Phendimetrazine

Registered South African indications:

• Obesity

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to other sympathomimetic agents
• Risk of dependency and abuse, especially in patients with a history of drug or alcohol abuse, personality disorders, or psychiatric illness
• Use with caution in patients with:
  • Anorexia
  • Insomnia
  • Impaired kidney function
  • Cardiovascular disease (especially coronary insufficiency)
  • Hypertension
  • Arteriosclerosis
  • Thyrotoxicosis
  • Prostatism
  • Extrapyramidal disorders
  • Narrow angle glaucoma
• Avoid use in children due to the possibility of growth suppression
• Pregnancy
• Breastfeeding
• Patients being treated with:
  • Monoamine oxidase inhibitors
  • Beta-blockers
  • Ephedrine
  • Other sympathomimetic agents (due to the risk of a hypertensive response)
• Exercise caution if administering within 14 days of discontinuing agents with a similar mechanism of action
• Concurrent use of alcohol is not recommended due to an increased potential for central nervous system effects, such as dizziness and confusion
• The hypersensitive effect of antihypertensive medication may be decreased by concurrent use with phendimetrazine

Cautions

• Elderly
• Known heart murmur or valvular heart disease
• Diabetes mellitus
• Hypertension or other cardiovascular conditions that might be exacerbated by increases in blood pressure or heart rate
• History of seizure disorders
• Tourette syndrome
• Anorexia
• Insomnia
• Prostatism
• Extrapyramidal disorders
• Prolonged use
• Abrupt withdrawal
• Use of anorectic agents within the prior year
• May impair ability to drive and operate machinery

Forms avail. in SA and covered in this monograph: tab

Obesity

• Oral (tab): 35-70mg, 12hrly; Max treatment duration: 6 weeks

Should be administered 1 hour before breakfast and the midday meal

May interfere with sleep if taken after 16h00

Not established for use in children

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Contraindicated

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended

Drugs in Sport

• Prohibited - In competition

Central Nervous System Disorders

• Agitation
• Dizziness
• Headache
• Insomnia
• Overstimulation
• Psychosis
• Restlessness
• Changes in libido

Cardiovascular Disorders

• Flushing
• Hypertension
• Ischemic events
• Palpitations
• Tachycardia
• Valvular disease
• Dilated cardiomyopathy

Respiratory Disorders

• Primary pulmonary hypertension

Gastrointestinal Disorders

• Constipation
• Diarrhoea
• Nausea
• Stomach pain
• Xerostomia

Genitourinary Disorders

• Dysuria
• Urinary frequency

Musculoskeletal Disorders

• Tremor

Skin and Subcutaneous Tissue Disorders

•  Diaphoresis

Sensory Disorders

• Blurred vision
• Mydriasis
• Retinal vein occlusion

• Anorectic agents
• Central nervous system stimulants
• Alcohol
• Acebrophylline
• Alkalinizing agents
• Cocaine
• Iobenguane I 123
• Iohexol
• Iomeprol
• Iopamidol
• Linezolid
• Monoamine oxidase inhibitors
• Beta blockers
• Ephedrine
• Sympathomimetic agents
• Antihypertensive agents

• Cardiovascular examination
• Echocardiogram 
• Weight
• Waist circumference
• Blood pressure

Phendimetrazine is a sympathomimetic amine with pharmacologic effects similar to the amphetamines. It activates the alpha adrenergic system, resulting in appetite suppression and increased metabolism.

Tablet 35mg

• Obesan X (LeBasi) originator