Phentramin™ is designed to:

• Suppress appetite
• Help regulate blood sugar levels
• Stimulate metabolism
• Help suppress stress hormones
• Enhance Thyroid Function
• Increase energy levels

What is the difference between Phentramin™ and Phentermine

Phentermine Hydrochloride (HCL) is a prescription medication used for weight control. It is in the sympathomimetic family of appetite suppressants used for the short term management of obesity. Phentermine is similar chemically to amphetamines.

Phentramin is a non-prescription product used for weight control. The ingredients are considered to be ‘all natural’. Phentramin is designed to produce weight control effects similar to the best selling prescription medications. While the formula has proven to be very effective for many people, Phentramin is not considered as ‘strong’ as Phentermine in terms of effect on the central nervous system.

Powerful ingredients - Advanced Formula

Though Phentramin is designed to produce effects similar to the most popular prescription weight loss medications, Phentramin is formulated from all natural, non-prescription ingredients. The active ingredients in Phentramin are:

Phentermine is used for:

Reducing weight in obese patients when used short-term and combined with exercise, diet, and behavioral modification.

Phentermine is an appetite suppressant. It works by helping to release certain chemicals in the brain that control appetite.

Do NOT use Phentermine if:

• you are allergic to any ingredient in Phentermine or other sympathomimetics (eg, pseudoephedrine)
• you are taking dexfenfluramine, fenfluramine, furazolidone, guanadrel, guanethidine, or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) in the last 14 days
• you have moderate to severe high blood pressure, an overactive thyroid, glaucoma, heart or blood vessel disease, or severe narrowing of the blood vessels
• you are in an agitated state, or have a history of substance abuse

Contact your doctor or health care provider right away if any of these apply to you.

Before using Phentermine :

Some medical conditions may interact with Phentermine . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a brain or spinal cord disorder, hardening of the arteries, high blood pressure, diabetes, or high cholesterol or lipid levels

Some MEDICINES MAY INTERACT with Phentermine . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Dexfenfluramine, fenfluramine, furazolidone, or MAOIs (eg, phenelzine) because the risk of serious side effects, such as increasing headache, high blood pressure, slow heart rate, elevated temperature, or possibly fatal lung problems, may be increased
• Serotonin specific reuptake inhibitors (eg, fluoxetine) because the risk of their side effects may be increased by Phentermine
• Guanadrel or guanethidine because their effectiveness may be decreased by Phentermine

Ask your health care provider if Phentermine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Phentermine :

Use Phentermine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Phentermine about 30 minutes before a meal.
• Take your last dose of Phentermine at least 4 to 6 hours before bedtime.
• If you are taking Phentermine 1 time a day, take your dose in the morning.
• If you miss a dose of Phentermine , take it as soon as possible. If it is after 12 pm and you are taking Phentermine 1 time a day, or after 4 pm and you are taking it more than 1 time a day, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Phentermine .

Important safety information:

• Phentermine may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Phentermine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Doing so may increase the risk of serious side effects.
• Tell your doctor or dentist that you take Phentermine before you receive any medical or dental care, emergency care, or surgery.
• Before you have any medical or dental treatments, emergency care, or surgery, tell your doctor or dentist that you are using Phentermine .
• Avoid drinking alcohol with Phentermine .
• Diabetes patients-Phentermine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Phentermine is not recommended for use in CHILDREN younger than 12 years old; safety and effectiveness in this age group have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Phentermine while you are pregnant. It is not known if Phentermine is found in breast milk. Do not breast-feed while taking Phentermine .

After you have taken Phentermine for a few weeks, it will usually not work as well as when you began taking it. This is known at TOLERANCE. Talk with your doctor if Phentermine stops working well. Do not take more medicine than prescribed.

Some people who use Phentermine for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. If you stop taking Phentermine suddenly, you may have WITHDRAWAL symptoms. These may include extreme tiredness, mental depression, trouble sleeping, irritability, or mental, mood, or personality changes.

Possible side effects of Phentermine :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Bad taste in mouth; changes in sex drive; constipation; diarrhea; difficulty sleeping; dizziness; dry mouth; exaggerated sense of well being; headache; impotence; nervousness; overstimulation; restlessness; sleeplessness; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; chest pain; fainting; fast heartbeat; pounding in the chest; shortness of breath; swelling of the legs and feet; tremor.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include confusion; diarrhea; nausea; rapid breathing; restlessness; stomach cramps; tremor; vomiting.

