Alternatives to Phentermine
Phentermine is one of the most effective weight loss PILLS for most people, however, sometimes it is not right for someone or it stops working as well. This page is to explain that other options are available. since everyone is different in how their bodies respond to things. Some of these other medications can be viewed as essentially being in the same type or class of medication as Phentermine (Sympathomimetics) but they are chemically different and might just work better for one person versus another.
For any of these options, I would prescribe the medication if we decide you are a candidate for it and you would have to pay for it with insurance or cash at your local pharmacy. You can use GoodRx in advance to check your personal cost. A visit with me for any of them is just a flat $110 fee for 30 days' worth of prescription. Some medications I offer and ship to you because it's cheaper than going to the pharmacy and that is listed in the description. All options should be used with a reduced-calorie diet and increased physical activity that is sustainable for good long-term results.
Qsymia - It's not an alternative to Phentermine but an advanced option. It has phentermine in it and also topiramate. The combination of these two medications helps your body feel less hungry and more full. I can order them as separate prescriptions to save you money. When Phentermine stops working "as well" for some people, the addition of Topiramate can bring the effectiveness back up.
Tenuate (Diethylpropion)- It's a once-daily tablet of 75mg per day by mouth first thing in the morning. Some people like to split it in half and use it in two dosages throughout the day.
Bontril (Phendimetrazine ER) - I like to order this as an extended-release capsule that is 105mg once daily by mouth in the morning.
Didrex (Benzphetamine) - This one is usually 50mg by mouth once daily to start but it can be advanced to twice daily or even three times daily dosages as tolerated.
Tenuate, Bontril ER, and Didrex are similar to Phentermine in that they can help decrease appetite and increase energy/metabolism. They can also have similar side effects such as increases in heart rate and blood pressure, as well as dry mouth, constipation, and insomnia.
DIFFERENT KINDS OF MEDICATIONS THAN THE ONES ABOVE. These work differently than Bontril, Didrex, Tenuate, and Phentermine and may be more suitable for those with strong heart disease or high blood pressure.
Acarbose - Great for carb lovers and those with insulin resistance or metabolic syndrome. Start at 25mg by mouth three times daily and if tolerated it can be titrated up after 4 weeks. Side effects include gastrointestinal upset.
Orlistat (also called Xenical or Alli) - This is a Lipase Inhibitor so it blocks calories absorption. It's great for those on a high-fat diet and metabolic syndrome as well. Gastrointestinal upset and "anal leakage" can occur. You should be on a good multivitamin if you take this as it can reduce the absorption of some vitamins. The dosage is 120mg capsule three times a day with food, if tolerated. This medication can also help improve triglycerides, blood pressure and hemoglobin A1C in diabetics.
Metformin - Great for weight loss in those with insulin resistance or metabolic syndrome. Start at 500mg daily with food and can increase to twice daily as tolerated. Side effects include gastrointestinal upset. This medication can also help improve Hemoglobin A1c in diabetics.