The phentermine/topiramate combination is contraindicated in which condition?

• A. Hypertension
• B. Diabetes
• C. Asthma
• D. Pregnancy

Answer: (D)

The main idea here is fetal safety. Phentermine/topiramate carries a significant teratogenic risk, mainly due to topiramate, which has been linked to birth defects such as orofacial clefts when taken during pregnancy. Because of this, the combination is absolutely contraindicated in pregnancy, and women of childbearing potential must use reliable contraception and have a negative pregnancy test before starting and during treatment.

Hypertension, diabetes, and asthma are not absolute contraindications to this medication, though the stimulant component means blood pressure and heart rate should be monitored and underlying conditions considered. The pregnancy status is the key factor that makes this therapy off-limits.