Weight management, short-term (alternative agent):
Note: Avoid in patients with heart disease, poorly controlled hypertension, pulmonary hypertension, or history of addiction or drug abuse (Perreault 2022). For short-term use (up to 12 weeks) as an adjunct to diet and exercise in patients who cannot take preferred agents and who have a BMI ≥30 kg/m2 or patients with a BMI ≥27 kg/m2 and ≥1 weight-associated comorbidity (eg, dyslipidemia) (AACE/ACE [Garvey 2016]; ES [Apovian 2015]). Some experts use long-term in select patients (ES [Apovian 2015]). Dosing is presented in terms of the salt, phentermine hydrochloride (not as phentermine base). Suprenza has been discontinued in the United States for more than 1 year.
Capsule, tablet (excluding Lomaira): Oral: 15 to 37.5 mg once daily before breakfast or 1 to 2 hours after breakfast; in some cases, may administer 18.75 mg once or twice daily using the tablets.
Tablet (Lomaira only): Oral: 8 mg 3 times daily 30 minutes before meals.
Orally disintegrating tablet: Oral: 15 to 37.5 mg once daily every morning.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Capsule, tablet (excluding Lomaira):
eGFR ≥30 mL/minute/1.73 m2: There are no dosage adjustments provided in the manufacturer's labeling; systemic exposure may be increased; use with caution.
eGFR 15 to 29 mL/minute/1.73 m2: Maximum dose: 15 mg/day.
eGFR <15 mL/minute/1.73 m2: Avoid use (has not been studied).
End-stage renal disease (ESRD) requiring dialysis: Avoid use (has not been studied).
Tablet (Lomaira only): There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); systemic exposure may be increased; use with caution.
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).
Obesity (short-term adjunct): Adolescents >16 years: Refer to adult dosing.
Adolescents >16 years:
Capsule, tablet (excluding Lomaira):
eGFR ≥30 mL/minute/1.73 m2: There are no dosage adjustments provided in the manufacturer's labeling; systemic exposure may be increased; use with caution.
eGFR 15 to 29 mL/minute/1.73 m2: Maximum daily dose: 15 mg/day.
eGFR <15 mL/minute/1.73 m2: Avoid use (has not been studied).
End-stage renal disease (ESRD) requiring dialysis: Avoid use (has not been studied).
Tablet (Lomaira only): There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); systemic exposure may be increased; use with caution.
Adolescents >16 years: There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Capsule, Oral, as hydrochloride:
Adipex-P: 37.5 mg
Generic: 15 mg, 30 mg, 37.5 mg
Tablet, Oral, as hydrochloride:
Adipex-P: 37.5 mg [DSC] [scored; contains brilliant blue fcf (fd&c blue #1), corn starch]
Adipex-P: 37.5 mg [scored; contains corn starch]
Lomaira: 8 mg [scored; contains brilliant blue fcf (fd&c blue #1), corn starch]
Generic: 37.5 mg
Yes
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Capsule, Oral, as hydrochloride:
Generic: 15 mg, 30 mg
Suprenza has been discontinued in the US for more than 1 year.
C-IV
Avoid late evening administration. Most effective when combined with a low-calorie diet and behavior modification counseling.
Capsules, tablets (excluding Lomaira): Administer before breakfast or 1 to 2 hours after breakfast. Tablets may be divided in half and dose may be given in 2 divided doses.
Tablet (Lomaira only): Administer 30 minutes before meals. Tablets are scored and may be divided in half.
Orally disintegrating tablets (ODT): With dry hands, place tablet on the tongue and allow to dissolve, then swallow with or without water. May administer with or without food.
Oral: Avoid late evening administration. Most effective when combined with a low-calorie diet and behavior modification counseling.
Capsules: Administer before breakfast or 1 to 2 hours after breakfast.
Tablets:
8 mg tablets (Lomaira): Administer 30 minutes before meals. Tablets are scored and may be divided in half.
37.5 mg tablets: Administer before breakfast or 1 to 2 hours after breakfast. Tablets may be divided in half and dose may be given in 2 divided doses.
Orally-disintegrating tablets (ODT): Administer in the morning, with or without food. With dry hands, place tablet on the tongue and allow to dissolve, then swallow with or without water.
