> ## Documentation Index > Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt > Use this file to discover all available pages before exploring further. # Phentermine > Phentermine has no EU marketing authorisation for weight loss — why EU regulators withdrew this drug class, and what a doctor considers instead. Phentermine is an old appetite-suppressant tablet, related to amphetamine, widely prescribed in the United States for short-term weight loss. It is a different situation in Europe, and Hi-Doctor does not offer it. We don't prescribe phentermine today, but our doctors can review your case and propose an equivalent weight-management treatment with EU authorisation. ## What it is Phentermine is an appetite suppressant chemically related to amphetamine that raises the level of noradrenaline in the brain, which reduces feelings of hunger. ## Why it isn't authorised in the EU European regulators reviewed this whole class of appetite suppressants in 1999, decided they had not been shown to work over the long term, and the European Commission ordered countries to withdraw them in March 2000. The EU courts later annulled those decisions on a technical point about the Commission's powers, but the products did not return to the market. Phentermine on its own is not authorised as a weight-loss medicine in the European Union today, so an EU doctor cannot prescribe it and an EU pharmacy cannot dispense it. Websites selling phentermine to EU addresses are operating outside EU medicines law, and what arrives in the post has not been checked by any European regulator. ## What the studies reported The EQUATE trial ran for only 28 weeks and was designed to test a phentermine/topiramate combination — the phentermine-only groups were comparison arms, not the trial's primary focus ([Obesity — EQUATE trial, Aronne 2013](https://clinicaltrials.gov/study/NCT00563368), ClinicalTrials.gov · NCT00563368). There is no modern long-term trial of phentermine on its own, and EU regulators concluded in 1999 that this class of appetite suppressant had not shown long-term efficacy in obesity. A readout is not the same as peer-reviewed publication. ## What has been reported | Concern | What's known | | -------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | | Increased heart rate | The EMA's committee cited this, and the unclear long-term effects on the heart and blood vessels, as a reason for refusing the EU-wide phentermine/topiramate application | | Potential for misuse | The Swedish Medical Products Agency assessment notes that phentermine's structural, pharmacological and neurochemical profile is similar to amphetamine, and that abuse potential has been shown in animal studies | Sources: [EMA — Questions and answers on the refusal of the marketing authorisation for Qsiva](https://www.ema.europa.eu) (phentermine/topiramate); Swedish Medical Products Agency — Qsiva Public Assessment Report; [EUR-Lex — Commission Decision C(2000) 452](https://eur-lex.europa.eu) of 9 March 2000; EUR-Lex — Artegodan and Others v Commission, Joined Cases T-74/00 and others. ## What can be considered instead Weekly GLP-1 receptor agonist. A doctor may prescribe it if BMI and history match the indications. Requires follow-up. Dual GLP-1/GIP agonist, assessed by the doctor based on comorbidities and BMI. Full detail on the [Mounjaro page](/library/medicines/mounjaro). Daily GLP-1 agonist, indicated in selected patients with elevated BMI after medical evaluation. Fat-absorption inhibitor, a non-GLP-1 alternative a doctor may consider. See the [alli / orlistat page](/library/medicines/alli). A once-daily semaglutide tablet ([Rybelsus](/library/medicines/rybelsus)) is also authorised in the EU, but only for type 2 diabetes — any use in weight management is an individual medical decision and may be off-label. A licensed doctor decides case by case, never automatically. Our doctors review every [weight-loss option](/essentials/treatments) and recommend what fits your history and goals. ## How Hi-Doctor handles it The questionnaire covers weight, medical history and current medication — see how [eligibility works](/essentials/how-it-works). The consultation cost is set out on [pricing](/essentials/pricing); any medicine a doctor does prescribe is paid separately at a pharmacy. ## Start a consultation Answer the weight-loss questionnaire and a registered doctor reviews it. They decide whether treatment is appropriate, which one, and at what dose — and declining is a normal outcome. See [what it costs](/essentials/pricing) and [how the review works](/essentials/how-it-works). This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.