I don't know how to feel about this. Not because she's taking weight loss medications, but because she's taking these 2 together. I've done about 4 hours of research and 95% of what I read says NOT to take these 2 meds together. The other 5% is from people who take them together and have had excellent results.

She gets the phentermine from her doctor and the tirzepatide from a compounding pharmacy (they mix it with sterile saline and not b12 or niacinamide). I don't think she's told either provider that she's taking them together, and I can't help feeling like there's a reason she's hiding it.

I'm on here partly to vent because I've shown her the research and expressed my concerns and she isn't listening, but also because I'm wondering if anyone here has combined phentermine with either tirzepatide, Zepbound, or Monjauro, and if so, how did it go?

Edited June 14, 20242 yr by SleeveToBypass2023

I'm answering your question as a nurse who works with both bariatric patients and diabetic patients.

First, these are two completely different meds, two different classes, two different ways of affecting the body.

Phentermine is an anoerectic medication and is an amphetamine that decreases the appetite.

Tirzepatide (generaic name for zepbound) is GLP-1 agonist and GIP agonist (it's a dual agonist vs typical single GLP-1 agonist like Ozempic) which stimulates insulin production with the purpose of lower blood sugar levels and helps someone feel full longer.

Second, there is a nationwide shortage of Zepbound since early April because of it's popularity. Patients have started choosing compound pharmacies to create this formula for them instead of discontinuing or changing to different medication. With that being said, the FDA doe NOT regulate compound pharmacies. Historically, compound pharmacy are popular with patients needing hormone replacement therapy and these pharmacies abilities to customize said medications.

Third, medically speaking, the only medication interaction of concern between the two would be once a patient lost considerable weight, that hypoglycemia would be an issue.

In my own experience, yes medical providers will write scripts for dual medications like this for various reasons, circumstances and medical conditions.

Edited June 14, 20242 yr by ynotiniowa

In some circles it’s commonly know as stacking. Her telehealth doctor who is prescribing the compound tirzepetide may actually know about her being on both meds. It may be for a short period of time. In researching I found minimal contraindications between the two medications. There are a few studies in progress that are researching combination therapies with more in development https://www.sciencedirect.com/science/article/pii/S2667368122000092#sec6

You are a good friend IMHO because you are being supportive while tactfully telling her your concerns and presenting her with research based evidence. That’s more than enough. Now let her chose how to proceed.

Edited June 14, 20242 yr by GreenTealael

6 hours ago, SleeveToBypass2023 said:

, and I can't help feeling like there's a reason she's hiding it.

I'm on here partly to vent because I've shown her the research and expressed my concerns and she isn't listening,

i echo @GreenTealael thoughts about being a good friend by expressing your concerns in a kind, non-judgmental way. The proverbial ball in her court now.

btw, @ynotiniowa, @GreenTealael your knowledge, intelligence and post-writing eloquence is just as satisfying as food porn.

52 minutes ago, GreenTealael said:

Her telehealth doctor who is prescribing the compound tirzepetide may actually know about her being on both meds.

She told me she deliberately didn't tell either one about the other med because she didn't want them to say she can't have both. (I just asked her, to be sure, and she confirmed my suspicions that she didn't tell either one).

What was of most concern that I found was that tirzepatide can lower bp and phentermine can raise it, which kind of plays tug of war with your heart. I also saw that taking both together can increase dizziness, weakness, and bring on severe headaches (she suffers from migraines already).

I showed her all this and she said "well, I only plan to b on the phentermine fo 6 months, but I'm going to stay on the tirzepatide for at least a year, so if I can just make it through the 6 months on both,. I'm golden"

So, I guess as long as she's not worried, and if there's doctors out there that are actually prescribing both, I won't worry too much.

I definitely won't alienate her by going on and on about it. I took my concerns to her, showed her what I found, and now I let it go. She's my bestfriend and I love her (friends for 42 years in September) so I just want what's best for her. She supported my surgery and revision, I can support her in this. I just don't want anything bad to happen to her by taking both of these meds together.

Edited June 14, 20242 yr by SleeveToBypass2023

28 minutes ago, ms.sss said:

i echo @GreenTealael thoughts about being a good friend by expressing your concerns in a kind, non-judgmental way. The proverbial ball in her court now.

btw, @ynotiniowa, @GreenTealael your knowledge, intelligence and post-writing eloquence is just as satisfying as food porn.

As always @ms.sss Thank you for the compliment and turning my focus to food (porn) ?

3 minutes ago, SleeveToBypass2023 said:

She told me she deliberately didn't tell either one about the other med because she didn't want them to say she can't have both. (I just asked her, to be sure, and she confirmed my suspicions that she didn't tell either one).

What was of most concern that I found was that Tirzepatide can lower bp and phentermine can raise it, which kind of plays tug of war with your heart. I also saw that taking both together can increase dizziness, weakness, and bring on severe headaches (she suffers from Migraines already).

I showed her all this and she said "well, I only plan to b on the phentermine fo 6 months, but I'm going to stay on the tirzepatide for at least a year, so if I can just make it through the 6 months on both,. I'm golden"

So, I guess as long as she's not worried, and if there's doctors out there that are actually prescribing both, I won't worry too much.

I definitely won't alienate her by going on and on about it. I took my concerns to her, showed her what I found, and now I let it go. She's my bestfriend and I love her (friends for 42 years in September) so I just want what's best for her. She supported my surgery and revision, I can support her in this. I just don't want anything bad to happen to her by taking both of these meds together.

This is the way

It's really not all that uncommon. They are 2 different meds that work differently . I'm just not sure why she needs both though. Tirzepatide is wonderful all on its own.

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