Beware of Topamax with Phentermine
Posted: 09 June 2008 03:56 AM   [ Ignore ]
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Just over 3 months ago I started a medical weight loss program that showed excellent results. I had 100 lbs to lose (age 45) and I had no health problems associated with my weight (my cholesterol was always low, my blood pressure was always normal, I don’t have Diabetes, etc). I was born with an extra heartbeat, but it was NEVER a problem. I was put on 50 MG of Topamax with 37.5 MG of Phentermne HCI (although I was told to cut the Phentermine pill in half). I walked every other day (3 miles each time) and lost 38.1 lbs in 3 months time. I had lost 11.6 lbs the previous month alone! The average weight loss for my particular medical diet was 26 pounds in 3 months. I was very pleased and so was my doctor.

One or both drugs took a while to get used to (extreme dizziness, lack of concentration, speech problems and confusion at first), but once my body adjusted after 10 days I was in HEAVEN! I had little appetite, a much better mood, I couldn’t sit still so I was very active and the weight came off easily (if I even tried to overeat, I because nauseous).

Then at the 3 month mark I took my usual walk but had difficulty finishing it; I was dizzy, sweating more than usual and lethargic. I felt better the next day so I walked again. This time I walked 2 miles and than had to stop. The symptoms were the same (but worse) and this time I felt nauseous and my heart felt as though it was jumping out of my chest. I felt so bad that in the late afternoon I drove myself to my doctor’s office (primary care physican PLUS weight loss supervisor).

My blood tests and urine tests were normal. However, my blood pressure was high for the 1st time in my life and my EKG was off the charts….irregular heartbeat with “extreme” variations. The doctor used the word “enhanced” extra beat. He did not believe the drugs were the problem due to my being on them 3 months w/o problem, so he told me not to walk. I didn’t walk, but I didn’t get any better. I got worse! When I tried to walk for 10 minutes in JC Penny’s cold store and started sweating profusely plus feeling dizzy and nauseous, I knew I had a problem! I immediately cut down on the Topamax w/o telling him. Within two days I was MUCH better, but still not 100%. When the doctor called me at home over the weekend, I knew he was scared for me, too. When I told him I was feeling BETTER with just 1/2 the Topamax dosage, he told me to immediately stop taking BOTH drugs. After the 3rd day, I was 100% better! I went back to walking and have had NO SYMPTOMS. That was 2 weeks ago.

I have gained a few pounds (which is depressing), but I meet with the doctor for my monthly visit tomorrow. We’ll see where I go from here. Even if he doesn’t believe I could have a problem with Topamax and Phentermine after being on them for 3 months, I KNOW one or both were the cause of my heart problems. PLEASE listen to your BODY when taking drugs for diet purposes. YOU know your body better than any doctor does. I would rather live another 30 years OBESE with my wonderful husband and children than die from diet drugs!

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Posted: 09 June 2008 06:10 AM   [ Ignore ]   [ # 1 ]
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FLNonny,

Thank you very much for sharing your story.

I agree with you. If something doesn’t feel right, stop taking the drug(s).

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Posted: 09 June 2008 07:34 AM   [ Ignore ]   [ # 2 ]
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FLNonny,

I asked a couple of weight loss doctors familiar with these drugs if any of their patients had experienced the same thing.

They asked…

1. Have you have ever had a heart murmur?

2. Were your electrolytes checked, especially bicarbonate (HCO3) and potassium?

3. Were your thyroid levels checked, that is Free T3, and T4?

4. What do you mean when you say that you were born with an extra heartbeat?

5. What was the result of your echocardiogram?

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Posted: 09 June 2008 12:55 PM   [ Ignore ]   [ # 3 ]
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Larry Hobbs - 09 June 2008 12:34 PM

FLNonny,

I asked a couple of weight loss doctors familiar with these drugs if any of their patients had experienced the same thing.

They asked…

1. Have you have ever had a heart murmur? 
I WAS BORN WITH AN EXTRA BEAT THAT CAUSES MY EKG’S TO BE ABNORMAL. BUT ALL MY FULL CADIO SCREENS (ULTRA SOUND, HALTER MONITOR, STRESS TEST), HAVE SHOWN NO HEART PROBLEMS. MY EKG"S NOW CONTAIN A NOTE THAT SAYS “IRREGULAR” IS NORMAL FOR ME. With that said, the EKG reading once I started having problems was irratic. All the hearthbeats were “enhanced” (Dr’s words) and I felt as though my heart was jumping out of my body. I could tell the moment my doctor checked my heart w/ his stethascope (before the EKG) that he was worried. I could hear it in his voice and see it in his face. At that time, I was very lethargic, nauseous, dizzy, but I had stopped sweating.
2. Were your electrolytes checked, especially bicarbonate (HCO3) and potassium?  YES, EVERYTHING CAME BACK “Normal.”
3. Were your thyroid levels checked, that is Free T3, and T4?  YES, MY THYROID LEVELS WERE CHECKED AND CAME BACK “Normal”

4. What do you mean when you say that you were born with an extra heartbeat? SEE ABOVE #1
5. What was the result of your echocardiogram?