Weight management, short-term: Short-term (few weeks) in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity with an initial body mass index ≥30 kg/m2 or ≥27 kg/m2 in the presence of other risk factors (eg, diabetes, hyperlipidemia, controlled hypertension). Note: Some experts use long-term in select patients (ES [Apovian 2015]).
Phentermine may be confused with phentolamine, phenytoin
The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs that have a heightened risk of causing significant patient harm when used in error.
Phentermine (alone and in combination) has been associated with CNS effects, including delirium, mania, and psychosis (Ref). Literature has reported insomnia, irritability, and anxiety in 24% to 27% of users (Ref).
Mechanism: Dose-related; related to the pharmacologic action; stimulates release of norepinephrine and dopamine (Ref).
Onset: Varied; typically occurs within 1 week of initiation (Ref) but may occur several months after initiation (Ref).
Risk factors:
• High dose (112.5 to 150 mg/day) (Ref)
• Personal or family history of psychiatric disease (Ref)
Primary pulmonary hypertension (PPH) has been reported in patients receiving a combination of phentermine and fenfluramine or dexfenfluramine (Ref). The possibility of an association between PPH and the use of phentermine alone cannot be ruled out; at least one case has been reported (Ref).
Mechanism: Time-related; related to the pharmacologic action; hypothesized to be due to an increased 5-HT and subsequent vascular remodeling (Ref).
Onset: Delayed. In a case report with phentermine alone, onset of PPH occurred 3 months after the use of phentermine for 5 weeks (Ref).
Risk factors:
• Duration of use >3 months (Ref)
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Frequency not defined:
Cardiovascular: Increased blood pressure, ischemia, palpitations, tachycardia (Yanovski 2014)
Dermatologic: Urticaria
Endocrine & metabolic: Change in libido
Gastrointestinal: Constipation (Yanovski 2014), diarrhea (Yanovski 2014), gastrointestinal distress (Yanovski 2014), unpleasant taste (Yanovski 2014), xerostomia (Yanovski 2014)
Genitourinary: Impotence
Nervous system: Dizziness (Yanovski 2014), dysphoria, euphoria, headache (Yanovski 2014), insomnia (Yanovski 2014), overstimulation, psychosis (Jo 2019), restlessness (Yanovski 2014)
Neuromuscular & skeletal: Tremor (Yanovski 2014)
Postmarketing:
Cardiovascular: Acquired valvular heart disease (in combination with fenfluramine or dexfenfluramine) (Connolly 1997), acute myocardial infarction (Lewis 2019, Prasad 2019), cerebrovascular accident (Lewis 2019), heart failure (in combination) (Connolly 1997), prolonged QT interval on ECG (Hung 2006), supraventricular tachycardia (Kumar 2021), ventricular fibrillation (Tobbia 2012), ventricular tachycardia (polymorphic; in combination) (Hung 2006)
Nervous system: Anxiety (Yanovski 2014), cerebral hemorrhage (McNeil 2018), irritability (Yanovski 2014)
Renal: Acute interstitial nephritis (Shao 2018)
Respiratory: Primary pulmonary hypertension (Bang 2010)
Hypersensitivity or idiosyncrasy to phentermine, other sympathomimetic amines or any component of the formulation; history of cardiovascular disease (eg, arrhythmias, heart failure, coronary artery disease, stroke, uncontrolled hypertension); hyperthyroidism; glaucoma; agitated states; history of drug abuse; use during or within 14 days following MAO inhibitor therapy; pregnancy; breast-feeding
Concerns related to adverse effects:
• CNS effects: CNS stimulants may impair the ability to engage in potentially hazardous activities (eg, operating machinery or driving).
• Heart failure: In a scientific statement from the American Heart Association, phentermine has been determined to be an agent that may cause direct myocardial toxicity (magnitude: major) (AHA [Page 2016]).
• Primary pulmonary hypertension (PPH): A rare, frequently fatal disease of the lungs, PPH has been reported to occur in patients receiving a combination of phentermine and fenfluramine or dexfenfluramine. The possibility of an association between PPH and the use of phentermine alone cannot be ruled out; rare cases of PPH have been reported in patients taking phentermine alone. Discontinue in patients experiencing new-onset dyspnea, chest pain, syncope, or lower extremity edema.
