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One study observed that people experienced no significant side effects when they took phentermine for up to 24 months ( However, the FDA has approved phentermine in combination with topiramate for long-term use, since the doses of the two ingredients are lower than the maximum doses of the individual drugs ( The most commonly reported side effects of phentermine and combined phentermine and topiramate are ( dry mouth sleep problems dizziness heart palpitations skin flushing fatigue constipation irritability nausea vomiting While rare, some severe side effects are possible, such as increased blood pressure, suicidal ideation, metabolic acidosis, increased creatinine levels, fetal harm, vision problems, cognitive impairment, and hypokalemia ( You shouldnt take phentermine if you have heart disease, hyperthyroidism, glaucoma, or severe kidney or liver disease or if youre pregnant or nursing ( Phentermine should also not be prescribed in combination with monoamine oxidase inhibitors (MAOIs), a class of medications used to treat depression