Fenfluramine Medication: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Fenfluramine is a prescription medication primarily used to manage specific types of epilepsy, including Dravet syndrome and Lennox-Gastaut syndrome. It works by regulating serotonin levels in the brain, which helps reduce the frequency and severity of seizures. While Fenfluramine was once prescribed for weight loss, it is no longer approved for that purpose due to safety concerns. Always consult your healthcare provider before starting or adjusting your dosage. Our telemedicine providers are available to address any questions you may have about Fenfluramine.

Names of the Medication

US Brand Name: Fintepla (Fenfluramine)

The generic name of a medication refers to its active ingredient. In this case, “Fenfluramine” is the generic name, while “Fintepla” is the brand name under which it is marketed.

Pharmacologic Category

1. Antiepileptic Agents
2. Serotonin Receptor Modulators

Fenfluramine Dosage

Fenfluramine is prescribed for specific conditions, with the dosage carefully tailored to the individual’s needs. Always follow your healthcare provider’s instructions and never adjust your dose without their guidance. If you have questions about your prescription or need assistance with dosage adjustments, our telemedicine providers are here to help.

Fenfluramine for Seizures: Dravet Syndrome

Adults: The typical starting dose is 0.1 mg/kg taken twice daily. The dose may be gradually increased, with a maximum dose of 0.35 mg/kg twice daily (up to 26 mg per day). Treatment is ongoing and requires regular monitoring by your healthcare provider.

Fenfluramine for Lennox-Gastaut Syndrome

Adults: The initial dose is 0.1 mg/kg twice daily, with a maximum dose of 0.35 mg/kg twice daily (up to 26 mg per day). Long-term treatment should include routine follow-ups with your healthcare provider to ensure safety and effectiveness.

Fenfluramine and Weight Loss History

Note: Fenfluramine was previously prescribed for weight loss but is no longer approved for this use due to significant safety concerns.

Other Conditions

1. Attention Deficit Hyperactivity Disorder (ADHD): Fenfluramine is not approved for the treatment of ADHD.
2. Anxiety Disorders, Depression, Autism Spectrum Disorder, Binge Eating Disorder, Narcolepsy: Fenfluramine is not approved for these conditions. If you are experiencing symptoms of these disorders, please consult one of our telemedicine providers to explore appropriate treatment options.

Dosage Forms and Strengths

Oral solution: 2.2 mg/mL

Administration Instructions

Fenfluramine is taken orally as a liquid solution and can be administered with or without food. Use the provided syringe or dosing cup to measure your dose accurately. Avoid using household spoons, as they may lead to incorrect dosing. If you miss a dose, take it as soon as you remember. However, if it is close to the time of your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once to make up for a missed dose.

Fenfluramine Side Effects

Like all medications, Fenfluramine may cause side effects. It is important to be aware of these and to contact your healthcare provider if you experience any concerning symptoms. Below are some potential side effects associated with Fenfluramine:

Common (10% or more): Decreased appetite, fatigue, diarrhea, drowsiness, upper respiratory tract infections.

Less Common (1-10%): Increased blood pressure, depression, anxiety, dizziness, nausea.

Rare (less than 1%): Heart valve problems, pulmonary hypertension (a serious lung condition).

If you experience severe side effects, such as difficulty breathing, chest pain, or swelling in the legs, seek medical attention immediately. You can also consult one of our telemedicine providers for further guidance.

Contraindications for Fenfluramine

A contraindication is a specific situation in which a medication should not be used because it may pose a risk to the patient. Fenfluramine has several contraindications, meaning it is not suitable for certain individuals. Below are the key contraindications for Fenfluramine:

1. Allergic Reaction: If you have had an allergic reaction to Fenfluramine or any of its ingredients, you should not take this medication. Symptoms of an allergic reaction may include rash, swelling, or difficulty breathing, which can be life-threatening.
2. Heart Valve Problems: Fenfluramine has been linked to heart valve issues in the past. If you have a history of heart valve disease, this medication could worsen your condition.
3. Pulmonary Arterial Hypertension (PAH): Fenfluramine may increase the risk of worsening PAH, a condition that affects the blood vessels in the lungs. Patients with PAH should avoid this medication.
4. Severe Liver Disease: Fenfluramine is metabolized by the liver. If you have severe liver disease, your body may not process the medication effectively, increasing the risk of side effects or toxicity.
5. MAO Inhibitors: Taking Fenfluramine with monoamine oxidase inhibitors (MAOIs), a type of antidepressant, can lead to dangerously high serotonin levels, potentially causing a life-threatening condition known as serotonin syndrome.

Drug-to-Drug Interactions with Fenfluramine

Fenfluramine has the potential to interact with other medications, which may either increase the likelihood of side effects or reduce the effectiveness of one or both drugs. Below are some common medications that may interact with Fenfluramine:

SSRIs and SNRIs: Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), and serotonin-norepinephrine reuptake inhibitors (SNRIs), like venlafaxine (Effexor), can raise serotonin levels in the brain. When combined with Fenfluramine, this can increase the risk of a potentially serious condition known as serotonin syndrome.

