II. Precautions

  1. No longer available in United States
    1. Due to significant adverse effects (See below)
  2. Included for historical information only

III. 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

IV. Dosage

  1. Dosing: 15 mg bid (Historical reference only)

V. Mechanism

  1. D-Isomer of d,I-fenfluramine (Pondimin)
  2. Was used in combination with Phentermine (Ionamin)
    1. Combination was known as "Phen-Fen"

VI. 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

VII. 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]

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Ontology: Dexfenfluramine (C0011786)

Definition (MSH) The S-isomer of FENFLURAMINE. It is a serotonin agonist and is used as an anorectic. Unlike fenfluramine, it does not possess any catecholamine agonist activity.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D020372
SnomedCT 322047008, 412366002
English Dexfenfluramine, DEXFENFLURAMINE, Benzeneethanamine, N-ethyl-alpha-methyl-3-(trifluoromethyl)-, (S)-, dexfenfluramine, Dexfenfluramine [Chemical/Ingredient], Dexfenfluramine (product), Dexfenfluramine (substance)
Swedish Dexfenfluramin
Czech dexfenfluramin
Finnish Deksfenfluramiini
Russian DEKSFENFLURAMIN, ДЕКСФЕНФЛУРАМИН
Japanese デキスフェンフルラミン, デクストロフェンフルラミン, 塩酸デクスフェンフルラミン, デクスフェンフルラミン
Polish Deksfenfluramina
Spanish dexfenfluramina (producto), dexfenfluramina, dexfenfluramina (sustancia), Dexfenfluramina
French Dexfenfluramine
German Dexfenfluramin
Italian Desfenfluramina
Portuguese Dexfenfluramina

Ontology: Redux (C0728749)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D020372
English redux, Redux, Wyeth Brand of Dexfenfluramine Hydrochloride