What is a major contraindication to initiating phentermine/topiramate therapy?

What is a major contraindication to initiating phentermine/topiramate therapy?

• A. Hypertension
• B. History of kidney stones
• C. Pregnancy or plans for pregnancy
• D. Mild obesity without comorbidity

Answer: (C)

The major contraindication is pregnancy or plans for pregnancy because this medication combines phentermine with topiramate, and topiramate has clear teratogenic risk. Using it during pregnancy can cause fetal harm, including birth defects such as cleft lip/palate, so it must be avoided in anyone who is or is planning to become pregnant. Women of childbearing potential should use reliable contraception and discontinue the drug if pregnancy occurs. Hypertension needs careful monitoring because the stimulant component can raise blood pressure and heart rate, so uncontrolled or significant hypertension is a safety concern, but it’s not an absolute reason to avoid starting the therapy in a person who has controlled blood pressure. A history of kidney stones suggests a potential risk with topiramate, which can increase stone formation, so it warrants caution, but it’s not an outright contraindication. Mild obesity without other health issues isn’t a contraindication.

The major contraindication is pregnancy or plans for pregnancy because this medication combines phentermine with topiramate, and topiramate has clear teratogenic risk. Using it during pregnancy can cause fetal harm, including birth defects such as cleft lip/palate, so it must be avoided in anyone who is or is planning to become pregnant. Women of childbearing potential should use reliable contraception and discontinue the drug if pregnancy occurs.

Hypertension needs careful monitoring because the stimulant component can raise blood pressure and heart rate, so uncontrolled or significant hypertension is a safety concern, but it’s not an absolute reason to avoid starting the therapy in a person who has controlled blood pressure. A history of kidney stones suggests a potential risk with topiramate, which can increase stone formation, so it warrants caution, but it’s not an outright contraindication. Mild obesity without other health issues isn’t a contraindication.