CYCLE PROTOCOL
What week does Cycle A begin with a physician consult?
WEEK 1
What defines a 'restart' patient?
4 weeks off medication or longer FOR CS/5 WEEKS FOR GLPS
What is the minimum BMI to start Phentermine?
25
What is the most common standard starting dose of Phentermine?
37.5MG DAILY
Patient states they're concerned with the amount of medication they have to draw up now; what is your response? (GLP meds ONLY)
The concentration of the medication can vary based on the compounding pharmacy type. So, the units you administer may be different, but your dose remains the same.
How long is each medication cycle?
12 WEEKS
FOR GLP PATIENTS WHO MISS MORE THAN 14 DAYS SINCE LAST INJECTION, WHAT IS RECOMMENDED/REQUIRED?
APPROVED TO STAY AT CURRENT DOSE; RECOMMENDED TO DROP 1 DOSE
What BMI triggers stopping or weaning down on Phentermine?
23.8 begins wean down; cutoff is 23.5
What dose is most often used during wean-down?
15MG phentermine or Phendimetrazine
Patient states that their medication is "not working" what would your response be? (GLP medication ONLY)
EDUCATE!
Typically, when you feel as if the medication isn't working a few things can happen; therapeutic dose hasn't been met, over/under eating or patient may not be aware of weight loss so far, remember 1lb per week is GREAT!
When is the 4-week break required?
After Cycle B ends or 24 weeks total
WHAT IS REQUIRED FOR AN OVER 3 MONTH RESTART VISIT?
SEE DOCTOR, CYCLE STARTS OVER
What age range is eligible for controlled meds?
16 TO 65
What is the alternate med for ADR or no success with Phen?
Phendimetrazine
What's the main difference between SG and TZ?
SG is a GLP-1 and TZ is a GLP-1 and GIP; tz typically yeilds faster results with more weightloss and commonly known less SE
When does the wean-down phase typically occur?
Weeks 11 & 12 of Cycle B
What is required for restarts after 12+ months?
Treated as new patient with new intake
What conditions disqualify a patient?
Substance abuse, glaucoma, uncontrolled BP
What meds require a 4-week washout?
Adderall, Ritalin, Vyvanse
What needs to be confirmed when dispensing controlled substances?
DATE OF BIRTH
WHAT IS REQUIRED FOR PATIENTS TO TAKE MULTIPLE WEEKS OF MEDICATION HOME
1LB OF WEIGHT LOSS PER WEEK dispensed AVERAGE FROM LAST DISPENSE AND/OR CYCLE
WHAT IS REQUIRED FOR AN UNDER 3 MONTH RESTART BUT OVER 4 WEEKS SINCE LAST TAKEN MEDS?
CYCLE RESTARTS, NO DOCTOR VISIT REQUIRED
How often must a patient see a physician?
At least every 3 months; PE EVERY YEAR
CAN PATIENTS COME IN EARLY FOR MEDICATION PICK UP?
YES, PT CAN COME IN 2-3 DAYS EARLY AND IF REFILLS ARE AVAILABLE; MA CAN DISPENSE UP TO 3 WEEKS
Patient did their last injection on Monday the 1st, what day does the count for missed injections day 1 begin?
The following Tuesday or day 8