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The "phen-pro" combination of phentermine (30 mg) and fluoxetine hydrochloride (10 or 20 mg), a well-known alternative to the "phen-fen" diet drug combination, has gained greater currency since fenfluramine hydrochloride and dexfenfluramine hydrochloride were withdrawn from the US market. Fenfluramine and dexfenfluramine have been associated with aortic and mitral valve regurgitation.¹ Asymptomatic valve lesions occur in as many as 45% of patients taking phen-fen.² It is unknown how many of these patients will progress to the symptomatic state.

Neither phentermine nor fluoxetine has been found to be associated with valvular heart disease, despite an intensive search for valve lesions in patients receiving the drugs.³ One of us (M.A.) has treated nearly 800 obese patients with phen-pro since 1995. To document the absence of valvular heart disease in patients receiving phen-pro, Doppler echocardiography with color was performed on 60 randomly selected patients who had been administered the drug combination. Their ages . . . [Full Text of this Article]

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