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As the body reduces blood flow to non-essential areas to protect vital organs, visible and tactile changes appear: Dry mouth and cracked lips as saliva production drops Skin that tents when pinched and returns slowly to normal a sign of reduced elasticity Sunken eyes and dry, sticky membranes inside the mouth and cheeks Cool, pale, or clammy hands and feet from peripheral vasoconstriction In shock, the skin can become mottled or take on a gray, cyanotic color a grave sign of critically poor tissue oxygenation

Phentermine side effects tend to be most intense in the first week, then gradually diminish as the body adapts, though they may return if the dose is increased

doi: 10.1038/nm727 16 DongCSanchezLEPriceRA

When the patient has allergies or sensitivities to inactive ingredients

Although many patients experience no side effects, mild discomfort such as a headache or slight nausea may occasionally occur