Adult: For short-term management of exogenous obesity as an adjunct to comprehensive weight management programme in patients with BMI ≥30 kg/m2 and have not responded to diet and exercise alone: As conventional tab: 25 mg tid to be taken 1 hour before meals; if needed, an additional 25 mg (4th dose) may be taken in the evening for night hunger. As extended-release tab: 75 mg once daily to be taken at midmorning. Discontinue treatment if tolerance to amfepramone develops.
What are the brands available for Amfepramone in Hong Kong?
Prothin
Administration
Amfepramone Should be taken on an empty stomach.
Contraindications
Known hypersensitivity or idiosyncrasy to amfepramone or other sympathomimetic amines. Advanced arteriosclerosis, severe hypertension, hyperthyroidism, pulmonary hypertension, glaucoma, agitated states, history of drug abuse. Concomitant use with other anorectic drugs. Concurrent use with or within 14 days of discontinuing MAOIs.
Special Precautions
Patient with diabetes mellitus, hypertension, other CV conditions (e.g. arrhythmias); pre-existing psychosis, bipolar disorder, history of seizure disorders, Tourette's syndrome. Not recommended in patients with known heart murmur or valvular heart disease. Not recommended for use in patients who have used other anorectic agents within the prior year. Avoid abrupt withdrawal. Renal impairment. Elderly. Pregnancy and lactation.
Adverse Reactions
Significant: May cause direct myocardial toxicity (e.g. heart failure), valvular heart disease; CNS effects, exacerbation of behaviour and thought disorder symptoms, induction of mixed/manic episodes, increased risk of seizures; drug dependence or abuse (prolonged use); withdrawal syndrome (following abrupt discontinuation). Blood and lymphatic system disorders: Leucopenia, agranulocytosis. Cardiac disorders: Cardiac arrhythmia, palpitation, tachycardia. Eye disorders: Blurred vision, mydriasis. Gastrointestinal disorders: Abdominal distress, nausea, vomiting, diarrhoea, constipation, dysgeusia, xerostomia. General disorders and administration site conditions: Malaise, jitteriness. Investigations: ECG changes. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Dizziness, drowsiness, headache, tremor, dyskinesia, restlessness. Psychiatric disorders: Anxiety, depression, dysphoria, insomnia. Renal and urinary disorders: Dysuria, polyuria. Reproductive system and breast disorders: Changes in libido, gynaecomastia, menstrual irregularity, impotence. Respiratory, thoracic and mediastinal disorders: Dyspnoea. Skin and subcutaneous tissue disorders: Alopecia, erythema, rash, diaphoresis, urticaria. Vascular disorders: Hypertension. Potentially Fatal: Rarely, primary pulmonary hypertension.
This drug may cause dizziness or drowsiness, if affected, do not drive or operate machinery.
Monitoring Parameters
Perform baseline cardiac evaluation for pre-existing valvular heart disease and pulmonary hypertension before treatment initiation. Monitor echocardiogram during therapy; weight, waist circumference, and blood pressure.
Overdosage
Symptoms: Restlessness, confusion, panic states, hallucinations, hyperreflexia, tremor, mydriasis, nausea, vomiting, abdominal cramps, diarrhoea, rapid respiration, tachycardia, hyper- or hypotension, arrhythmia, and circulatory collapse. Management: Symptomatic treatment. May perform gastric lavage or give a barbiturate to induce sedation. May consider IV phentolamine for acute severe hypertension.
Drug Interactions
May lead to arrhythmias when given with anaesthetics. May alter the drug requirement of antidiabetics (e.g. insulin). Anorectic effect may be antagonised by phenothiazines. May interfere with the effects of antihypertensive agents (e.g. guanethidine, methyldopa). Enhanced CNS effects with sedatives. Potentially Fatal: Increased risk of hypertensive crisis with MAOIs. May increase the risk of serious cardiac problems with other anorectic agents (e.g. sibutramine).
Food Interaction
Enhanced CNS effects with alcohol.
Action
Description: Mechanism of Action: Amfepramone, an amfetamine congener, is a central stimulant and indirect-acting sympathomimetic amine. Its anorectic effect appears to be secondary to CNS effects, including stimulation of the hypothalamus to release norepinephrine. Synonym(s): Diethylpropion. Pharmacokinetics: Absorption: Readily absorbed from the gastrointestinal tract. Distribution: Crosses the blood-brain barrier and placenta; enters breastmilk. Metabolism: Extensively metabolised in the liver via N-dealkylation and reduction to form active metabolites. Excretion: Via urine. Elimination half-life: Approx 4-6 hours (aminoketone metabolites).
Chemical Structure
Amfepramone Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 7029, Diethylpropion. https://pubchem.ncbi.nlm.nih.gov/compound/Diethylpropion. Accessed Jan. 30, 2025.
Storage
Store between 20-25°C. Protect from excessive heat.
A08AA03 - amfepramone ; Belongs to the class of centrally acting antiobesity products. Used in the treatment of obesity.
References
Anon. Diethylpropion Hydrochloride. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 08/10/2024.Brayfield A, Cadart C (eds). Diethylpropion Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/10/2024.Diethylpropion Hydrochloride Tablet (Chartwell RX, LLC.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 08/10/2024.Diethylpropion Hydrochloride Tablet, Extended Release (Chartwell RX, LLC.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 08/10/2024.Diethylpropion Hydrochloride Tablet, Extended Release (Lannett Company, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 08/10/2024.Diethylpropion. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 08/10/2024.