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Topic: Fenfluramine

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	CNN - Valvular heart disease associated with fenfluramine-phentermine - June 8, 1997
		Fenfluramine and phentermine are prescription medications individually approved by the United States Food and Drug Administration as appetite suppressants for the treatment of obesity.
		Fenfluramine and phentermine (fenfluramine-phentermine) used in combination may yield equivalent efficacy in weight reduction at lower doses of each agent, with fewer side effects and improved patient tolerance.
		Fenfluramine is a sympathomimetic amine that has an anorectic action mediated through activation of serotonergic pathways in the brain.
	www.cnn.com /HEALTH/9707/08/fenphen.report/index.html (2745 words)

	Cardiac Valvulopathy Associated with Exposure to Fenfluramine or Dexfenfluramine: U.S. Department of Health and Human ...
		Fenfluramine and dexfenfluramine are appetite suppressants that were in widespread use in the United States.
		Both fenfluramine and dexfenfluramine appear to act by affecting the metabolism of the neurotransmitter serotonin in the brain.
		All persons exposed to fenfluramine or dexfenfluramine, for any period of time, either alone or in combination with other agents, should undergo a medical history and cardiovascular examination by their physician to determine the presence or absence of cardiopulmonary signs or symptoms.
	www.cdc.gov /mmwr/preview/mmwrhtml/00049815.htm (1926 words)

	overview
		In addition to heart valve dangers, fenfluramine is neurotoxic, causing the death of brain cells in animals at therapeutic dose levels.
		Fenfluramine is a drug closely related to Ritalin (methylphenidate) and to Dexedrine and Adderall (amphetamines).
		Fenfluramine studies that examine serotonin as a possible factor in violence are especially important to drug companies such as Eli Lilly who making drugs like Prozac which affect serotonin.
	www.breggin.com /overview.html (1190 words)

	Fenfluramine - Wikipedia, the free encyclopedia
		Fenfluramine is a drug that was part of the Fen-Phen anti-obesity medication (the other drug being phentermine).
		Also known as Pondimin, fenfluramine was introduced on the U.S. market in 1973.
		It is designed to increase the level of the neurotransmitter serotonin.
	en.wikipedia.org /wiki/Fenfluramine (162 words)

	Valvular Abnormalities with Dexfenfluramine and Fenfluramine
		For dexfenfluramine or fenfluramine the 5-year cumulative incidence of valvular abnormality was 7.1 (95% CI 3.6-17.8) per 10,000 subjects for 1-3 months use and 35.0 (16.4-76.2) per 10,000 subjects for > 4 months use.
		No usage data are available for the previous 20 years, but fenfluramine is known to have been widely used in the 1970s.
		Those who took dexfenfluramine or fenfluramine for ≥ 3 months, and those uncertain of the duration of use, should be given a physical examination for a heart murmur.
	www.medsafe.govt.nz /Profs/PUarticles/diet.htm (1753 words)

	Fenfluramine-induced pulmonary vasoconstriction: role of serotonin receptors and potassium channels -- ...
		to fenfluramine is partly mediated by 5-HT receptors.
		The pulmonary vascular reactivity to fenfluramines is known to be modulated by the endothelium.
		Aminorex, fenfluramine, and chlorphentermine are serotonin transporter substrates: implications for primary pulmonary hypertension.
	jap.physiology.org /cgi/content/full/91/2/755 (3795 words)

	Update on Valvular Abnormalities with Dexfenfluramine and Fenfluramine
		Individuals who have received dexfenfluramine or fenfluramine for ≥ 3 months at any time in the past and who have not yet been investigated should be evaluated for evidence of heart murmur or other abnormal cardiac signs, and referred to a cardiologist for echocardiography if any abnormality is identified.
		In both cases the patient had taken fenfluramine for more than a year in the 1970s and a heart murmur was diagnosed 1-4 years after commencing therapy.
		involved 19 recipients of fenfluramine and phentermine and 11 recipients of placebo who had been treated as part of a randomised trial which was terminated when dexfenfluramine and fenfluramine were removed from the market.
	www.medsafe.govt.nz /profs/PUarticles/dietupd.htm (1609 words)

