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This medication combines phentermine , an appetite suppressant, with topiramate , a medication whose exact weight-loss mechanism is not fully understood but is thought to reduce appetite and enhance satiety

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[11] Severe constipation, abdominal distension, or inability to pass gas may indicate ileus or intestinal obstruction and requires urgent medical attention

When transitioning between them , matching the appropriate dose level prevents both under-treatment and excessive side effects during the changeover period