Jocelyn asked

Can you discover PubMed articles or guidelines supporting that phentermine and also Adderall have to not it is in prescribed together? I"ve tried yet can"t seem to find anything. Trying to find documentation come send to the prescribers in mine area that mean me come dispense both in ~ the exact same time.

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At a glance

merged use that phentermine and Adderall (mixed amphetamine salts) is generally not recommended as result of their comparable mechanism of action and threat of additive next effects.

Answer

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It"s unlikely that you will find any type of scientific articles evaluating the linked use of Adderall (mixed amphetamine salts) and also phentermine due to the fact that they are basically the same type of drug (sympathomimetics).

In fact, the prescribing details for phentermine (and drugs the contain phentermine, like Qsymia) discusses the amphetamine-like nature that the drug:<1>

Phentermine is a sympathomimetic amine with pharmacologic activity similar to the prototype medicine of this class used in obesity, amphetamine (d- and dll-amphetamine).Adipex-P Prescribing Information

Combined Use

Combining sympathomimetic drugs is typically not recommended as result of the raised risk of specific side effects, including:<2><3>

Increased Blood PressureAgitationIrritabilityIncreased heart rate

There are no medical guidelines that recommend the merged use the phentermine and Adderall (amphetamine salts). Additionally, over there is no drug product approved by the FDA that combines the two.

There to be an investigational medicine undergoing clinical trials in the 1960s, Bionamin, that combined phentermine and also amphetamine salts however it was never approved because of the lack of efficacy and concern over side effects.<4><5>

Side effect Concern

In regards to anti-obesity drugs structurally similar to phentermine, they room all associated with major side effects. This side effects include main pulmonary hypertension (PPH) and cardiac valvulopathy.<6>

Phentermine shows up to it is in the the safest amphetamine-like drug indicated to act obesity and whether or not there is a risk of the significant side effects provided above (when supplied at encourage doses) is disputed.<7>

Nevertheless, a slew of drugs similar to phentermine the was once available on the market have actually all been withdrawn because of their association with those an unfavorable side effects (sibutramine, fenfluramine etc...)<8>

Using two Stimulants?

Going ago to possibly combining phentermine and also Adderall, their use together isn"t recommended because of their potentially additive effects since they work the same way (by resulting in the release of number of neurotransmitters, consisting of norepinephrine, dopamine and also to a lesser extent, serotonin).

Guidelines because that ADHD and for the therapy of excessive weight don"t introduce the combined use that stimulants (i.e. Sympathomimetics).<9><10>

If an unified pharmacologic treatment is needed, it usually is just with a stimulant and a non-stimulant.

For example, because that ADHD, a mix of methylphenidate and also guanfacine has actually been studied. For obesity, phentermine and topiramate together has actually been studied).<11><12>

Certainly, if phentermine and amphetamine are used together, program monitoring that blood pressure and also emotional state need to be excellent at the very least.

Final Words

Based on your question, you seem to it is in a pharmacist and are being asked come dispense phentermine and also Adderall in ~ the same time, i beg your pardon is absolutely a reason for concern.

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Be certain to usage your skilled judgment on a case-by-case basis and also speak through the prescriber come make certain they totally consider the risks and benefits that this therapy. Always document your conversations! Additionally, be sure the patient knows the risks.