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Dexfenfluramine

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Dexfenfluramine, Redux

  • Precautions
  1. No longer available in United States
    1. Due to significant adverse effects (See below)
  2. Included for historical information only
  • Adverse Effects
  • Evaluating for adverse cardiac effects
  1. Careful history and exam
  2. Echocardiogram indications
    1. Symptoms suggestive of cardiopulmonary disease
    2. New onset murmur
    3. Consider for high patient anxiety
  • Dosage
  1. Dosing: 15 mg bid (Historical reference only)
  • Mechanism
  1. D-Isomer of d,I-fenfluramine (Pondimin)
  2. Was used in combination with Phentermine (Ionamin)
    1. Combination was known as "Phen-Fen"
  • Efficacy
  1. Obese patient over 6 months (n=822)
    1. Diet alone: 4.9 kg Weight Reduction
    2. Redux and Diet: 9.7 kg Weight Reduction
  2. Obese patients over 1 year (n=60)
    1. Diet alone: 7.2 kg Weight Reduction
    2. Redux and Diet: 9.8 kg Weight Reduction
  3. No difference from diet alone 5 months after treatment
  • Adverse Effects
  1. Drowsiness
  2. Diarrhea
  3. Dry Mouth
  4. Primary Pulmonary Hypertension
    1. Associated with use beyond 3 months
    2. Risk increased from 1 per Million to 18 per Million
    3. Obesity increases Pulmonary Hypertension risk 2 fold
  5. Valvular Heart Disease association
    1. New Heart Murmurs developed in 24 Phen-Fen Patients
      1. Mitral Regurgitation
      2. Aortic Insufficiency
      3. Tricuspid Regurgitation
    2. Occurred in women with over 1 year of Phen-Fen use
    3. References
      1. Connolly (1997) N Engl J Med, 337(9): 581-8 [PubMed]