Adipex

Adipex-P

Generic Name: phentermine (FEN ter meen)
Brand Names: Adipex-P, Fastin, Ionamin, Obenix, Obephen, Oby-Cap, Oby-Trim, Panshape M, Phentercot, Phentride, Pro-Fast HS, Pro-Fast SA, Pro-Fast SR, Teramine, Zantryl

What is the most important information I should know about Adipex?

Taking Adipex together with other diet medications such as fenfluramine (Phen-Fen) or dexfenfluramine (Redux) can cause a rare fatal lung disorder called pulmonary hypertension. Do not take Adipex with any other diet medications without your doctors advice.

Adipex can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of Adipex. Adipex may be habit-forming and should be used only by the person it was prescribed for. Keep track of how many pills have been used from each new bottle of this medicine. Adipex is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

You may have withdrawal symptoms, such as depression and extreme tiredness, when you stop using Adipex after using it over a long period of time. Do not stop using Adipex suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

What is Adipex?

Adipex is a stimulant that is similar to an amphetamine. Adipex is an appetite suppressant that affects the central nervous system.

Adipex is used togther with diet and exercise to treat obesity (overweight) in people with risk factors such as high blood pressure, high cholesterol, or diabetes.

Adipex may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Adipex?

Do not take Adipex if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Adipex before the MAO inhibitor has cleared from your body.

Taking Adipex together with other diet medications such as fenfluramine (Phen-Fen) or dexfenfluramine (Redux) can cause a rare fatal lung disorder called pulmonary hypertension. Do not take Adipex with any other diet medications without your doctors advice.

Do not take this medication if you are allergic to Adipex or other stimulants, or if you have:

• heart disease or high blood pressure;
• arteriosclerosis (hardening of the arteries);
• an overactive thyroid;
• glaucoma;
• if you are in an agitated state; or
• if you have a history of drug or alcohol abuse.

Before taking Adipex, tell your doctor if you are allergic to any drugs, or if you have:

• problems with your thyroid,
• an anxiety disorder,
• epilepsy or another seizure disorder, or
• diabetes.

If you have any of these conditions, you may not be able to use Adipex, or you may need a dosage adjustment or special tests during treatment.

It is not known whether Adipex will harm an unborn baby. Do not take Adipex without first talking to your doctor if you are pregnant. It is also not known whether Adipex passes into breast milk or if it could harm a nursing baby. Do not take Adipex without first talking to your doctor if you are breast-feeding a baby. Do not give this medication to anyone younger than 16 years old without the advice of a doctor.

How should I take Adipex?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Taking high doses of Adipex over long periods of time can cause severe skin problems, sleep problems (insomnia), personality changes, and feeling hyperactive or irritable. Take this medicine with a full glass of water. It is best to take Adipex on an empty stomach before breakfast, or at least 10 to 14 hours before bedtime.

Adipex should be taken only for a short time, such as a few weeks.

Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.

You may have withdrawal symptoms when you stop using Adipex after using it over a long period of time. Do not stop using this medication suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Do not take Adipex in the evening because it may cause sleep problems (insomnia).

Stop taking Adipex if you have increased hunger or if you otherwise think the medication is not working properly. Do not take more Adipex for an increased effect. Taking too much of this medication can cause serious, life-threatening side effects.

Adipex may be habit-forming and should be used only by the person it was prescribed for. Keep track of how many pills have been used from each new bottle of this medicine. Adipex is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription. Store Adipex at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medication. An overdose of Adipex can be fatal.

Symptoms of a Adipex overdose may include confusion, hallucinations, feeling restless or aggressive, nausea, vomiting, diarrhea, stomach pain, irregular heartbeat, tremors, rapid breathing, confusion, hallucinations, feeling light-headed, fainting, or seizure (convulsions).

What should I avoid while taking Adipex?

Avoid drinking alcohol. It can increase some of the side effects of Adipex. Adipex can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of Adipex?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Adipex and call your doctor at once if you have any of these serious side effects:

• chest pain, swelling in your ankles or feet, feeling light-headed, fainting, or feeling short of breath, even with mild exertion;
• fast or uneven heartbeat;
• unusual thoughts or behavior, feeling restless or confused; or
• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).

Less serious side effects may be more likely to occur, such as:

• feeling nervous or anxious;
• headache, dizziness, tremors;
• trouble sleeping (insomnia);
• dry mouth or an unpleasant taste in your mouth;
• diarrhea or constipation; or
• itching.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Adipex?

Before taking Adipex, tell your doctor if you are using any of the following drugs:

• medicines to treat high blood pressure;
• insulin or diabetes medication you take by mouth;
• guanadrel (Hylorel), guanethidine (Ismelin);
• antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft); or
• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

If you are using any of these drugs, you may not be able to use Adipex, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Adipex. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about Adipex written for health professionals that you may read.

What does my medication look like?

Phentermine is available with a prescription under the brand names Adipex and Fastin. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Adipex-P 37.5 mg white, oblong, scored tablets with blue speckles
• Adipex-P 37.5 mg light-blue-and-white capsules with two blue bands
• Fastin 30 mg blue-and-clear capsules with blue and white beads

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Methadone

Generic Name: methadone (METH a done)
Brand Names: Diskets, Dolophine, Methadose

What is methadone?

