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fenfluramine (Pondimin, Ponderil, Ponderex, Adipomin, Fintepla)
Tradename: Pondimin. DEA-controlled substance: class 2. DEA-controlled substance: class 4 [3].
Withdrawn from US market in 1997 following case reports of heart valve abnormalities in patients using flenfluramine or dexfenfluramine for appetite suppression [3].
Indications:
- obesity
- Dravet syndrome in patients age >= 2 years of age (Fintepla) [6]
Dosage:
1) start 20 mg PO BID
2) max: 120 mg/day
3) Dravet syndrome: low-dose (Fintepla) [6]
Tabs: 20 mg.
Pharmacokinetics:
1) metabolized in liver to largely inactive metabolites
2) metabolites excreted by the kidney
3) 1/2life: 11-30 hours
Adverse effects:
1) insomnia
2) agitation
3) nervousness
4) hyperthermia
5) hyperventilation
6) hypertension
7) convulsions
8) pulmonary hypertension
9) valvular heart disease
a) mild aortic regurgitation (6 months of therapy)
b) no significant cardiac risk after 3 months of therapy [5]
Drug interactions:
- may cause false positives in immunoassays for amphetamines in urine
Mechanism of action:
1) CNS stimulants
2) appetite suppressant
3) serotonin agonist
Interactions
drug adverse effects (more general classes)
Specific
dexfenfluramine (Redux)
General
adrenergic neuron stimulant
amine
analeptic (CNS stimulant)
anorexiant (appetite suppressant)
aromatic compound
Properties
MISC-INFO: elimination route KIDNEY
1/2life 11-30 HOURS
therapeutic-range 30-300 NG/ML
toxic-range >1000 NG/ML
pregnancy-category C
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995
- Fresno Bee, Dec. 2000
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 461
- Journal Watch 21(13):109, 2001
Davidoff et al, Arch Intern Med 161:1429, 2001
- George J
New Drug Approved for Rare Childhood Seizures -
Fenfluramine reduced convulsive seizures in Dravet syndrome
MedPage Today June 26, 2020
https://www.medpagetoday.com/washington-watch/fdageneral/87282
Component-of
fenfluramine/phentermine (fen-phen)