MAO Inhibitors: Monoamine oxidase inhibitors (MAOIs), including phenelzine (Nardil) and tranylcypromine (Parnate), can also significantly elevate serotonin levels when taken with Fenfluramine, leading to dangerous interactions. These medications should not be used together.

Triptans: Medications used to treat migraines, such as sumatriptan (Imitrex), may similarly increase serotonin levels. Caution is advised when combining these drugs with Fenfluramine.

Antiepileptic Drugs: Certain antiepileptic medications, such as valproic acid (Depakote) or clobazam (Onfi), may interact with Fenfluramine. These interactions could alter the effectiveness of the treatment or heighten the risk of side effects. Close monitoring by your healthcare provider is recommended.

Fenfluramine and Pregnancy

Is Fenfluramine safe to use during pregnancy? The safety of Fenfluramine during pregnancy has not been conclusively determined. While animal studies suggest there may be potential risks, there is limited data available regarding its effects on human pregnancies. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of Fenfluramine with your healthcare provider. Our telemedicine providers are here to guide you in making an informed decision tailored to your specific needs.

Fenfluramine While Breastfeeding

Is Fenfluramine safe to take while breastfeeding? Currently, there is limited information on whether Fenfluramine passes into breast milk. Due to the possibility of serious side effects in nursing infants, it is generally recommended to avoid using Fenfluramine while breastfeeding. Speak with your healthcare provider to explore safer alternatives. Our telemedicine team is available to assist you in evaluating your options and finding the best course of action.

Estimated Cost of Fenfluramine Medication

The cost of Fenfluramine can vary significantly depending on factors such as dosage and pharmacy. Without insurance, a 30-day supply typically ranges from $1,000 to $1,500. However, using a GoodRx coupon may reduce the cost to approximately $900 to $1,200. Prices can differ between pharmacies, so it’s a good idea to compare options or use a discount service like GoodRx to find the most affordable price in your area.

Possible Alternatives to Fenfluramine

If Fenfluramine is not the right choice for you, there are alternative treatments available depending on your specific condition. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers can help you explore these options:

1. Epilepsy: Other antiepileptic medications, such as levetiracetam (Keppra) or lamotrigine (Lamictal), may be effective. Additionally, lifestyle adjustments, including stress management and maintaining a consistent sleep schedule, can help reduce seizure frequency.
2. Dravet Syndrome: Alternative treatments may include medications like clobazam (Onfi) or stiripentol (Diacomit). A ketogenic diet has also been shown to help manage seizures in some patients with this condition.
3. Lennox-Gastaut Syndrome: Options such as rufinamide (Banzel) or topiramate (Topamax) may be considered. For some patients, vagus nerve stimulation (VNS) therapy may also be beneficial.
4. Obesity: Lifestyle modifications, including a healthy diet and regular exercise, are foundational. Medications like orlistat (Alli) or phentermine (Adipex-P) may also be prescribed to support weight loss efforts.
5. ADHD: Stimulant medications, such as methylphenidate (Ritalin), or non-stimulant options like atomoxetine (Strattera), may be effective. Behavioral therapy is another valuable treatment approach.
6. Anxiety Disorders: Medications such as sertraline (Zoloft) or escitalopram (Lexapro) may be prescribed. Cognitive-behavioral therapy (CBT) is also a proven and effective treatment for managing anxiety.
7. Depression: Antidepressants, including fluoxetine (Prozac) or venlafaxine (Effexor), may be helpful. Therapy and lifestyle changes, such as regular physical activity, can also play a significant role in managing depression.
8. Autism Spectrum Disorder: Behavioral therapies and medications like risperidone (Risperdal) may help manage symptoms. Early intervention programs can provide additional support for children with autism.
9. Binge Eating Disorder: Treatments may include medications such as lisdexamfetamine (Vyvanse) or fluoxetine (Prozac). Cognitive-behavioral therapy (CBT) is another effective option for addressing this condition.
10. Narcolepsy: Medications like modafinil (Provigil) or armodafinil (Nuvigil) can help manage symptoms. Establishing a consistent sleep schedule and practicing good sleep hygiene can also be beneficial.

Recent Updates on Fenfluramine Research

Recent studies have underscored the effectiveness of Fenfluramine in reducing seizure frequency, particularly in individuals with Dravet syndrome and Lennox-Gastaut syndrome. A 2022 clinical trial revealed a significant decrease in convulsive seizures among patients treated with Fenfluramine compared to those receiving a placebo. These findings emphasize the growing recognition of Fenfluramine as a valuable option for managing severe epilepsy conditions.

Ongoing research is focused on evaluating the long-term safety of Fenfluramine treatment, with particular attention to its effects on heart health. Additionally, scientists are investigating its potential use in treating other forms of epilepsy, further expanding the range of Fenfluramine’s therapeutic benefits. If you are considering Fenfluramine as part of your seizure management plan or want to stay updated on the latest advancements, our telemedicine providers are available to offer expert guidance, share the most current research, and support you in making informed decisions about your care.

James Kingsley

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