Methadone is a narcotic pain reliever, similar to morphine. Methadone also reduces withdrawal symptoms in people addicted to heroin or other narcotic drugs without causing the "high" associated with the drug addiction.

Methadone is used as a pain reliever and as part of drug addiction detoxification and maintenance programs.

Methadone may also be used for purposes other than those listed in this medication guide.

Important information about methadone

Taking methadone improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from methadone. Follow all dosing instructions carefully.

Like other narcotic medicines, methadone can slow your breathing, even long after the pain-relieving effects of the medication wear off. Death may occur if breathing becomes too weak. Never use more methadone than your doctor has prescribed. Call your doctor if you think the medicine is not working.

Do not stop using methadone suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Do not drink alcohol while you are taking methadone. Dangerous side effects or death can occur when alcohol is combined with methadone. Check your food and medicine labels to be sure these products do not contain alcohol. Methadone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Before using methadone

Taking methadone improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from methadone. Follow all dosing instructions carefully. Methadone may be habit-forming and should be used only by the person it was prescribed for. Methadone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not use this medication if you have ever had an allergic reaction to a narcotic medicine (examples include codeine, morphine, Oxycontin, Darvocet, Percocet, Vicodin, Lortab, and many others). You should also not take methadone if you are having an asthma attack or if you have a bowel obstruction called paralytic ileus.

Before taking methadone, talk to your doctor if you have:

• a personal or family history of "Long QT syndrome";
• asthma, COPD, sleep apnea, or other breathing disorders;
• liver or kidney disease;
• underactive thyroid;
• curvature of the spine;
• a history of head injury or brain tumor;
• epilepsy or other seizure disorder;
• low blood pressure;
• gallbladder disease;
• Addison's disease or other adrenal gland disorders;
• enlarged prostate, urination problems;
• mental illness; or
• a history of drug or alcohol addiction.

FDA pregnancy category C. This medication may be harmful to an unborn baby. It could also cause addiction or withdrawal symptoms in a newborn if the mother takes methadone during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Methadone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults and people with debilitating conditions may be more sensitive to the effects of this medication.

How should I use methadone?

Use methadone exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

Like other narcotic medicines, methadone can slow your breathing, even long after the pain-relieving effects of the medication wear off. Death may occur if breathing becomes too weak. Never use more methadone than your doctor has prescribed. Call your doctor if you think the medicine is not working.

When methadone is used as part of a treatment program for drug addiction or detoxification, you will receive the medication through a clinic or special pharmacy.

Your doctor may recommend that methadone be given to you by a family member or other caregiver. This is to make sure you are using the medicine as it was prescribed as part of your treatment.

Additional forms of counseling and/or monitoring may be recommended during treatment with methadone.

Methadone is available in tablets, dispersible tablets, oral solution (liquid) and as an injection. The pill and oral liquid forms of methadone must never be used to make a methadone injection.

Measure the liquid form of methadone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The methadone dispersible tablet (Diskets) is made to be dissolved in water. Do not chew, crush, or swallow the tablet whole. Place the tablet into a 4-ounce glass of water, orange juice, or other citrus-flavored non-alcoholic beverage and allow the tablet to disperse in the liquid. The tablet will not dissolve completely. Drink this mixture right away. To make sure you get the entire dose, add a little more liquid to the same glass, swirl gently and drink right away.

Store methadone at room temperature away from moisture and heat.

Keep track of how much of this medicine has been used. Methadone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.An overdose of methadone can be fatal, especially if you take it with alcohol or other narcotic medications.

Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.

What should I avoid while using methadone?

Do not drink alcohol while you are taking methadone. Dangerous side effects or death can occur when alcohol is combined with methadone. Check your food and medicine labels to be sure these products do not contain alcohol. Methadone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Methadone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• shallow breathing;
• hallucinations or confusion; or
• fast or pounding heartbeats, chest pain, trouble breathing, feeling light-headed, fainting.

Other, less serious side effects may be more likely to occur, such as:

• feeling anxious, nervous, or restless;
• sleep problems (insomnia);
• dizziness, drowsiness, or weakness;
• dry mouth, nausea, vomiting, diarrhea, constipation, loss of appetite; or
• decreased sex drive, impotence, or difficulty having an orgasm.

This list is not complete and other side effects may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect methadone?

Do not use methadone with other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Do not use methadone with any of the following drugs without first talking to your doctor:

• a diuretic (water pill);
• antibiotics such as azithromycin (Zithromax), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E-Mycin, Ery-Tab), itraconazole (Sporanox), ketoconazole (Nizoral), metronidazole (Flagyl) or voriconazole (Vfend);
• heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac) or verapamil (Calan, Covera, Isoptin, Verelan);
• HIV medicines such as abacavir (Ziagen), amprenavir (Agenerase), didanosine (Videx), efavirenz (Sustiva), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), stavudine (Zerit), or zidovudine (Retrovir);
• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);
• other narcotic medications such as pentazocine (Talwin), nalbuphine (Nubain), buprenorphine (Subutex), or butorphanol (Stadol);
• rifampin (Rifadin, Rimactane, Rifater); or
• seizure medication such as phenobarbital (Luminal, Solfoton) or phenytoin (Dilantin).

This list is not complete and there are many other medicines that may cause serious medical problems if you take them together with methadone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about methadone.

What does my medication look like?

Methadone is available with a prescription under the brand names Dolophine and Methadose. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.