EKG results; SEE ABOVE #1

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Posted: 09 June 2008 01:18 PM   [ Ignore ]   [ # 4 ]
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FLNonny,

Thanks for the info.

I will pass this along to see if the doctors have seen this before.

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Posted: 09 June 2008 06:35 PM   [ Ignore ]   [ # 5 ]
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FLNonny,

The weight loss doctors I emailed about your case are interested in speaking to your doctor to find out more, if possible.

These doctors have treated thousands of patients with these drugs.

Would you mind emailing me your doctor’s name and phone number?

You can send it to me at larryhobbs@cox.net.

If you rather not, I certainly understand.

Thanks.

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Posted: 09 June 2008 06:57 PM   [ Ignore ]   [ # 6 ]
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Larry Hobbs - 09 June 2008 11:35 PM

FLNonny,

The weight loss doctors I emailed about your case are interested in speaking to your doctor to find out more, if possible.

These doctors have treated thousands of patients with these drugs.

Would you mind emailing me your doctor’s name and phone number?

Larry, I am still on the diet plan and learn Friday where we go from here since I am no longer on the two medications. I am the first “problem” (I believe) the relatively new physicians’ weight loss program has experienced. I believe I am client #77 out of less than 200. I would rather not be kicked out of the program due to upsetting the doctors. The main doctor for this program is also my primary care physican whom I have seen for years; I have much respect for him as a man (and as a physician) and I do not believe he would want me tossing a wrench into his medical program. I will update this site should I learn anything new from him or from additional testing, but I truly would rather not put you or anyone in contact with him at this time; I have to face this man monthly and he has seen me thru a recent surgery, sleep apnea, constand bronchitis (not in the last year thankfully) and many other conditions that he treated with such great care and compassion. He has yet to fully diagnose my recent heart problems so at least allow me to give him first dibbs at figuring out what went wrong with the Topamax & Phentermine. Thank you for understanding.

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Posted: 09 June 2008 07:07 PM   [ Ignore ]   [ # 7 ]
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FLNonny,

I understand.

If your doctor would like to speak to some other doctors who have a lot of experience with these drugs, and perhaps can provide some insight, I will be glad to send you their names and phone numbers.

They would be glad to talk to your doctor.

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Posted: 17 June 2008 11:41 AM   [ Ignore ]   [ # 8 ]
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I met with my weight loss/primary care doctor last week for my usual monthly visit. He told me to stay away from the Topamax, but to take 1/2 of the phentermine. That amount caused MANY minor heart palpitations that I did not like (he seemed to think they were “normal” and acceptable).
I received permission to take just 1/4 of the phentermine tablet. Since taking that dosage, I have experienced NO PROBLEMS and my appetite has been curbed enough so that I do not overeat. I am now down a total of 43.5 lbs with 57 lbs left to lose. I am back to walking daily in the Florida heat for over an hour at a time w/o problem. Since I am not experiencing any erratic heart beats, dizziness, nausea, sweating or complete exhaustion, I KNOW that either Topamax or a combination of Topamax with Phentermine caused my heart problems.

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Posted: 18 June 2008 01:35 PM   [ Ignore ]   [ # 9 ]
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FLNonny,

That is good that you figure it out.

I agree with you that it is obvious that the drugs or the dose that caused your heart problems.

You are obviously more sensitive to phentermine than most people.

Some nutritionally-oriented doctors have found that magnesium reduces or eliminates palpitations, not necessarily in people taking phentermine, but just in patients who have palpitations.

——-

I think it is smart than anytime something does not feel right, always look at whatever drugs you are taking first to see if they could be causing the problem.

This includes looking at all drugs you are taking including blood pressure medicine, cholesterol medicine, antidepressant medicine, anti-anxiety medicine, etc.

I think that the side effects of drugs are dramatically under-reported.

A good friend of mine who is a brilliant 76-year-old doctor said he was recently taking a drug and his back was hurting, so he stopped the drug and his back pain went away.

He then talked to his ex-wife and found that she had the exact same experience with the exact same drug.

But when he looked it up, they listed this as a “Rare” side effect of the drug.

He said, “How rare can it be when both me and my ex-wife had the same side effect from this drug? Are we just two of these “Rare” cases? I think not.”

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