Diet and Health FAQ

Tagged As: weight loss diet pill online

Question:
I have been taking Phentermine for a while now and I am quite pleased. However the site that I buy from http://www.diet-pill-online.com has several different Diet Pills and I am very tempted to try one other than Phentermine. Does anyone here have some sucess stories they can share with me on some of these other weight loss diet pills online? Which is the best?

Answer:
I think you will find that there are no great differences between the sympathomimetic [stimulant/appetite suppressant] drugs, especially given that all of them are taken once a day, usually in timed-release form, or otherwise have a long duration of action. Controlled studies (of varying quality) have not demonstrated the superiority of any one of these when used as monotherapy (though an attempted meta-analysis mentioned at the end of this article looks at a subset of these drugs). There may be some subtleties: for example, immediate-release phentermine 37.5mg lasts 12-15 hours, but all the drug is released as once, and so may feel more stimulating than a timed-release preparation of phentermine or the other drugs. Note too, that phentermine HCl 37.5mg has 30mg of phentermine base. Phentermine resin (Ionamin) is dosed in milligrams of base, so Ionamin 30 has the same amount of drug as 37.5mg of phentermine HCl, but it's leached from the ion-exchange resin slowly as it works its way thru the gut. Similarly, a timed- release capsule of 30mg phentermine HCl really contains only 24mg of phentermine base, so the daily dose is smaller. Roughly speaking: 37.5mg of phentermine HCl ~= 30mg phentermine base in a resin complex (Ionamin) ~= 105mg of phendimetrazine HCl ~= 75mg of diethylpropion HCl. In immediate release terms: 15mg of phentermine base ~= 18.75mg of phentermine HCl ~= 35mg of phendimetrazine HCl ~= 25mg of diethylpropion I'm not sure where to place Didrex, benzphetamine HCl, which comes in 50mg tablets. This is (as far as I can tell from Pharmacia/Upjohn's literature) an immediate-release, scored tablet. The web sites that sell it assume a maximum daily dose of 50mg, either taken as one tablet, or taking 1/2 in the AM and 1/2 in the mid-afternoon, though I suspect that might be underdosing some people, at least those who are already tolerant to 37.5mg of phentermine HCl. Benzphetamine, like phendimetrazine, are C-III controlled substances, unlike the other two drugs, which are classified as C-IV, indicating a somewhat lower abuse liability (DEA classifications can have less to do with pharmacology than with reputation). Preludin {phenmetrazine} was a 1970's era anorectic drug that became a popular drug of abuse, much like d-amphetamine, and was placed in C-II along with amphetamine and methamphetamine before being removed from the US market by its European manufacturer Boehringer Ingelheim. Its less potent and less powerful N-methyl congener phendimetrazine may have been placed in C-III due to its chemical similarity to the more notorious drug. Benzphetamine has a complex metabolism: it likely acts by itself, but it is also metabolized in part to d-methamphetamine and d-amphetamine, and people taking this drug will test positive for both metabolites in any urine drug screening. Its classification in C-III might seem to be justified by its metabolism. Another drug which doesn't appear at all in online pharmacies (at least the ones I've come across) is mazindol (Sanorex). This is a rather peculiar-looking drug chemically, and seems to have more complex effects on both norepinephrine and dopamine, similar to the tricyclic antidepressants. It is somewhat stimulating, but generally is not perceived to be particularly pleasant. It comes in 1mg and 2mg tablets, taken once a day. It's a C-IV drug. There is almost complete cross-tolerance between these *stimulant* drugs; it's unlikely that once you reach a 10% or 20% weight loss with one of them, switching to a different one will help you lose more. Diethylpropion has a reputation (perhaps undeserved) for having fewer effects on the heart and blood pressure, but that may also reflect that it's simply less potent and powerful all around. It is not yet clear whether adding a lipase inhibitor like Orlistat to an anorectic drug leads to greater weight loss than either drug alone. Here's an interesting abstract of a recent attempted meta-analysis of studies of drug therapy. Arch Intern Med 2001 Aug 13;161(15):1814-1824 Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Glazer G. University of Rochester School of Medicine, NY, USA. To clarify the efficacy of antiobesity drugs, this article reviews all long-term (> or =36 weeks), placebo-controlled trials of obesity pharmacotherapy published since 1960. Since fears of anorexiant-induced heart valve damage preclude many physicians and patients from even considering antiobesity drugs, this area is also reviewed in-depth. Electronic database and manual bibliography search was used to identify all relevant publications. While existing studies are too few and heterogeneous to warrant meta-analysis, their review does provide evidence highly relevant to the safety and efficacy of available anorexiants. Weight loss attributable to obesity pharmacotherapy (ie, in excess of placebo) in trials lasting 36 to 52 weeks was 8.1% or 7.9 kg for those receiving phentermine resin, 5.0 % or 4.3 kg for those receiving sibutramine hydrochloride, 3.4% or 3.4 kg for those receiving orlistat, and -1.5% or -1.5 kg for those receiving diethylpropion hydrochloride. Physiologic, pathologic, and epidemiological studies strongly support that anorexiant-induced valvulopathy is attributable to specific serotonergic properties of the fenfluramines that are not present with available weight loss drugs. [I should mention that meta-analyses look at published papers, and to claim that valvulopathy is associated with the fenfluramines and not with other drugs reflects as much the increase in the use of cardiac doppler ultrasonography during the time the phentermine/ fenfluramine combination became widely used. Other studies coming out suggest that the reputation of both fenfluramine and dexfenfluramine for being the sole cause of damage to heart valves may have been somewhat unfair, though these have always been somewhat controversial drugs, due to their long-known association with a rare incidence of pulmonary hypertension in some people taking them.]