Therapeutics and Drug Brief
FDA Issues Warning on Diet Drug Combination
Source: Science and Technology News. Lancet 1997;349:189.
The combination of fenflura-mine and phentermine ("fen/phen") to treat obesity has recently enjoyed new popularity and widespread use. Recently, the FDA suggested that patients taking this combination be monitored for potential toxicity manifested as abnormalities of cardiac valves. The FDA has not suggested that healthy women taking the drugs without consequences need to stop them.
Investigators at the Mayo Clinic and Fargo, ND, MeritCare Medical Center, have noted glistening white changes on the aortic, mitral, and tricuspid valves of 33 women ranging in age from 30 to 72 who have used fen/phen. Similar findings have not been reported with dexfenfluramine (Redux). Average duration of use of the drugs was 12 months. The appearance is similar to that of persons with carcinoid or ergotamine toxicity and is hypothesized to be related to high circulating levels of serotonin. About half of these affected women also had pulmonary hypertension.
The actual relationship of the drugs to the findings is not clearly established, nor is it clear whether it is either drug, or the combination of the two, that is actually responsible for the changes seen.
The Therapeutic and Drug Brief in this issue is written by Louis Kuritzky, MD, Courtesy Clinical Assistant Professor, University of Florida, Gainesville.
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