopic, crystalline powder which is soluble in water and lower alcohols, slightly soluble in chloroform and insoluble in ether. Our members represent more than 60 professional nursing specialties. Do not crush, break, or chew it. Below is a chart of body mass index (BMI) based on various heights and weights. 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. Rule 4731-11-02 | General provisions. A total of 24 patients developed heart valve disease while taking this drug, which led the FDA to withdraw the product from the market in 1997. To provide you with the most relevant and helpful information, and understand which Here are the results of a recent poll that asked current phentermine patients where they received their phentermine prescription ( Rule 4731-11-04 | Controlled substances: Utilization of short term anorexiants for weight reduction. Specializes in Cardiology, Research, Family Practice. Do You Need a Prescription for Phentermine? The goal of the drug is to help patients lose weight and increase energy since the withdrawal symptoms of include fatigue and weight gain through an increase in appetite, the product is rendered a waste of the patients time and money. 1 The drug has two primary functions in the human body, which is the reason why it is always accompanied by these lifestyle changes. It can help weight loss by making you less hungry. Or it can help you feel full longer. Phentermine should never be taken after 6 pm in the afternoon as it causes insomnia. https://www.uptodate.com/contents/search. Duromine is not funded by Pharmac, so patients pay $160-$200 per month when they present a standard prescription of 30mg daily - in addition to the GP consultation fee. The dosage varies from 15mg to 37.5mg per day. CTP holders continue to be prohibited from prescribing all other anorexiants including, but not limited to phentermine (Adipex). Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. 5 Y$iqzZz\vlt1a;svw&aBS8Z(HGCkr&_Qxt97t,GWceTL^QqX(%8_A2'"%tD'DNz"G*"Tc. More, these sites also operate pharmacies that are not VIPPS-accredited, so you may also be putting your personal information and or money at-risk ( But weight management can take time. Won Son J, et al. For more information, the rule package submitted to the Common Sense Initiative (CSI) office for review can be found here:https://med.ohio.gov/LinkClick.aspx?fileticket=Q2JmI7o-3HI%3d&portalid=0, 2023 The Ohio State Medical Association. Phentermine is intended to help overweight and obese patients who have already tried losing weight with diet and exercise. It is illegal & unsafe to buy phentermine online consider Phen Caps instead! Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic and/or tricuspid valves, has been reported in otherwise healthy persons who had taken a combination of Phentermine with fenfluramine or dexfenfluramine for weight loss. hbbd``b`z$@D`]"@DeX- Bb V ``LA\F*? Not only can losing weight harm an unborn baby during pregnancy, but the drug may also cause adverse effects. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Phentermine is intended to help overweight and obese patients who have already tried losing weight with diet and exercise. Get the best fitness, food, and weight loss tips to succeed on your journey! Phentermine is a Schedule 4 drug. Accessed Oct. 11, 2022. allnurses is a Nursing Career & Support site for Nurses and Students.