Weight Loss Clinic

Bodies By Design



​Phentermine/Topiramate






What is phentermine and topiramate?

Phentermine is an appetite suppressant similar to an amphetamine. Topiramate is a seizure medication, also called an anticonvulsant.

Phentermine and topiramate is a combination medicine used together with diet and exercise to treat obesity. This medicine is sometimes used to treat obesity that may be related to diabetes, high cholesterol, or high blood pressure. Phentermine and topiramate will not treat any these underlying conditions. Keep using any other medicines your doctor has prescribed to treat these conditions.


What is the most important information I should know about phentermine and topiramate?

Do not use if you are pregnant. This medicine may cause birth defects.
You should not use phentermine and topiramate if you have glaucoma or overactive thyroid.

Do not use phentermine and topiramate if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not use this medicine if you are allergic to phentermine or topiramate, or if you have:

  • glaucoma;
  • overactive thyroid; or
  • if you are pregnant or may become pregnant.


To make sure this medicine is safe for you, tell your doctor if you have:

  • high blood pressure, heart disease, heart rhythm problems, congestive heart failure;
  • a history of heart attack or stroke;
  • a history of depression, mental illness, or suicidal thoughts;
  • diabetes;
  • kidney disease (or if you are on dialysis);
  • history of kidney stones;
  • liver disease;
  • seizures or epilepsy;
  • low bone mineral density; or
  • if you have ever had metabolic acidosis (too much acid in your blood).


​​Do not use if you are pregnant, and use effective birth control to prevent pregnancy while taking phentermine and topiramate. This medicine can harm an unborn baby or cause birth defects. Weight loss during pregnancy also can harm an unborn baby, even if you are overweight. You may need to have a negative pregnancy test before starting this treatment.

Phentermine and topiramate can cause irregular vaginal bleeding while you are taking birth control pills. This should not make the pills less effective in preventing pregnancy.


All women of child baring age who have not had a hysterectomy or tubal ligation must be on some type of birth control and will be required to have a pregnancy test preformed each month before receiving Phentermine/Topiramate.


​Phentermine may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.


​Drink plenty of water each day to prevent dehydration or kidney stones while you are taking phentermine and topiramate. You can easily become dehydrated while taking this medicine, which can lead to severely low blood pressure or a serious electrolyte imbalance.


You should not stop using phentermine and topiramate suddenly or you could have a seizure (convulsions). Follow your doctor's instructions about tapering your dose.


What should I avoid while taking phentermine and topiramate?

  • Ketogenic or "ketosis" diets that are high in fat and low in carbohydrates can increase the risk of kidney stones. Avoid the use of such diets while you are taking this medicine.
  • This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
  • Drinking alcohol with this medicine can cause side effects.
  • Do not take any other weight-loss products without your doctor's advice.


Phentermine and topiramate side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • pounding heartbeats or fluttering in your chest (even if you are resting);
  • sudden vision problems, sometimes with eye pain or redness;
  • trouble concentrating, problems with speech or memory;
  • a seizure (convulsions);
  • feeling very thirsty or hot, decreased sweating, hot and dry skin;
  • low blood sugar--headache, hunger, weakness, sweating, irritability, dizziness, or feeling jittery;
  • signs of metabolic acidosis--confusion, vomiting, lack of energy, irregular heartbeats; or
  • signs of a kidney stone--pain in your side or lower back, blood in your urine, painful or difficult urination.


Common side effects may include:

  • dizziness;
  • constipation;
  • numbness or tingly feeling;
  • sleep problems (insomnia); or
  • dry mouth, changes in your sense of taste.


This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.


​​While taking Phentermine/Topiramate we recommend you stop by the clinic at your convenience weekly for your weigh-ins so that we may monitor your progress and address any problems you may be having with the medication or your diet. We understand this is not always possible and if you are unable to make it into the clinic weekly we encourage you to take advantage of our 24 hour support via phone or email @ 423-398-5273 and bbdweightloss@gmail.com.