• Valvular heart disease: Serious regurgitant cardiac valvular disease (primarily affecting the mitral, aortic, and/or tricuspid valves) has been reported to occur in patients receiving a combination of phentermine and fenfluramine or dexfenfluramine. The possibility of an association between valvular heart disease and the use of phentermine alone cannot be ruled out; rare cases of valvular heart disease have been reported in patients taking phentermine alone.
Disease-related concerns:
• Cardiovascular disease: Avoid stimulants in patients with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems that could increase the risk of sudden death that these conditions alone carry. Use with caution in patients with mild hypertension and other cardiovascular conditions that might be exacerbated by increases in blood pressure or heart rate.
• Diabetes: Use with caution in patients with diabetes mellitus; antidiabetic agent requirements (eg, insulin or oral hypoglycemic agents) may be decreased with anorexigens and concomitant dietary restrictions.
• Renal impairment: Use caution in patients with renal impairment; an increase in exposure is expected. Avoid use in patients with eGFR <15 mL/minute/1.73 m2, including end-stage renal disease (ESRD) requiring dialysis (has not been studied).
• Seizure disorders: Avoid or use with caution in patients with history of seizures (Apovian 2015).
• Tourette syndrome: Use with caution in patients with Tourette syndrome; stimulants may unmask tics.
Special populations:
• Elderly: Use caution in this age group due to the risk for causing dependence, hypertension, angina, and myocardial infarction.
Dosage form specific issues:
• Tartrazine: Some products may contain tartrazine Some products may contain tartrazine (FDC yellow #5), which may cause allergic reactions in patients with sensitivity (caution in patients with asthma or aspirin hypersensitivity).
Other warnings/precautions:
• Abuse potential: Phentermine is pharmacologically related to the amphetamines, which have a high abuse potential; prolonged use may lead to dependency. Prescriptions should be written for the smallest quantity consistent with good patient care to minimize possibility of overdose.
• Appropriate use: Phentermine is not approved for long-term use. Clinicians should carefully examine the potentially benefits against potential risks associated with use of medications in this class. Consult weight loss guidelines for current pharmacotherapy recommendations. Therapy should be used in conjunction with a comprehensive weight management program.
• Tolerance: Tolerance to the anorectic effect usually develops within a few weeks; discontinue use when tolerance develops, do not exceed recommended dosage in an attempt to overcome tolerance.
Substrate of CYP3A4 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential
Acebrophylline: May enhance the stimulatory effect of CNS Stimulants. Risk X: Avoid combination
Alcohol (Ethyl): May enhance the adverse/toxic effect of Phentermine. Risk C: Monitor therapy
Alkalinizing Agents: May decrease the excretion of Amphetamines. Management: Consider alternatives to using amphetamines and alkalinizing agents in combination. If these agents must be used together, patients should be monitored closely for excessive amphetamine effects. Risk D: Consider therapy modification
Amifampridine: Agents With Seizure Threshold Lowering Potential may enhance the neuroexcitatory and/or seizure-potentiating effect of Amifampridine. Risk C: Monitor therapy
Ammonium Chloride: May decrease the serum concentration of Amphetamines. This effect is likely due to an enhanced excretion of amphetamines in the urine. Risk C: Monitor therapy
Antacids: May decrease the excretion of Amphetamines. Risk C: Monitor therapy
Antihistamines: Amphetamines may diminish the sedative effect of Antihistamines. Risk C: Monitor therapy
Antihypertensive Agents: Amphetamines may diminish the antihypertensive effect of Antihypertensive Agents. Risk C: Monitor therapy
Antipsychotic Agents: May diminish the stimulatory effect of Amphetamines. Risk C: Monitor therapy
Ascorbic Acid: May decrease the serum concentration of Amphetamines. Risk C: Monitor therapy
Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
BuPROPion: May enhance the neuroexcitatory and/or seizure-potentiating effect of Agents With Seizure Threshold Lowering Potential. Risk C: Monitor therapy
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Carbonic Anhydrase Inhibitors: May decrease the excretion of Amphetamines. Risk C: Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider therapy modification
CYP2D6 Inhibitors (Moderate): May increase the serum concentration of Amphetamines. Management: Monitor for amphetamine toxicities (including serotonin syndrome) if used with a moderate CYP2D6 inhibitor. Initiate amphetamine therapy at lower doses, monitor frequently, and adjust doses as needed. Discontinue amphetamines if serotoinin syndrome occurs Risk C: Monitor therapy
CYP2D6 Inhibitors (Strong): May increase the serum concentration of Amphetamines. Management: Monitor for amphetamine toxicities (including serotonin syndrome) if used with a strong CYP2D6 inhibitor. Initiate amphetamine therapy at lower doses, monitor frequently, and adjust doses as needed. Discontinue amphetamines if serotoinin syndrome occurs. Risk C: Monitor therapy
