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It is involved in presynaptic inhibition of the excitatory neurotransmitters, acetylcholine release and substance P, which decreases smooth muscle peristalsis and contractility

Retrieved from Azuri, J., Hammerman, A., Aboalhasan, E., et al

15 mg/92 mg (phentermine 15 mg and topiramate USP, 92 mg) (equivalent to 18.66 mg of Phentermine Hydrochloride, USP)

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Utilize refrigerator thermometers to ensure that the temperature remains within the specified range

Key adjustments at this phase: Reduce portion sizes by 20% to 30% across all meals Add a sixth small meal if you cannot finish larger ones Move heavy carbohydrates to earlier in the day when digestion is strongest Switch to softer, easier-to-digest proteins (fish, eggs, Greek yogurt) on dose increase days Keep hydration consistent at 8 to 10 glasses per day, sipped throughout rather than gulped at meals Phase 3: therapeutic doses (10mg, 12.5mg, 15mg, weeks 13+) At higher doses, some people find eating enough to be the challenge, not eating too little