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Phentermine is drug that is an appetite suppressant for the short-term treatment of obesity and because of its small molecular weight (149), this drug probably transfers readily and in significant quantity into human milk. It could cause stimulation, tremors, anorexia and other central nervous system effects in the nursing women. This medication should not be used by lactating mothers or childbearing women.
This drug has often been prescribed together with fenfluramine -- this medication combo is popularly known as fen-phen. Researchers reported in the New England Journal of Medicine, that fen-phen (fenfluramine and phentermine) may be the root cause for cardiovascular damage in 24 women with no previous history of cardiac disease. Due to the potential and very serious side effects, it is cautioned that these medications should only be used by people whose obesity poses a serious health risk or is combined with heart disease, high blood pressure, diabetes, or other health problems.
The said drug regimen has an adult half-life of between 7 and 20 hours, and peaks in the bloodstream 8 hours following administration. For example if a seven hour half-life, over 90% of the medication would theoretically be excreted from your system in 28 hours. Assuming a 20 hour half-life, it would take approximately 80 hours for most to be cleared. I would suggest discussing your concerns with your Pharmacist or Health Care Provider, so you can come to a well-informed decision whether to take this drug or not.
If you do decide to wait a bit to nurse your baby, I would highly suggest expressing your milk as often as you can as she would normally nurse. If you don't express, your supply will begin to lessen and the sodium content of your milk will start to increase. Do not consume the milk you express at this very moment.