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Can you get phentermine over the counter?

Phentermine is a prescription-only weight-loss medication. Learn about Rx and OTC alternatives.
By | Updated on Mar. 10, 2025 Medically reviewed by Gerardo Sison, Pharm.D.
Three open OTC pill bottles: Can you get phentermine over the counter?

Key takeaways

  • Phentermine is a weight-loss drug approved for people 17 and older who have obesity or are overweight with a weight-related condition.

  • Phentermine isn’t sold over the counter and is only available with a prescription from a doctor or healthcare provider.

  • Due to the risks of misuse and the potential for developing dependence, phentermine is classified as a Schedule IV controlled substance.

  • Some people may look for alternatives to phentermine, such as over-the-counter (OTC) weight-loss options like Alli (orlistat), green tea extract, and glucomannan.

In this article:

Phentermine is a prescription drug used to treat obesity in adults and children aged 17 and older. It’s used alongside lifestyle changes such as a healthy diet and regular exercise to reduce appetite and manage weight. Although it’s an effective drug, it’s only intended for short-term use due to risks of misuse and dependence. Unlike over-the-counter options like Alli (orlistat) and natural supplements, phentermine requires a prescription from a healthcare provider. Consult a doctor or healthcare provider to explore the best weight-loss options for you.

RELATED: Phentermine side effects and how to avoid them

Can you get phentermine over the counter?

No, phentermine isn’t available over the counter. Instead, it’s classified as a Schedule IV controlled substance and is available by prescription only. Controlled substances have restrictions on how they’re prescribed and dispensed at pharmacies to help reduce the potential for misuse or abuse. For example, a healthcare provider may prescribe phentermine in a limited quantity to ensure it’s used short term. 

To obtain phentermine, you typically need a consultation with a licensed healthcare provider. A doctor will determine whether phentermine is appropriate for you based on your medical history, current health status, and other medications. 

Although phentermine isn’t available OTC, other types of weight-loss medications and weight-loss supplements can be purchased OTC. These options may be more suitable for certain people, including those with a history of drug misuse. However, while some dietary supplements are marketed as OTC “phentermine alternatives,” these are not approved by the U.S. Food and Drug Administration (FDA) for weight loss and are not equivalent to phentermine in terms of efficacy or safety.

RELATED: Who can take phentermine for weight loss?

Over-the-counter phentermine alternatives

Many people may prefer OTC diet pills or supplements instead of prescription drugs because they can often be easier to find and usually carry fewer risks. Some people might have health conditions such as heart disease or a history of drug abuse that prevent them from using phentermine. Various OTC alternatives for weight loss include Alli (orlistat) and appetite suppressants made from natural ingredients. 

Alli (orlistat)

At this time, Alli is the only FDA-approved OTC weight-loss medication available. It’s approved for use in overweight adults when used alongside a reduced-calorie and low-fat diet. It works by reducing the amount of fat the body absorbs. 

Alli may have a modest effect on your ability to lose weight. In clinical trials, Alli helped people lose 50% more weight than with diet alone. Therefore, if you lose 5 pounds with diet alone, Alli could help you lose an additional 2 to 3 pounds. The most common side effects of Alli include stomach pain, oily stools, and more urgent or frequent bathroom trips.

Orlistat, the active ingredient of Alli, is also available as a brand-name prescription drug called Xenical. However, Alli capsules contain 60 milligrams of orlistat, whereas Xenical capsules contain 120 milligrams. 

Glucomannan

Glucomannan is a type of soluble fiber that may be used as a supplement for weight loss. It works by absorbing water and creating a viscous gel that lines the gut, extending the time it takes for your stomach to empty. As a result, it may help increase feelings of fullness. 

Although its effects on weight loss may be inconsistent, some clinical studies suggest a positive effect. A review of six studies involving 225 overweight and obese adults found that taking glucomannan led to an average weight loss of around 2 pounds. The results were particularly significant for women, who lost an average of around 4 pounds. 

When used short-term, glucomannan is typically well tolerated. Mild side effects such as belching, bloating, and stomach discomfort may occur. However, blockages in the esophagus have been reported.

Green tea and green tea extract

Green tea is a popular beverage known for its potential health benefits, particularly related to weight loss. Green tea extract may work to manage weight by increasing fat metabolism and reducing fat absorption. 

One study found that after 12 weeks of taking a high-dose green tea extract, obese women lost an average of around 2 pounds and had decreases in waist circumference and body mass index (BMI). Total cholesterol levels dropped by around 5%, and certain hormone levels related to obesity improved. 

Green tea is generally well-tolerated. However, consuming green tea in large amounts may lead to side effects such as nausea, constipation, and stomach discomfort. 

Probiotics

Millions of microorganisms, such as bacteria, viruses, and fungi, live in your digestive tract. These microorganisms work together to form what’s known as the gut microbiota, which is important for helping your body break down food and absorb nutrients. Probiotics are beneficial bacteria found in some yogurts and dietary supplements. They might help with weight loss by managing the types of microorganisms in your gut.

Although studies on the effects of probiotics on body fat, weight, and waist and hip circumference have found inconsistent results, some research shows that probiotics can support a reduction in body weight and fat percentage. The results from one study showed that taking probiotics led to a small but significant decrease in body weight by around 1 pound, a reduction in body mass index (BMI) of 0.27 kg/m², and a decrease in body fat percentage by 0.60%. 

For the most part, probiotics do not cause side effects in healthy individuals. If and when they do, the side effects, such as gas, are typically minor and stomach-related. 

RELATED: Phentermine interactions to avoid

Keep in mind dietary supplements are not approved by the FDA for safety or effectiveness before they hit the shelves. It’s always a good idea to research and talk to a healthcare professional before trying new weight-loss products.

Prescription phentermine alternatives

Phentermine alternatives also include prescription medications. Although these options aren’t sold OTC and are only available with a doctor’s prescription, they are all FDA-approved alternatives to phentermine. This means they have undergone rigorous review by the FDA and have been approved based on their evidence of safety and effectiveness. Moreover, some phentermine alternatives are indicated for long-term use, while phentermine is only approved for short-term use.

Oral alternatives:

GLP-1 receptor agonists are a class of medications that help manage diabetes and can also support weight management. They work by mimicking a natural hormone that regulates blood sugar levels. These prescription medicines may be recommended and used with lifestyle changes.

Each drug has its risks and benefits. Consult a healthcare provider for medical advice on which option is right for you based on your medical conditions, other medications, and weight-loss goals.