Fenfluramine

Fenfluramine

Clinical data
Pregnancy category	? (United States)  ? (Australia)
Routes of administration	Oral
ATC code	A08AA02 (WHO)
Legal status
Legal status	Schedule IV, Withdrawn from market
Pharmacokinetic data
Bioavailability	?
Metabolism	Hepatic
Elimination half-life	20 hours
Excretion	Renal
Identifiers
IUPAC name N-ethyl-1-[3-(trifluoromethyl)- phenyl]propan-2-amine
CAS Number	458-24-2
PubChem CID	3337
DrugBank	APRD00319
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C12H16F3N
Molar mass	231.257

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Evidence Based Medicine
Cochrane Collaboration on Fenfluramine Bandolier on Fenfluramine TRIP on Fenfluramine
Clinical Trials
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List of terms related to Fenfluramine

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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 the racemic mixture of two enantiomers, dexfenfluramine and levofenfluramine. It is designed to increase the level of the neurotransmitter serotonin, a chemical that regulates mood, appetite and other functions. Fenfluramine causes the release of serotonin by disrupting vesicular storage of the neurotransmitter, and reversing serotonin transporter function. The end result is a feeling of fullness and loss of appetite.

The drug was withdrawn from the U.S. market in 1997 after reports of heart valve disease and pulmonary hypertension, including a condition known as cardiac fibrosis. After the US withdrawal of fenfluramine, it was also withdrawn from other markets around the world.

The distinctive valvular abnormality seen with fenfluramine is a thickening of the leaflet and chordae tendinae. Roth suggested a mechanism by which fenfluramine damaged the valves. Heart valves also have serotonin receptors, which regulate their growth. He reported that fenfluramine and its active metabolite norfenfluramine stimulated the serotonin receptors 5-hydroxytryptamine (5-HT). In particular norfenfluramine is a potent agonist (stimulant) of 5-HT_2B receptors. These receptors are plentiful in human cardiac valves and appear to be essential for normal cardiac development. Roth suggested that the mechanism by which fenfluramine causes damage is through inappropriately stimulating the valve cells to divide. This valve damage is found in other drugs that act on 5-HT_2B receptors.

External links

• RxList.com - Fenfluramine
• Inchem.org - Fenfluramine

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