Bontril, also known by its generic name Phendimetrazine, is a prescription medication approved by the Food and Drug Administration (FDA) for short-term weight management. It is intended to be used in conjunction with a reduced-calorie diet, behavior change, and exercise in certain overweight people, such as those who are obese or have weight-related medical problems. Phendimetrazine has been successfully used to treat obesity for over 40 years, gaining FDA approval in 1976.
Who is a Candidate for Bontril?
Bontril may be prescribed for adults with a body mass index (BMI) of 30 or greater. Adults with a BMI of 27 or greater may be considered candidates for Bontril if they have at least one weight-related medical condition. A healthcare provider will evaluate a patient's past medical history, current medications, vital signs, and BMI to determine if phendimetrazine is a safe and appropriate option.
How Bontril Works
Phendimetrazine is an appetite suppressant, meaning it decreases the sensation of hunger, cravings, and binge eating. It is also a Central Nervous System stimulant, meaning it helps to increase energy level. It is thought to help people lose weight by reducing appetite, which may help you want to eat less food. Phendimetrazine works by activating the body's alpha-adrenergic system, which suppresses appetite and increases metabolism. It also works to release norepinephrine and dopamine by binding to and reversing the NET, a transport system for these hormones.
Dosage and Administration
Take Bontril exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Bontril is usually taken 1 hour before meals. Never use phendimetrazine in larger amounts, or for longer than prescribed. Bontril is for short-term use only.
The immediate-release form of this medication should be taken by mouth as directed by your doctor, usually 2 to 3 times a day (1 hour before meals). The sustained-release form of phendimetrazine is usually taken once a day 30 - 60 minutes before the morning meal. Swallow this medication whole. Do not crush, chew, or break the capsules.
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The dosage is based on your medical condition and response to treatment. Your doctor will adjust the dose to find the best dose for you. Use this medication regularly and exactly as prescribed in order to get the most benefit from it. Phendimetrazine is usually taken for only a few weeks at a time. It should not be taken with other appetite suppressants.
Phendimetrazine vs. Phentermine
Phendimetrazine and phentermine are very similar medications. However, phendimetrazine has a shorter half-life, which means it has a shorter duration than phentermine. Due to this, it can be taken up to three times daily if needed, whereas phentermine can not. Also, due to the shorter duration of action, it decreases the side effect of insomnia which can occur with phentermine when it is taken too late.
What to Expect During Treatment
Phendimetrazine is not a simple or quick fix to being overweight. However, it is intended to assist you in the initial phases of your weight loss regimen that includes incorporating healthier nutrition and lifestyle habits. The goal is to help you achieve your health and weight loss goals through the use of nutritional counseling, fitness education, accountability, and continuous support.
Potential Side Effects
Like all medications, Bontril can cause side effects.
Common Side Effects:
- Dizziness
- Dry mouth
- Difficulty sleeping
- Irritability
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Feeling of skipped heartbeats
- Fast heartbeat
- High blood pressure
- Feeling restless
- Tremors
- Sweating more than usual
- Headache
- Increased urination
Serious Side Effects:
- Pulmonary Hypertension: Phendimetrazine may increase your risk of developing pulmonary hypertension (high blood pressure in the blood vessels between your heart and your lungs), which can be life-threatening.
- Symptoms: Trouble breathing, chest pain, fainting, swelling in your legs. Stop taking phendimetrazine and get help right away if you have any of these symptoms.
- Heart Valve Problems: Phendimetrazine or medicines like it may rarely cause problems with your heart valves, which can be serious.
- Symptoms: Unusual shortness of breath, feeling of skipped heartbeats, chest pain, swelling in the legs, fainting or feeling dizzy. Stop taking phendimetrazine and get help right away if you have any of these symptoms.
- Severe Allergic Reactions: Phendimetrazine may cause allergic reactions, which can be serious.
- Symptoms: Breathing problems or wheezing, racing heart, fever or general ill feeling, swollen lymph nodes, swelling of the face, lips, mouth, tongue, or throat, trouble swallowing or throat tightness, itching, skin rash, or pale red bumps on the skin called hives, nausea or vomiting, dizziness, feeling lightheaded, or fainting, stomach cramps, joint pain. Stop taking phendimetrazine and get help right away if you have any of these symptoms of a serious allergic reaction.
