FENFLURAMINE
It is an approved serotonin-releasing medication used to treat seizures in particular epilepsy conditions.
What is Fenfluramine used for?
- Dravet syndrome associated seizures
- Lennox- Gastaut syndrome associated seizures
What is Fenfluramine available as?
- Oral solution. (as of August 2025; It is imported to India, very expensive and difficult to get it)
How much time does Fenfluramine take to act?
Fenfluramine typically starts to show its effects within a few hours of taking it. In the context of its medical use for conditions like seizures in Dravet syndrome (a rare form of epilepsy), it may take a few weeks to observe significant improvements in seizure control.
What should I do if I missed taking the dose of Fenfluramine?
You can take it as soon as you remember, and if you have missed more than 2 doses you should peak to your doctor. NEVER GIVE A DOUBLE DOSE OF FENFLURAMINE.How should Fenfluramine be taken or administered?
Oral liquid: Use the measuring tool which is provided to measure the oral liquid. do not use a kitchen spoon. Blend the liquid with juices, water, or semi-solid foods like puddings or applesauce. Swallow this mixture right away.When Should I take Fenfluramine?
Fenfluramine can generally be taken before or after food, depending on how your body reacts to it. If you are experiencing any stomach discomfort or nausea, taking it after food might help.
Could there be negative outcomes from this medication?
Medications have benefits and rare side effects. Stay alert to react quickly if needed. Most people tolerate them well, but serious reactions can occur. If your symptoms are severe, get medical attention right once. This ensures safe, effective treatment.
Side effects (adverse drug reactions) of Fenfluramine:
- Gut issues: Loss of appetite, nausea, vomiting, diarrhoea, constipation, low blood sugar, reduced saliva, drooling.
- Nervous system: Fatigue, drowsiness, weakness, sluggishness, mood changes, balance issues, tremors, headaches, dizziness, insomnia, poor focus, fast heart rate.
- Respiratory & Infections: Colds, sore throat, cough, runny nose, bronchitis, ear infections.
- Skin & Appearance: Rashes, eczema, sweating, drooling, skin irritation.
- Metabolic & Other: Weight loss, dehydration, high blood pressure, abnormal heart tests, hormone changes (e.g., prolactin).
- Behavioural & Emotional: Agitation, irritability, low activity, unusual behaviours, anxiety, emotional issues.
- Other: Urinary issues, muscle swelling or stiffness, fever.
Is it okay to use other common medications alongside Fenfluramine?
When taking Fenfluramine, it is important to be cautious about potential drug interactions with other medications. Some medications may interact with fenfluramine, that could either reduce its effectiveness or increase the risk of side effects.
Antidepressants (SSRIs, SNRIs): Antidepressants can interact with fenfluramine, leading to serotonin syndrome, a rare but serious condition.
Anticonvulsants: Some other medications for epilepsy or seizure disorders might affect how Fenfluramine works, or vice versa.
Which foods should I stay away from when taking Fenfluramine?
While taking Fenfluramine, there aren’t typically strict food restrictions, but there are some general guidelines to keep in mind to help avoid potential side effects or interactions:
- High-fat or high-sugar foods: Fenfluramine can affect appetite and metabolism and pairing it with unhealthy foods might counteract some of its intended effects. Eating a balanced diet with whole foods is always a good idea when managing any medication.
- Caffeine: Since fenfluramine can have stimulating effects, combining it with too much caffeine (from coffee, energy drinks, etc.) could increase the risk of side effects like anxiety, increased heart rate, or restlessness.
- Alcohol: Alcohol can exacerbate some of the side effects of fenfluramine, including drowsiness, dizziness, or impaired coordination. HENCE AVOID
- Salty foods: If you have any risk factors for high blood pressure or heart conditions, it’s wise to avoid excess sodium in your diet, as fenfluramine may have effects on your cardiovascular system
- Grapefruit: Some medications interact with grapefruit and may affect how the drug is processed by the body, although fenfluramine specifically doesn’t have a major grapefruit interaction. Still, it’s a good practice to check with your healthcare provider if you have any concerns.
PREGNANCY AND LACTATION:
Care should be used when using Fenfluramine during pregnancy and lactation. To carefully consider the possible advantages and hazards for the mother and the unborn child during these times, it is crucial to speak with a healthcare professional.
What potential risks could arise if pregnancy occurs during ongoing treatment with Fenfluramine?
Yes, there are some risks to consider if you are thinking about becoming pregnant while taking fenfluramine.
Where should I store Fenfluramine?
Fenfluramine should be stored at room temperature, between 20°C to 25°C. In india store in a cool cupboard, where there is no direct sunlight like near windows. Do not refrigerate or freeze
Monitoring parameters of Felbamate:
- Echocardiogram to examine for valvular heart disease and pulmonary arterial hypertension.
- Body weight.
- Blood pressure.
- Serotonin syndrome signs and indicators, include changes in mental state.
How can I deal with Fenfluramine side effects?
- Dizziness: Utilize sturdy furniture for support, and refrain from operating machinery or driving until the issue is resolved.
- Fatigue: Light exercise and short daytime naps can help improve energy levels and reduce tiredness.
- Heart rhythm and severe allergic reactions: Immediately seek medical attention if you have chest pain, breathing difficulties, light-headedness, or changes in your heartbeat.
- Suicidal thoughts: Get in touch with your doctor if you notice any changes in your mood or thinking while taking Fenfluramine.
However, talk to your doctor if you find it difficult to perform daily day activities due to the side effects of medications.
SUMMARY
Fenfluramine is a medication primarily used to treat Dravet syndrome, a severe form of epilepsy in children, by affecting brain chemicals to control seizures. It should generally be avoided during pregnancy due to potential risks and it is important to consult your doctor if you’re breastfeeding. Fatigue, sleeplessness, diarrhoea, sleepiness, and decreased appetite are typical adverse effects. There may also be a rare risk of heart valve problems. Only under a doctor’s supervision should it be used, especially during pregnancy and lactation.
Let us know If this was useful!
Author:
- Dr Ramya. R, Pharm D, Clinical pharmacologist, Aster Hospitals, Bengaluru
- Dr Praveen Kumar, B. Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru.
- Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital.
