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Additionally, excessive dosing or delayed metabolism can trigger a Phase II transition, resulting in a deeper block that functionally resembles non-depolarizing paralysis

The incidence of increases in serum creatinine of greater than or equal to 0.3 mg/dL at any time during treatment in adults was 7.2% for phentermine and topiramate extended-release 7.5 mg/46 mg and 8.4% for phentermine and topiramate extended-release 15 mg/92 mg, compared to 2% for placebo

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Therefore, various combination treatment options are being explored to maximize drug efficacy while minimizing side effects