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That title belongs to phentermine, a generic drug that has been around for decades and has managed to hold its own despite the arrival of new competitors. The drug is viewed as effective and relatively safe to help jump-start diets in patients who are obese. However, phentermine — a stimulant that can give users an inexpensive high — has a long history of misuse. It has also frequently flown under the radar of regulators, who tend to focus their resources on deadlier drugs like opioid painkillers. Adding to the concern is the fact that many doctors have an incentive to recommend it: Phentermine is a mainstay of weight-loss clinics nationwide, prescribed by physicians who profit by selling the pill to patients. Fans of the drug trade tips on social media sites and websites like phentermine. Catizone, executive director of the National Association of Boards of Pharmacy. Phentermine — approved in and now made by several manufacturers — commands 80 percent of the market for diet drugs, according to IMS Health, which tracks prescription drug use. The newer drugs, by contrast, can cost hundreds of dollars a month and are sometimes not covered by insurance. In the s, phentermine was used as one half of the combination treatment known as fen-phen, the weight-loss sensation that was later discovered to cause heart-valve problems in some patients.
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