Proper storage of Phentermine :

Store Phentermine at room temperature, between 59 and 77 degrees F (15 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Phentermine out of the reach of children and away from pets.

General information:

• If you have any questions about Phentermine , please talk with your doctor, pharmacist, or other health care provider.
• Phentermine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Phentermine . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Meridia is used for:

Treating obesity. It should be used with a reduced calorie diet.

Meridia is a diet aid. It appears to work by regulating chemicals in the appetite center in the brain to cause a temporary reduction in hunger or craving for food.

Do NOT use Meridia if:

• you are allergic to any ingredient in Meridia
• you have an eating disorder (eg, anorexia, bulimia), uncontrolled or severe high blood pressure, hardening of the arteries, increased blood pressure in the lungs, or have had a stroke
• you have severe liver or kidney problems or you are on dialysis for severe kidney problems
• you are taking a selective serotonin reuptake inhibitor (SSRI) (eg, fluoxetine), another appetite suppressant, or you have taken a monoamine oxidase inhibitor (MAO) inhibitor (eg, phenelzine) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Meridia :

Some medical conditions may interact with Meridia . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have kidney or liver disease, heart disease, increased risk for bleeding, narrow-angle glaucoma, or seizures

Some MEDICINES MAY INTERACT with Meridia . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Dihydroergotamine, imidazoles (eg, itraconazole, ketoconazole), lithium, MAO inhibitors (eg, phenelzine), narcotic analgesics (eg, codeine), SSRIs (eg, fluoxetine), sumatriptan, or tryptophan they may increase the risk of Meridia ’s side effects, including increased risk of restlessness, fever, excessive sweating, twitching, and seizures that can, rarely, be life-threatening
• Cyclosporine because the risk of its side effects may be increased by Meridia

This may not be a complete list of all interactions that may occur. Ask your health care provider if Meridia may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Meridia :

Use Meridia as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Meridia . Talk to your pharmacist if you have questions about this information.
• Take Meridia by mouth with or without food.
• Unless otherwise directed by your doctor, Meridia should be taken in the morning to avoid sleeping problems.
• If you miss a dose of Meridia , skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Meridia .

Important safety information:

• Meridia may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Meridia with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Meridia ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Changes in dietary habits and increased exercise are important parts of a successful weight loss program. To maintain your ideal weight, these changes should be continued for life. Follow the guidelines given to you by your doctor or diet counselor.
• Lab tests, including blood pressure, pulse monitoring, and weight monitoring, may be performed while you use Meridia . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use an effective method of birth control while you are taking Meridia .
• Meridia should not be used in CHILDREN or ADOLESCENTS; safety and effectiveness in children and adolescents have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Meridia while pregnant. It is not known if Meridia is found in breast milk. Do not breast-feed while taking Meridia .

When used for long periods of time or at high doses, some people develop a need to continue taking Meridia . This is known as DEPENDENCE or addiction.

Possible side effects of Meridia :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; constipation; dizziness; dry mouth; flu-like symptoms; headache; increased cough; increased or decreased appetite; indigestion; joint pain; migraine; nasal inflammation; nausea; nervousness; painful menstruation; sinus inflammation; sleeplessness; sore throat; upset stomach; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; anxiety; change in amount of urine; chest pain; clumsiness; confusion; depression; difficulty breathing; disorientation; excitement; eye pain; fainting; fast or irregular heartbeat; high fever; increased sweating; large, unchanging pupils; loss of consciousness; one-sided weakness; restlessness; seizures; shivering; shortness of breath; stomach pain; swelling of the feet, ankles, or legs; tremors; unusual bruising or bleeding; vision problems; vomiting; weakness.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately.

Proper storage of Meridia :

Store Meridia at room temperature, at 77 degrees F (25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Meridia out of the reach of children and away from pets.

General information:

• If you have any questions about Meridia , please talk with your doctor, pharmacist, or other health care provider.
• Meridia is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Meridia . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Ionamin is used for:

Reducing weight in obese patients when used short-term and combined with exercise, diet, and behavioral modification.

