Weight loss supplements have become increasingly popular, promising a quick and easy path to a slimmer physique. However, it's crucial to understand the potential side effects and risks associated with these products. This article will explore the side effects associated with weight loss supplements, with a focus on Phentermine hydrochloride and Metamucil Sunrise Oral Powder.
Phentermine Hydrochloride: Uses, Dosage, and Side Effects
Phentermine hydrochloride is a sympathomimetic amine anorectic, meaning it stimulates the central nervous system and suppresses appetite. It is indicated as a short-term adjunct (a few weeks) 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/m2, or ≥ 27 kg/m2 in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia).
Dosage and Administration
Dosage should be individualized to obtain an adequate response with the lowest effective dose. The usual adult dose is one capsule (37.5 mg) or one tablet (37.5 mg) daily, as prescribed by the physician, administered before breakfast or 1 to 2 hours after breakfast for appetite control. Late evening administration should be avoided due to the risk of insomnia. For patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2), the recommended maximum dosage is 15 mg daily.
Contraindications and Warnings
Phentermine is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. A minimum weight gain, and no weight loss, is currently recommended for all pregnant women, including those who are already overweight or obese, due to obligatory weight gain that occurs in maternal tissues during pregnancy.
Coadministration with other drugs for weight loss is not recommended, as the safety and efficacy of such combinations have not been established.
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Potential Side Effects
Adverse events have been reported in the cardiovascular, central nervous, gastrointestinal, allergic, and endocrine systems.
- Cardiovascular: Rare cases of primary pulmonary hypertension (PPH) and serious regurgitant cardiac valvular disease have been reported. Symptoms of PPH include dyspnea, angina pectoris, syncope, or lower extremity edema. Use caution in patients with even mild hypertension, as phentermine may increase blood pressure.
- Central Nervous System: Phentermine may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle. Other potential side effects include insomnia, irritability, hyperactivity, and personality changes.
- Gastrointestinal: Gastrointestinal symptoms may include nausea, vomiting, diarrhea, and abdominal cramps.
- Other: Tolerance to the anorectic effect may develop within a few weeks. There is a risk of abuse and dependence, and concomitant alcohol use may result in an adverse drug reaction.
Drug Interactions
Phentermine may interact with several medications:
- Monoamine oxidase inhibitors (MAOIs): Risk of hypertensive crisis.
- Insulin and oral hypoglycemics: Requirements may be altered.
- Adrenergic neuron blocking drugs: Hypotensive effect may be decreased by phentermine.
Special Populations
- Renal Impairment: Avoid use in patients with eGFR less than 15 mL/min/m2 or end-stage renal disease requiring dialysis. Use with caution in patients with renal impairment. In patients with severe renal impairment (eGFR 15 to 29 mL/min/1.73m2), limit the dosage of phentermine to 15 mg daily.
- Geriatric Use: Due to substantial renal excretion, use with caution in elderly patients.
- Pediatric Use: Safety and effectiveness have not been established in pediatric patients.
- Nursing Mothers: Discontinue drug or nursing, taking into consideration the importance of the drug to the mother.
Abuse and Dependence
Phentermine is related chemically and pharmacologically to amphetamine and other related stimulant drugs that have been extensively abused. 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. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity, and personality changes.
Metamucil Sunrise Oral Powder: Uses, Dosage, and Side Effects
Metamucil Sunrise Oral Powder is a bulk-forming laxative used to treat constipation. It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass. Psyllium, one type of bulk-forming laxative, has also been used along with a proper diet to treat high cholesterol.
Dosage and Administration
Take this medication by mouth as directed by your doctor. If you are self-treating, follow all directions on the product package. To prevent choking from this medication, take it with a full glass of water or other liquid (8 ounces/240 milliliters). For powder forms of this medication, measure each dose according to the directions on the product label. Mix in a full glass of water or other liquid (8 ounces/240 milliliters), stir completely, and drink right away. You may add more liquid to the mixture if it becomes too thick.
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Precautions
Before taking this bulk-forming laxative, tell your doctor or pharmacist if you are allergic to it, or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Before using this medication, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal blockage, difficulty swallowing, appendicitis or symptoms of appendicitis, a sudden change in bowel habits that lasts for longer than 2 weeks, bleeding from the rectum.
Potential Side Effects
Gas or stomach cramping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. This product must be taken with at least a full glass of water or other liquid (8 ounces/240 milliliters) so that it will not swell in the throat, causing choking. Get medical help right away if after taking this product you have symptoms of choking such as: chest pain, vomiting, difficulty swallowing/breathing. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
Drug Interactions
This product may decrease the absorption of other medications you may be taking. Take this product at least 2 hours from your other medications.
Other Weight Loss Medications and Considerations
Besides Phentermine and Metamucil, other medications like Ozempic and Mounjaro are approved for diabetes but are also used for weight loss. However, these diabetes and weight loss medications are not for everyone. People who have a history of pancreatitis should discuss the risks with their doctor before starting the drugs. Patients who have medullary thyroid cancer or a family history of it should not take them, because of the potential risk of thyroid C-cell tumors.
It is important to note that some side effects may not be a result of the drug but the weight loss itself, such as hair loss, or they could be due to an underlying disease.
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The Importance of Medical Supervision
Reports of aspiration underline the need for medical supervision while taking weight loss medications. Some people take these medications without ever making a trip to see their doctor, which could lead to complications if patients are not being screened properly and counseled properly.