	SOFT/TIAFT 98 - Urinary Excretion of dl-Fenfluramine in Rat Urine (Site not responding. Last check: 2007-11-02)
		Fenfluramine is administered orally as the racemic mixture, but its optical isomers have different actions.
		To investigate the metabolism of racemic fenfluramine, the urinary excretion of fenfluramine was studied in rats.
		After administration of 15mg/kg of racemic fenfluramine, d-fenfluramine, l-fenfluramine and its metabolites d-norfenfluramine and l-norfenfluramine in urine were well resolved by chromatographic separation of TFP derivatives on DB-5 with retention times of 11.2, 11.8, 8.4, 8.6 min respectively.
	www.tiaft.org /tiaft98/thu/t_o_24.html (293 words)

	Phentermine/Fenfluramine from Michael D. Myers M.D. Inc.
		fenfluramine was withdrawn from the market because of its association with Valvular Heart Disease.
		Fenfluramine acts through serotonergic mechanisms resulting in a feeling of increased satiety.
		Fenfluramine may produce somewhat opposite effects with drowsiness, sedation, diarrhea, and depression.
	www.weight.com /Previous_approaches/phenfen.html (1020 words)

	Fen-phen and heart valve disease (Site not responding. Last check: 2007-11-02)
		Fenfluramine and phentermine have been prescribed separately for the treatment of obesity since the 1970s.
		Early studies showed that people who used a combination of fenfluramine and phentermine had a 20% to 30% risk of developing heart valve disease in the mitral, aortic, and tricuspid heart valves.
		The prevalence of mitral regurgitation for the combined use of fenfluramine and phentermine was 5.1%, and there was no significant duration effect.
	www.webmd.com /hw/health_guide_atoz/aa143876.asp (409 words)

	Cotreatment with Racemic Fenfluramine Inhibits the Development of Tolerance to Morphine Analgesia in Rats -- Arends et ...
		A parallel study was performed to investigate the effect of fenfluramine on the pharmacokinetics of morphine and its 3-glucuronide.
		The rates of morphine and fenfluramine infusion used are indicated in the symbol legend, and are the same in the combination treatments.
		The mechanism responsible for fenfluramine's interference with the tolerance process to morphine is not known.
	jpet.aspetjournals.org /cgi/content/full/286/2/585 (5837 words)

	On the resolution of fenfluramine - Publication - RTI International (Site not responding. Last check: 2007-11-02)
		Resolution of fenfluramine with (+)-dibenzoyltartaric acid affords (+)-fenfluramine in contradiction of literature claims that (-)-fenfluramine is obtained by use of (+)-dibenzoyltartaric acid.
		The intermediate dibenzoyltartrate salt has been fully characterized and the absolute configuration of the enantiomers of fenfluramine has been confirmed to be as previously established.
		Morehead, A.T., Reges, R.A., Lewin, A.H., and Carroll, F.I. On the resolution of fenfluramine.
	www.rti.org /abstract.cfm?pubid=1706 (109 words)

	Valvular heart disease and fenfluramine-phentermine
		The serotoninergic drugs fenfluramine and its d-isomer dexfenfluramine as well as the adrenergic agonist phentermine have been increasingly prescribed for the treatment of obesity.
		The authors note that their report is not a case-control study, and does not conclusively prove that the combination of fenfluramine and phentermine caused the lesions they describe.
		The presence of these valvular lesions in a cohort of women less than 50 years of age is distinctly unusual, however, and their association with fenfluramine-phentermine consumption is "not likely to be due to chance".
	www.journalclub.org /vol2/a53.html (1276 words)

	BMPR2 germline mutations in pulmonary hypertension associated with fenfluramine derivatives -- Humbert et al. 20 (3): ...
		BMPR2 germline mutations in pulmonary hypertension associated with fenfluramine derivatives -- Humbert et al.
		fenfluramine and dexfenfluramine have mutations in the bone
		Nitric oxide deficiency in fenfluramine- and dexfenfluramine-induced pulmonary hypertension.
	erj.ersjournals.com /cgi/content/full/20/3/518 (3787 words)

	Fenfluramine
		FENFLURAMINE (PondiminÂ®) was originally marketed as a drug to help you lose weight.
		Keep in mind that fenfluramine was intended to be used in addition to a healthy diet and exercise.
		While your prescriber or health care professional will most likely prescribe fenfluramine for only a few months; however, some people have used it for longer periods.
	www.stjohn.org /HealthInfoLib/swArticle.aspx?26,1338 (437 words)