Ionamin is an appetite suppressant. It works by helping to release certain chemicals in the brain that control appetite.

Do NOT use Ionamin if:

• you are allergic to any ingredient in Ionamin or other sympathomimetics (eg, pseudoephedrine)
• you are taking dexfenfluramine, fenfluramine, furazolidone, guanadrel, guanethidine, or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) in the last 14 days
• you have moderate to severe or uncontrolled high blood pressure, an overactive thyroid, glaucoma, heart or blood vessel disease, or severe narrowing of the blood vessels
• you have high blood pressure in the lungs
• you are in an agitated state, or have a history of substance abuse

Contact your doctor or health care provider right away if any of these apply to you.

Before using Ionamin :

Some medical conditions may interact with Ionamin . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a brain or spinal cord disorder, hardening of the arteries, high blood pressure, diabetes, or high cholesterol or lipid levels

Some MEDICINES MAY INTERACT with Ionamin . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Dexfenfluramine, fenfluramine, furazolidone, or MAOIs (eg, phenelzine) because the risk of serious side effects, such as increasing headache, high blood pressure, slow heart rate, elevated temperature, or possibly fatal lung problems, may be increased
• Serotonin specific reuptake inhibitors (eg, fluoxetine) because the risk of their side effects may be increased by Ionamin
• Guanadrel or guanethidine because their effectiveness may be decreased by Ionamin

Ask your health care provider if Ionamin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Ionamin :

Use Ionamin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Ionamin by mouth before breakfast or 10 to 14 hours before bedtime unless directed otherwise by your doctor.
• Swallow Ionamin whole. Do not break, crush, or chew before swallowing.
• If you miss a dose of Ionamin , take it as soon as possible. If it is after 12 pm, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Ionamin .

Important safety information:

• Ionamin may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Ionamin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor. Doing so may increase the risk of serious side effects.
• Tell your doctor immediately if you are not able to exercise as well as you could before you started taking Ionamin .
• Before you have any medical or dental treatments, emergency care, or surgery, tell your doctor or dentist that you are using Ionamin .
• Avoid drinking alcohol with Ionamin .
• Diabetes patients-Ionamin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Use Ionamin with caution in the ELDERLY; they may be more sensitive to its effects.
• Ionamin is not recommended for use in CHILDREN younger than 16 years old; safety and effectiveness in this age group have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Ionamin while you are pregnant. It is not known if Ionamin is found in breast milk. Do not breast-feed while taking Ionamin .

After you have taken Ionamin for a few weeks, it will usually not work as well as when you began taking it. This is known at TOLERANCE. Talk with your doctor if Ionamin stops working well. Do not take more medicine than prescribed.

Some people who use Ionamin for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. If you stop taking Ionamin suddenly, you may have WITHDRAWAL symptoms. These may include extreme tiredness, mental depression, trouble sleeping, irritability, or mental, mood, or personality changes.

Possible side effects of Ionamin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Bad taste in mouth; constipation; diarrhea; difficulty sleeping; dizziness; dry mouth; exaggerated sense of well being; headache; nervousness; overstimulation; restlessness; sleeplessness; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; changes in sex drive; chest pain; decreased sexual ability; fainting; fast or irregular heartbeat; mental or mood changes; pounding in the chest; shortness of breath; swelling of the legs and feet; tremor.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include aggressive behavior; confusion; depression; exaggerated reflexes; hallucinations; irregular heartbeat; nausea; panic; rapid breathing; severe or persistent dizziness, diarrhea, or restlessness; severe tiredness; stomach cramps; tremor; vomiting.

Proper storage of Ionamin :

Store Ionamin at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ionamin out of the reach of children and away from pets.

General information:

• If you have any questions about Ionamin , please talk with your doctor, pharmacist, or other health care provider.
• Ionamin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Ionamin . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Uses of Hoodia

Hoodia products have been marketed worldwide for weight loss; however, there appears to be little quality control or protection of the endangered source plant.

Hoodia Dosing

There is no published research to support dosages of the herb.

Contraindications

No information is available.

Pregnancy/Lactation

There are no known concerns with pregnancy and lactation.

Hoodia Interactions

None well documented.