This is not a complete list of possible side effects. Call your doctor for medical advice about side effects. In Canada - Call your doctor for medical advice about side effects. You can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
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Warnings and Precautions
Before taking phendimetrazine, tell your doctor or pharmacist if you are allergic to it; or to any other sympathomimetic amines (including decongestants such as pseudoephedrine, stimulants such as amphetamine, appetite suppressants such as phentermine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems.
Who Should Not Use Phendimetrazine?
Phendimetrazine should not be used by those with certain medical conditions or those taking certain medications. Contraindications include:
- Allergies to Phendimetrazine or any of the ingredients in the specific product dispensed
- Heart disease, heart murmur, or heart valve problems
- High blood pressure, including pulmonary hypertension
- Thyroid problems (hyperthyroidism)
- Agitation
- Substance use disorder
- Eye problems (glaucoma)
- Pregnancy
- Breastfeeding
Important Considerations Before Use:
- Pregnancy: Do not take phendimetrazine if you are pregnant. Weight loss offers no potential benefit to a pregnant woman and may harm an unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
- Breastfeeding: It is unknown if this drug passes into breast milk. However, similar drugs pass into breast milk. Breastfeeding is not recommended while using this drug.
- Drug Interactions: Phendimetrazine should not be taken while you are using certain other medicines.
Drug Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist.
This drug should not be used with certain medications because very serious interactions may occur. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication.
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Some products have ingredients that could raise your heart rate or blood pressure. In particular, make sure that you discuss if you are using any of the following before taking phendimetrazine:
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- Linezolid (Zyvox), which is a medicine used for certain bacterial infections
- A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinsonâs disease
- A medicine or supplement for weight loss
- A medicine for high blood pressure
- A medicine for diabetes
This may not be a complete list of medicines that can interact with phendimetrazine. Always check with your health care provider.
Other Important Information
- Phendimetrazine is a controlled substance because it can be misused or lead to dependence. Store phendimetrazine in a safe place to protect it from theft. It is illegal to sell or give away this medicine.
- Phendimetrazine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how phendimetrazine affects you.
- Phendimetrazine is usually only taken for a few weeks. This medicine may be habit-forming and has a risk of being misused. Do not increase your dose, take it more often, or use it for a longer time than prescribed.
- Avoid drinking alcohol while using this medicine.
- Do not take other medicines unless they have been discussed with your doctor. This includes prescription and nonprescription (over-the-counter) medicines, dietary supplements, herbal remedies, or medicines for appetite control, asthma, colds, cough, hay fever, and sinus problems.
- If you have diabetes, check your blood sugar regularly as directed and share the results with your doctor. This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests, or if you have any questions, check with your doctor.
Overdose
Taking too much phendimetrazine can cause restlessness, confusion, aggression, hallucinations, and panic. It can also lead to extreme tiredness and sadness. Heart issues may include abnormal heartbeats, high or low blood pressure, and weak blood circulation. Other symptoms may include nausea, vomiting, diarrhea, and stomach pain. In extreme cases, there may be seizures, unconsciousness, and even death.
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. Canada residents can call 1-844-764-7669.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose or late in the evening, skip the missed dose. Take your next dose at the regular time.
Storage
Store at room temperature away from light and moisture. Do not store in the bathroom. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.
Patient Reviews
Patient reviews for Bontril are mixed. Some patients report significant weight loss and improved health markers, while others report minimal or no weight loss and unpleasant side effects. Some examples include:
- Positive Reviews: Some patients have reported losing significant weight within a few weeks or months of starting Bontril, with improvements in conditions like diabetes.
- Negative Reviews: Some patients report experiencing side effects like irritability, anxiety, racing heart, and constipation. Some patients also report that the medication did not help them lose weight or curb their appetite.
It's important to remember that individual results may vary, and it's crucial to discuss your specific situation and potential risks with your healthcare provider.
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