Phendimetrazine

Uses

Phendimetrazine is a sympathomimetic amine used as adjunct therapy for the short term management of exogenous obesity.

Used in the management of exogenous obesity as a short term adjunct (a few weeks) in a regimen of weight reduction based on caloric restriction.

Phendimetrazine is also used to associated treatment for these conditions: Exogenous Obesity

How Phendimetrazine works

Phendimetrazine may act in a similar way to amphetamines in that it activates the alpha-adrenergic system to induce an appetite suppressive and metabolic increase effect. The drug also acts as a norepinephrine-dopamine releasing agent (NDRA). It can bind to and reverse the NET.

Toxicity

Acute overdosage of phendimetrazine may manifest itself by the following signs and symptoms: unusual restlessness, confusion, belligerance, hallucinations, and panic states. Fatigue and depression usually follow the central stimulation. Cardiovascular effects include arrhythmias, hypertension, or hypotension and circulatory collapse. Gastrointestinal symptoms include nausea, vomiting, diarrhea, and abdominal cramps. Poisoning may result in convulsions, coma and death.

Food Interaction

• Take separate from meals. Take phendimetrazine one hour before eating.

[Moderate] GENERALLY AVOID: Alcohol may potentiate the central nervous system and cardiovascular effects of centrally-acting appetite suppressants.

In one study, concurrent administration of methamphetamine (30 mg intravenously) and ethanol (1 gm

This increases cardiac work and myocardial oxygen consumption, which may lead to more adverse cardiovascular effects than either agent alone.

Subjective effects of ethanol were diminished in the eight study subjects, but those of methamphetamine were not affected.

The pharmacokinetics of methamphetamine were also unaffected except for a decrease in the apparent volume of distribution at steady state.

MANAGEMENT: Concomitant use of centrally-acting appetite suppressants and alcohol should be avoided if possible, especially in patients with a history of cardiovascular disease.

Patients should be counselled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Phendimetrazine Hypertension interaction

[Major] The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc.

Sudden death has been reported in adults and children taking CNS stimulant treatment.

Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment.

A careful assessment of the cardiovascular status should be done in patients being considered for treatment.

This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram).

Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

[Major] CNS stimulant medications have shown to increase blood pressure, and their use might be contraindicated in patients with severe hypertension.

Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions.

All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

Phendimetrazine Drug Interaction

Major: duloxetine, duloxetine, escitalopram, escitalopramModerate: levothyroxine, levothyroxineUnknown: omega-3 polyunsaturated fatty acids, omega-3 polyunsaturated fatty acids, topiramate, topiramate, cyanocobalamin, cyanocobalamin, ergocalciferol, ergocalciferol, cholecalciferol, cholecalciferol, alprazolam, alprazolam, cetirizine, cetirizine

Phendimetrazine Disease Interaction

Major: cardiovascular, glaucoma, agitation, cardiac disease, glaucoma, hypertension, liver disease, psychiatric disorders, pulmonary hypertension, substance abuse, ticsModerate: bipolar disorders, diabetes, psychotic disorders, renal dysfunction, seizure disorders, diabetics

Elimination Route

Peak plasma levels occur within 1 to 3 hours. Absorption is usually complete by 4 to 6 hours.

Half Life

19-24 hours

Elimination Route

The major route of elimination is via the kidneys where most of the drug and metabolites are excreted.

Innovators Monograph

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