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The combination of phentermine hydrochloride and fenfluramine hydrochloride, known as phen-fen, has been widely used for the treatment of exogenous obesity.¹ The therapy has been highly successful. Up to 10 million obese people have been treated, reversing the trend in recent years toward increasing obesity in the US population. In 1996, the Food and Drug Administration approved dexfenfluramine hydrochloride for long-term monotherapy for obesity.

Unfortunately, both therapies have been found to pose serious risks. Fenfluramine, the second component of phen-fen, and dexfenfluramine have been associated with a 30-fold increased risk for primary pulmonary hypertension.² Anchors³ has suggested that this risk could be avoided by using fluoxetine hydrochloride instead of fenfluramine in combination with phentermine.

The second risk is more ominous. Connolly et al⁴ have described a series of 24 patients who developed clinical mitral valve insufficiency while taking phen-fen. Physicians who have prescribed phen-fen might hope that primary pulmonary hypertension . . . [Full Text of this Article]

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