	(S)-fenfluramine
		Fenfluramine 1 is the active ingredient of a obesity drug acting on the digestion of carbohydrates, the activity being restricted mainly to the S enantiomer [1, 2], which can be obtained by separation of the diastereoisomers [3] or by preferential crystallisation of derivates, which were identified of being conglomerates [4].
		Further, it is no longer necessary to bother with the regioselectivity of the nucleophilic attack on the epoxide, which allows the usage of the simplest method for the preparation of the aminoalcohols: ethylamine in ethanol.
		In order to realise the ring opening of the aziridines 5 and 12 into fenfluramine 1, we used catalytic hydrogenation [11], peculiar to open the ring at the less substituted side, in the case of the aziridine 12, and benzylic hydrogenolysis in the case of the aziridines 5.
	www.erowid.org /archive/rhodium/chemistry/fenfluramine.html (10160 words)

	Pondimin Online, Description, Chemistry, Ingredients - Fenfluramine - RxList Monographs
		Pondimin (fenfluramine hydrochloride) is an anorectic drug for oral administration.
		Immediate release tablets containing 20 mg fenfluramine hydrochloride are orange, scored, compressed tablets engraved AHR and 6447.
		Fenfluramine HCl has the following chemical name: N-ethyl-alpha-methyl-3-(trifluoromethyl) benzeneethanamine hydrochloride.
	www.rxlist.com /cgi/generic/fenflur.htm (95 words)

	Absence of Fenfluramine-Induced Anorexia and Reduced c-fos Induction in the Hypothalamus and Central Amygdaloid Complex ...
		Fenfluramine, a serotonin releaser and uptake inhibitor, has been widely prescribed as an appetite suppressant.
		and c-fos induction elicited by fenfluramine in wild-type mice,
		In response to fenfluramine, positively stained nuclei were seen in the CeA and BNST of wild types only (B, E) and were absent in knock-outs (C, F).
	www.jneurosci.org /cgi/content/full/18/14/5537 (5503 words)

	Rules - 2003 "Proposed Removal of Fenfluramine From the Controlled Substances Act; Withdrawal of Proposed ...
		DEA has determined that fenfluramine should remain in schedule IV due to the withdrawal of the petition, the removal of products containing the drug from the United States marketplace, and the public health and safety concerns expressed by the Department of Health and Human Services that arose after publication of the proposed rule.
		The fenfluramine product Redux, an anorectic indicated for the management of exogenous obesity, was approved by the Food and Drug Administration (FDA) of the Department of Health and Human Services (DHHS) for marketing in the United States in 1996.
		The health and safety concerns that prompted the manufacturers' voluntary withdrawal of fenfluramine from the marketplace and DHHS's subsequent codification of this withdrawal, see 21 CFR 216.24, occurred after DEA's proposed rulemaking was published.
	www.deadiversion.usdoj.gov /fed_regs/rules/2003/fr0515.htm (700 words)

	Aminorex, Fenfluramine, and Chlorphentermine Are Serotonin Transporter Substrates : Implications for Primary Pulmonary ...
		Aminorex, Fenfluramine, and Chlorphentermine Are Serotonin Transporter Substrates : Implications for Primary Pulmonary Hypertension -- Rothman et al.
		It is noteworthy that fenfluramine and d-fenfluramine cause depletion
		Effects of fenfluramine on eight outpatients with the syndrome of autism.
	circ.ahajournals.org /cgi/content/full/100/8/869 (3836 words)

	1997 MAYO CLINIC STUDY ON FEN PHEN \| THE PPH TEAM
		Patient 2: A 45-year-old woman (pretreatment body mass index, 34.2 kg/m2) was treated with fenfluramine-phentermine (fenfluramine, 20 mg three times daily, and phentermine, 30 mg per day) for one year before dyspnea and a heart murmur were noted.
		Patient 3: A 48-year-old woman (pretreatment body mass index, 34.7 kg/m2) without a history of cardiac disease was treated with fenfluramine-phentermine (fenfluramine, 20 mg three times daily, and phentermine.
		Patient 6: A 51-year-old woman (pretreatment body mass index, 32.8 kg/m2) with normal findings on cardiac examination was treated with fenfluramine-phentermine (fenfluramine, 20 mg three times daily, and phentermine, 30 mg per day in divided doses).
	pph.poweradvocates.com /fen_phen_study_mayo.html (2929 words)

	Connection between Fenfluramine or Dexfenfluramine and Valvular Heart Disease (via CobWeb/3.1 ... (Site not responding. Last check: 2007-11-02)
		In September 1997, the popular appetite suppressants were voluntarily withdrawn from the market by their manufacturer in the wake of reports that patients who took the drugs--whether alone or in combination with phentermine, a combination commonly called "fen-phen"--developed potentially dangerous heart-valve abnormalities.
		In this study, patients who had taken fenfluramine or dexfenfluramine (alone or in combination with phentermine) for various time periods had a significantly higher incidence of cardiac-valve abnormalities than those who had not.
		Patients who took fenfluramine or dexfenfluramine should be examined by a physician, who should perform a stethoscopic examination of the heart.
	www.101weightlossarticles.com.cob-web.org:8888 /supplements/fenfluramine1.html (892 words)

