Phentermine??

[TennesseeNP123]

Question---how long is it appropriate for a patient to be on phentermine for weight loss? I've tried googling, etc and find conflicting answers, but most say less than 3 months....The office I'm working at has multiple pts that have been on phentermine for years!

Also, some pts are on phentermine for "fatigue".....obviously, other things have been ruled out like hypothyroid, anemia, etc etc, but does the diagnosis change the appropriateness for phentermine length of time??

[AtomicWoman]

When I initiate phentermine (always in combination with diet and exercise), I tell the patient "this medication is approved for short-term use only. I will write only for 3 months of it and then you will need to discontinue it". I always see pts. for f/up at the 1 month (esp. to check for side effects like insomnia and jitteryness) and 3 month mark. When I tell patients this up front, they don't ask me to write for it for a longer time. (Or maybe they just go to another provider who will!) Once in a while, I will be asked to approve a refill for someone who is not my patient and who has been on it long-term. I have the luxury of saying, "I am not comfortable refilling this" and forwarding it to the person who last prescribed it. (Sometimes they say, no, too!)

The manufacturer actually says "a few weeks" if you look up the prescribing directions. That's kind of fuzzy, IMO. And I will not prescribe it as an "upper" for fatigue.

[BlueDevil,DNP, DNP, RN]

I don't write for it, it simply doesn't work and it's probably dangerous. I've known people who have used it and 100% of them have regained ever pound as soon as they discontinued it. There just aren't any short cuts to weight loss and that's all there is to it. Not a risk I'm willing to take.

[AtomicWoman]

I never make the suggestion to use it, but patients will come with stories like, "My friend used it to kick-start her weight loss while she started dieting and exercise". Typically, the patient will come back at the one-month mark and report a weight loss of about 5 pounds, and they feel good they have started the process of losing weight. Do I think the weight-loss will stick? Not likely, but then again, most diet plans also are not good at long-term weight loss, mainly because patients lose interest in doing what needs to be done to maintain the weight loss. If a patient just wants the med and isn't willing to change eating habits and exercise more, I will not prescribe the med.

[TennesseeNP123]

Thanks guys....