Hoodia Adverse Reactions

No adverse reactions have been reported.

Toxicology

No toxicology data is available.

Botany

H. gordonii is a rare, succulent plant found in the Kalahari Desert of southern Africa. The leafless, swollen, spiny stem is similar to that of a columnar cactus, and is topped by showy, saucer-shaped flowers. The flowers emit a carrion-like odor that attracts pollinating insects. It is considered an endangered species because of the high potential for over-exploitation and is listed in Appendix II of Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Commercial plantations have been established in South Africa to provide for anticipated demand for the plant, although the slow growth of the plant may make commercial cultivation difficult. 1 Hoodia was formerly in the Asclepiadaceae (milkweed) family, but it has recently been subsumed into the Apocynaceae (dogbane) family. 2 Other species in the genera Hoodia and Trichocaulon have been claimed to have similar biological activity to H. gordonii . 3

History

Hoodia was not well known to the Western world until recently. Ethnobotanical reports date back to 1796; however, Hoodia received little attention until a South African scientific project evaluated its appetite suppressant effects in 1963. 4 Modern techniques of structure analysis revealed the bioactive molecule P57 in the 1980s. As a result, a patent was filed by the Council for Scientific and Industrial Research (CSIR) in 1995 in South Africa. 3 At the same time, a licensing agreement was signed between CSIR and the company. A sublicense was granted to Pfizer for further clinical development of P57, which Pfizer relinquished in 2003. In 2003, CSIR responded to criticism of its appropriation of San (southern Africa’s oldest human inhabitants) indigenous knowledge by signing a memorandum of understanding with the South African San Council. That provided for benefit sharing of Hoodia royalties. 4 In the meantime, a thriving, apparently illicit, worldwide market has emerged that offers Hoodia herbal products as dietary supplements.

Chemistry

The active appetite suppressant principle of H. gordonii is P57, a pregnane steroid glycoside with 3 saccharides and a tiglate ester. 3 The details of structure elucidation have not been published outside of the patent literature; however, a recent meeting presentation reported isolation of 13 oxypregnanes from H. gordonii . 5 Other presentations at this meeting disclosed methods for thin layer chromatographic analysis of Hoodia , 6 polymerase chain reaction identification methods, 7 and microscopic identification. 8 A high-performance liquid chromatography mass spectrometry method for analysis of P57 has also been reported. 9

Hoodia Uses and Pharmacology

There is a single published report concerning the pharmacology of Hoodia and P57. Intracerebroventricular injection of P57 into male rats reduced food intake 50% to 60% over a 24-hour period. Similar experiments with the aglycone or a second analog had no effect, nor did intraperitoneal injections of P57. P57 was inactive against Na/K adenosine triphosphatase (ATPase), despite having a structure with some similarity to the cardiac glycosides found in the same plant family. 10 Investigators detected an increase in hypothalamic adenosine triphosphate (ATP) content for rats on a normal diet when P57 was administered intracerebroventricularly. Hypothalamic ATP levels dropped in untreated rats fed a hypocaloric diet; P57 reversed this reduction. 10 Thus, it appears that P57 may operate through normalization of hypothalamic ATP levels to produce anorexia.

The patent makes reference to an agonistic effect of P57 on the melanocortin-4 receptor 3 ; melanocortin-4 (MCR-4) agonists have been considered as potential treatment for obesity by the pharmaceutical industry. 11 However, the complex pharmacology of the melanocortin receptor family has made manipulation of this system difficult. The patent claims that MCR-4 receptor agonism regulates neuropeptide Y and increases cholcystikinin have not been reported in peer-reviewed journals. 3

In addition, patents claim Hoodia products are useful in control of gastric acid secretion 12 and treatment of diabetes. 13

Dosage

Poorly documented clinical trials are reported to have proof of concept for weight loss, 4 but scientific basis is lacking. There is no published research to support dosages of the herb.

Pregnancy/Lactation

There are no known concerns with pregnancy and lactation.

Interactions

None well documented.

Adverse Reactions

No adverse reactions have been reported.

Toxicology

There is no documentation for the safety of Hoodia , although its demonstrated inactivity against Na/K ATPase mitigates concerns about the potential for cardiotoxicity.