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Risk C: Monitor therapy
Esketamine: May enhance the hypertensive effect of CNS Stimulants. Risk C: Monitor therapy
Ethosuximide: Amphetamines may diminish the therapeutic effect of Ethosuximide. Amphetamines may decrease the serum concentration of Ethosuximide. Risk C: Monitor therapy
Gastrointestinal Acidifying Agents: May decrease the serum concentration of Amphetamines. Risk C: Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy
Iobenguane Radiopharmaceutical Products: Amphetamines may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Risk X: Avoid combination
Iobenguane Radiopharmaceutical Products: CNS Stimulants may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Risk X: Avoid combination
Ioflupane I 123: Amphetamines may diminish the diagnostic effect of Ioflupane I 123. Risk C: Monitor therapy
Iohexol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iohexol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iohexol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic antiseizure drugs. Risk D: Consider therapy modification
Iomeprol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iomeprol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iomeprol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic antiseizure drugs. Risk D: Consider therapy modification
Iopamidol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iopamidol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic antiseizure drugs. Risk D: Consider therapy modification
Kratom: May enhance the adverse/toxic effect of Sympathomimetics. Risk X: Avoid combination
Methenamine: May decrease the serum concentration of Amphetamines. This effect is likely due to an enhanced excretion of amphetamines in the urine. Risk C: Monitor therapy
Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Amphetamines. While linezolid and tedizolid may interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to monographs specific to those agents for details. Risk X: Avoid combination
Multivitamins/Fluoride (with ADE): May decrease the serum concentration of Amphetamines. More specifically, the ascorbic acid (vitamin C) in many multivitamins may decrease amphetamine concentrations. Risk C: Monitor therapy
Multivitamins/Minerals (with ADEK, Folate, Iron): May decrease the serum concentration of Amphetamines. Risk C: Monitor therapy
Multivitamins/Minerals (with AE, No Iron): May decrease the serum concentration of Amphetamines. Specifically, vitamin C may impair absorption of amphetamines. Risk C: Monitor therapy
Opioid Agonists: Amphetamines may enhance the analgesic effect of Opioid Agonists. Risk C: Monitor therapy
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy
PHENobarbital: Amphetamines may decrease the serum concentration of PHENobarbital. Risk C: Monitor therapy
Phenytoin: Amphetamines may decrease the serum concentration of Phenytoin. Risk C: Monitor therapy
Quinolones: Amphetamines may enhance the cardiotoxic effect of Quinolones. Risk C: Monitor therapy
Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors): Amphetamines may enhance the serotonergic effect of Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors). This could result in serotonin syndrome. Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors) may increase the serum concentration of Amphetamines. Management: Monitor for amphetamine toxicities, including serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability). Initiate amphetamines at lower doses, monitor frequently, and adjust dose as needed. Risk C: Monitor therapy
Serotonergic Agents (High Risk): Amphetamines may enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability). Initiate amphetamines at lower doses, monitor frequently, and adjust doses as needed. Risk C: Monitor therapy
Sibutramine: May enhance the adverse/toxic effect of Centrally Acting Weight Loss Agents. Risk X: Avoid combination
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Risk C: Monitor therapy
Solriamfetol: CNS Stimulants may enhance the hypertensive effect of Solriamfetol. CNS Stimulants may enhance the tachycardic effect of Solriamfetol. Risk C: Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Tricyclic Antidepressants: May enhance the adverse/toxic effect of Amphetamines. Tricyclic Antidepressants may potentiate the cardiovascular effects of Amphetamines. Amphetamines may enhance the serotonergic effect of Tricyclic Antidepressants. This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) and increased cardiovascular effects when these agents are combined. Risk C: Monitor therapy
Urinary Acidifying Agents: May decrease the serum concentration of Amphetamines. Risk C: Monitor therapy
Phentermine was evaluated in patients with infertility and overweight/obesity. Patients in the single center retrospective study (n=55) used contraception during therapy and were instructed to stop phentermine 1 month prior to trying to conceive. Although patients treated with phentermine had significant weight loss, pregnancy and live birth rates were not increased between patients who lost <5% or >5% of their initial body weight (Chang 2020).