	EIN Published Report: Endocarditis Associated with Fenfluramine/Dexfenfluramine 8-98 (Site not responding. Last check: 2007-11-02)
		The appetite suppressants fenfluramine and dexfenfluramine were withdrawn from the market last summer because of their association with cardiac valvulopathy (MMWR Morb Mortal Wkly Rep 1997;46:1061).
		These results suggest that infectious diseases consultants rarely encounter endocarditis in association with fenfluramine or dexfenfluramine therapy and that the prevalence of the illness may be very low.
		Endocarditis associated with fenfluramine or dexfenfluramine therapy is also of interest to the FDA.
	www.idsociety.org /EIN/Pub_Rpts/8-98.htm (484 words)

	Statistical evidence supporting the hypothesis that use of fenfluramine-phentermine is associated with a higher ...
		There were also reports of valvulopathy in patients treated with Fenfluramine alone, Dexphenfluramine alone (commonly known as Redux), and in patients treated with Fen-Phen in combination with Dexfenfluramine.
		In the first phase of this study, all patients filling prescriptions for fenfluramine were identified.
		There were 25 echocardiograms on patients from the fenfluramine cohort performed prior to their first fenfluramine prescription.
	www.msu.edu /user/nelsonm9/StatisticalEvidence.html (1890 words)

	DEA Intends To Deschedule Fenfluramine And Dexfenfluramine
		"By descheduling fenfluramine and its isomer dexfenfluramine, the DEA will be providing patients with appropriate access to pharmacotherapy as a weight management option," said Marc W. Deitch, M.D., Senior Vice President, Medical Affairs and Medical Director of Wyeth-Ayerst.
		Interneuron Pharmaceuticals, Inc. filed a petition with the DEA on March 18, 1991, requesting that fenfluramine and its isomer dexfenfluramine be removed from Schedule IV and all other controls of the Controlled Substances Act (CSA).
		On September 29, 1995, the Food and Drug Administration's Drug Abuse and Endocrinologic and Metabolic Drugs Advisory Committee unanimously recommended that fenfluramine and its isomers be descheduled.
	www.docguide.com /dg.nsf/PrintPrint/696682916B40A2728525649000584090 (885 words)

	Diet Pills Health: Fenfluramine in Chinese Weight Loss Pills (via CobWeb/3.1 planetlab-3.cs.princeton.edu) (Site not responding. Last check: 2007-11-02)
		In 2001, FDA issued a nationwide alert on the recall of thirteen "Treasure of the East" herbal dietary supplements because of a dangerous ingredient, aristolochic acid, which is toxic to the kidney.
		Fenfluramine and another diet drug, phentermine, were used in combination for weight loss until it was determined that the combination of drugs was linked to valvulopathy, a serious and sometimes fatal heart disease.
		Fenfluramine and a chemically similar drug, dexfenfluramine, were removed from the market in 1997.
	www.diet-pills-information.org.cob-web.org:8888 /diet-pills-health-fenfluramine.htm (319 words)

	Carilion - FENFLURAMINE (Oral) (Tablet) - [Medication]
		You should not use fenfluramine if you have taken a type of medicine called a MAO inhibitor (such as Nardil®, Marplan®, or Parnate®) within the past 14 days.
		A rare side effect caused by fenfluramine is called pulmonary hypertension, or high blood pressure in the lungs.
		Tell your doctor or dentist that you are taking fenfluramine before having any kind of surgery.
	www.carilion.com /kbase/htm/mdx-/qudr/719/mdx-qudr719.htm (507 words)

	Fen-Phen - Health and Medical Information produced by doctors - MedicineNet.com
		ROCHESTER, MINN - The combination of two drugs, fenfluramine and phentermine has become a popular medical regimen together with dieting and exercise as a weight reduction program for obese individuals.
		The authors concluded, "These cases arouse concern that fenfluramine- phentermine therapy may be associated with valvular heart disease.
		Because the annual number of prescriptions of fenfluramine and phentermine is reportedly around 20 million, the editors of MedicineNet wish to assist in heightening public awareness about these possible drugs risks.
	www.medicinenet.com /script/main/art.asp?articlekey=545 (362 words)

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