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Red-Flag Symptoms Stop exercise immediately and seek medical attention if you experience: Heart rate exceeding 90% of age-predicted maximum that does not decrease with rest Chest pain, pressure, or tightness Palpitations that feel irregular (skipped beats, rapid fluttering) Lightheadedness or near-syncope Severe headache during exertion A 2018 review in Circulation noted that stimulant-associated palpitations are common (reported in 2% to 10% of patients) but rarely indicate dangerous arrhythmias in structurally normal hearts [10]

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A safe transition typically involves discontinuing phentermine, allowing 3 to 7 days for sympathomimetic clearance, then starting semaglutide at the lowest dose (0.25 mg weekly injection or 3 mg oral)

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