Obesity increases the risk of infertility. Optimal weight control prior to conception improves pregnancy outcomes. However, medications for weight loss are not recommended prior to pregnancy due to safety issues and adverse events. Weight loss medications should be discontinued prior to conception (ACOG 2021; Wharton 2020).
Information related to the use of phentermine during pregnancy is limited (D'Adesky 2019; Jones 2002; McElhatton 2006).
An increased risk of adverse maternal and fetal events is associated with obesity. However, moderate gestational weight gain based on pre-pregnancy BMI is required for positive fetal outcomes in all pregnancies, including patients with overweight or obesity. Therefore, medications for weight loss therapy are not recommended during pregnancy (ACOG 2021; Wharton 2020). Use of phentermine is contraindicated during pregnancy (lack of potential benefit and possible fetal harm).
It is not known if phentermine is present in breast milk; however, other amphetamines have been detected in breast milk.
Due to safety concerns, medications for weight loss therapy are not recommended for patients who are breastfeeding (Wharton 2020). Use of phentermine is contraindicated in breastfeeding patients.
Capsules, tablets (excluding Lomaira): Should be taken before breakfast or 1 to 2 hours after breakfast.
Tablet (Lomaira only): Should be taken 30 minutes before meals.
Weight and waist circumference every month for the first 3 months, then at 3-month intervals (Apovian 2015); blood pressure
Adult classification of weight by BMI (kg/m2):
Underweight: <18.5
Normal: 18.5 to 24.9
Overweight: 25 to 29.9
Obesity, class I: 30 to 34.9
Obesity, class II: 35 to 39.9
Obesity, class III: ≥40
Waist circumference: In adults with a BMI of 25 to 34.9 kg/m2, high-risk waist circumference is defined as:
Males >102 cm (>40 in).
Females >88 cm (>35 in).
Phentermine is a sympathomimetic amine with pharmacologic properties similar to the amphetamines. The mechanism of action in reducing appetite appears to be secondary to CNS effects, including stimulation of the hypothalamus to release norepinephrine.
Absorption: Well absorbed. Rate and extent of exposure of orally disintegrating tablets (ODT) are equivalent to capsules and tablets administered under fasting conditions. Administration of the ODT after a high-fat/high-calorie breakfast decreased Cmax by ~5% and AUC by ~12%.
Distribution: Vd: 348 L
Protein binding: 17.5%
Metabolism: Hepatic via p-hydroxylation (aromatic ring) and N-oxidation (aliphatic side chain); primarily metabolized by CYP3A4 (but does not show extensive metabolism).
Half-life elimination: ~20 hours
Time to peak: 3-4.4 hours
Excretion: Primarily urine (62%-85% as unchanged drug)
Renal function impairment: Exposure increases can be expected in patients with renal impairment.
Capsules (Adipex-P Oral)
37.5 mg (per each): $2.78
Capsules (Phentermine HCl Oral)
15 mg (per each): $0.34 - $1.57
30 mg (per each): $0.48 - $1.65
37.5 mg (per each): $0.33 - $1.57
Tablets (Adipex-P Oral)
37.5 mg (per each): $2.11
Tablets (Lomaira Oral)
8 mg (per each): $0.64
Tablets (Phentermine HCl Oral)
37.5 mg (per each): $0.18 - $1.54
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