Drug General Information (ID: DDI3DLM21B)
Drug Name			Phentermine		Drug Info		Picosulfuric acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Appetite Depressants				Vitamins
Structure

Mechanism of Phentermine-Picosulfuric acid Interaction (Severity Level: Moderate)
Increased risk of lowers seizure threshold Click to Show/Hide Mechanism Graph
Drug Name		Phentermine				Picosulfuric acid
Mechanism		Lower seizure threshold				Lower seizure threshold
Key Mechanism Factor 1
		Factor Name		Lowers seizure threshold
		Factor Description		The combination of medications that lower the seizure threshold is a factor that makes people with epilepsy more likely to have seizures. A seizure is a sudden, uncontrolled electrical disturbance in the brain that can cause changes in your behavior, movements or sensations, and level of consciousness.
Mechanism Description		Increased risk of lowers seizure threshold by the combination of Phentermine and Picosulfuric acid

Recommended Action
Management		Caution is advised when bowel cleansing preparations are prescribed in patients treated with agents that can lower the seizure threshold. Bowel cleansing preparations should not be used if these patients have impaired renal function or perfusion, dehydration, or uncorrected electrolyte abnormalities. Baseline and postprocedure labs including serum electrolytes, calcium, phosphate, BUN, and creatinine should be considered, particularly in the elderly. Patients should be advised not to exceed the recommended dosage of their bowel cleansing preparation and to drink sufficient quantities of clear fluids before, during, and after the bowel preparation process. Administration of an electrolyte rehydration solution may help attenuate the electrolyte abnormalities and hypovolemia.

References
1	Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates). Braintree Laboratories, Braintree, MA.
2	Salik JM, Kurtin P "Severe hyponatremia after colonoscopy preparation in a patient with the acquired immune deficiency syndrome." Am J Gastroenterol 80 (1985): 177-9. [PMID: 2983533]
3	Cerner Multum, Inc. "UK Summary of Product Characteristics.".