Contraindications: Phentermine 37.5mg is absolutely contraindicated in individuals with coronary artery disease, uncontrolled hypertension (systolic ≥180 mmHg), cardiac arrhythmia, heart failure, history of stroke or TIA, hyperthyroidism, glaucoma, or a history of drug abuse. Concurrent use with MAO inhibitors — or within 14 days of MAOI discontinuation — carries risk of hypertensive crisis and is strictly prohibited. Pregnancy and breastfeeding are categorical contraindications.
Side Effects: Cardiovascular side effects are the primary concern: tachycardia, palpitations, hypertension, and in rare cases, primary pulmonary arterial hypertension. Non-cardiac effects include dry mouth, insomnia, restlessness, constipation, and transient headache. CNS stimulation-related anxiety and irritability are dose-dependent and more pronounced in users with pre-existing anxiety disorders. Tolerance to the stimulant effect typically develops within 4–6 weeks.
Monitoring: Biweekly blood pressure and resting heart rate measurement is the minimum monitoring standard. A 12-lead ECG before initiation is recommended for any user over 40 or with a family history of cardiac disease. Liver and renal function baseline panels are advisable for cycles exceeding 8 weeks. Any chest pain, dyspnoea, or syncope during use requires immediate cessation and medical evaluation.
PCT: Phentermine does not suppress the hypothalamic-pituitary-gonadal axis and therefore does not require conventional anabolic PCT. However, a two-week stimulant-free period after completing the 30-tablet course allows cardiovascular parameters (HR, BP) to return to pre-treatment baseline before reassessment. Users combining phentermine with anabolic compounds should manage PCT for the anabolic component separately and consult a clinician regarding cumulative cardiovascular burden.