Fenfluramine, sold under the brand name Fintepla, is a serotonergic medication used for the treatment of seizures associated with Dravet syndrome and Lennox–Gastaut syndrome.[3][7][4] It was formerly used as an appetite suppressant in the treatment of obesity, but was discontinued for this use due to cardiovascular toxicity before being repurposed for new indications.[8][9] Fenfluramine was used for weight loss both alone under the brand name Pondimin and in combination with phentermine commonly known as fen-phen.[8][10][11]
Side effects of fenfluramine in people treated for seizures include decreased appetite, somnolence, sedation, lethargy, diarrhea, constipation, abnormal echocardiogram, fatigue, malaise, asthenia, ataxia, balance disorder, gait disturbance, increased blood pressure, drooling, excessive salivation, fever, upper respiratory tract infection, vomiting, appetite loss, weight loss, falls, and status epilepticus.[3] Fenfluramine acts as a serotonin and norepinephrine releasing agent, agonist of the serotonin 5-HT2 receptors, and sigma σ1 receptor positive modulator.[12][13][14] Its mechanism of action in the treatment of seizures is unknown,[3] but may involve increased activation of certain serotonin receptors and the sigma σ1 receptor.[13][9][15] Chemically, fenfluramine is a phenethylamine and amphetamine.[12]
Fenfluramine was developed in the early 1960s and was first introduced for medical use as an appetite suppressant in France in 1963 followed by approval in the United States in 1973.[8] In the 1990s, fenfluramine came to be associated with cardiovascular toxicity, and because of this, was withdrawn from the United States market in 1997.[8][16] Subsequently, it was repurposed for the treatment of seizures and was reintroduced in the United States and the European Union in 2020.[7][4][9] Fenfluramine was previously a schedule IV controlled substance in the United States.[7] However, the substance has since no-longer been subject to control pursuant to rule-making issued on 23 December 2022.[17]
- ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
- ^ Anvisa (24 July 2023). "RDC Nº 804 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 804 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 25 July 2023). Archived from the original on 27 August 2023. Retrieved 27 August 2023.
- ^ a b c d "FINTEPLA- fenfluramine solution". DailyMed. 14 December 2023. Retrieved 10 November 2024.
- ^ a b c "Fintepla EPAR". European Medicines Agency (EMA). 13 October 2020. Retrieved 8 January 2021.
- ^ "Fintepla Product information". Union Register of medicinal products. Retrieved 3 March 2023.
- ^ Cite error: The named reference
Dart2004was invoked but never defined (see the help page). - ^ a b c "FDA Approves New Therapy for Dravet Syndrome". U.S. Food and Drug Administration (FDA) (Press release). 25 June 2020. Retrieved 25 June 2020.
This article incorporates text from this source, which is in the public domain.
- ^ a b c d Cite error: The named reference
Barceloux2012was invoked but never defined (see the help page). - ^ a b c Odi R, Invernizzi RW, Gallily T, Bialer M, Perucca E (October 2021). "Fenfluramine repurposing from weight loss to epilepsy: What we do and do not know". Pharmacol Ther. 226: 107866. doi:10.1016/j.pharmthera.2021.107866. PMID 33895186.
- ^ Swiss Pharmaceutical Society (2000). Swiss Pharmaceutical Society (ed.). Index Nominum 2000: International Drug Directory. Taylor & Francis. pp. 431–432. ISBN 978-3-88763-075-1.
- ^ Kolata G (23 September 1997). "How Fen-Phen, A Diet 'Miracle,' Rose and Fell". New York Times. NY, NY, USA.
- ^ a b Rothman RB, Baumann MH (2000). "Neurochemical mechanisms of phentermine and fenfluramine: Therapeutic and adverse effects". Drug Development Research. 51 (2): 52–65. doi:10.1002/1098-2299(200010)51:2<52::AID-DDR2>3.0.CO;2-H. eISSN 1098-2299. ISSN 0272-4391. S2CID 84029575.
- ^ a b Martin P, Reeder T, Sourbron J, de Witte PA, Gammaitoni AR, Galer BS (August 2021). "An Emerging Role for Sigma-1 Receptors in the Treatment of Developmental and Epileptic Encephalopathies". Int J Mol Sci. 22 (16): 8416. doi:10.3390/ijms22168416. PMC 8395113. PMID 34445144.
- ^ Cite error: The named reference
pmid32169824was invoked but never defined (see the help page). - ^ Polster T (February 2019). "Individualized treatment approaches: Fenfluramine, a novel antiepileptic medication for the treatment of seizures in Dravet syndrome". Epilepsy Behav. 91: 99–102. doi:10.1016/j.yebeh.2018.08.021. PMID 30269941. S2CID 52889559.
- ^ Cite error: The named reference
pmid11307869was invoked but never defined (see the help page). - ^ "Schedules of Controlled Substances: Removal of Fenfluramine From Control". U.S. Federal Register. 23 December 2022.
