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For patients taking metformin and phentermine taken together for weight loss: the most common GI side effects from metformin can be reduced by starting with extended-release metformin and taking it with food

Microdosing may not produce the same level of weight loss seen with standard dosing, and outcomes depend on individual factors and medical oversight

Patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 should discuss the risks of thyroid tumors with their healthcare provider

They may try to increase the likelihood of approval on the second try by including additional documentation or further evidence of medical necessity

Small studies examining liraglutide with phentermine have shown minimal additional benefit beyond GLP-1 monotherapy