Dieters who have used fen-phen or Redux for any amount of time should see their doctor and get a physical exam, even if they feel fine, the government said Thursday.
The advice comes two months after fenfluramine - the “fen” in the diet drug combination fen-phen - and Redux were pulled from the market because they had been linked to potentially deadly heart valve damage.
Previously, the government had recommended that dieters who had shortness of breath and other symptoms of heart damage after taking the drugs should have an echocardiogram, a painless test that uses sound waves to get a picture of the heart in action. But the government had no advice for those who appeared to be fine.
“Consumers have been calling in and doctors have been calling in asking, ‘What are we supposed to do now?”’ said Dr. Murray Lumpkin of the Food and Drug Administration, which developed the guidelines along with the Centers for Disease Control and Prevention and the National Institutes of Health.
“We got a working group together to deliberate on what we could tell them based on what we know now.”
The new guidelines are an attempt to quell confusion until the government learns more about fenfluramine and Redux.
Among other things, the government isn’t certain how long someone has to take the drugs before heart valve damage results.
The experts said:
Those who have ever taken either of the two drugs, alone or with other weight-loss medication, should see their doctor for a physical to find any signs of heart or lung damage.
People who have taken the drugs and have noticed a shortness of breath, ankle swelling or a new heart murmur should get an echocardiogram, which costs about $800.
Doctors should strongly consider an echocardiogram for those who have taken the drugs and don’t have symptoms but are about to have a tooth cleaning, dental implants or other procedure in which bacteria can enter the bloodstream.
Dr. James Weiss, who runs the echocardiology lab at Johns Hopkins University in Baltimore, endorsed the recommendation. People’s regular doctors “are in the best position to know whether or not their patient has clinical evidence of valvular disease,” he said.
Fenfluramine and Redux, or dexfenfluramine, were pulled from the market in September as evidence of heart valve damage mounted.
The government now has reports of at least 132 people who have taken fenfluramine or Redux and have deformed valves. The FDA has said that 30 percent of dieters with no symptoms might have valve damage.
Since 1995, 14 million prescriptions have been written for fenfluramine or Redux, most of them for women. The government estimates between 1 million and 5 million Americans have taken the drugs.
The American Heart Association endorsed the recommendations.
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