Reactions 678 - 22 Nov 1997 Recommendations for fenfluramine/dexfenfluramine users The US Department of Health and Human Services has issued interim recommendations for patients who have taken fenfluramine or dexfenfluramine. The recommendations were jointly developed by the US FDA, the Centers for Disease Control and Prevention and the National Institutes of Health, based on the current knowledge about the association of these agents with valvular heart disease. Until further information is available, the Department of Health and Human Services recommends that anyone who has taken fenfluramine or dexfenfluramine, either alone or in combination with other drugs, should undergo a physical examination to determine whether they have any signs or symptoms of heart or lung disease. An echocardiogram should then be performed in any patients who have signs or symptoms of heart or lung disease, such as a new heart murmur or shortness of breath. The Department of Health and Human Services also note that patients with valvular heart disease may have an increased risk of developing bacterial endocarditis. Thus, they recommend that an echocardiogram should be strongly considered in any patient who has taken fenfluramine or dexfenfluramine, regardless of whether there are any signs or symptoms or heart or lung disease, before the patient undergoes any invasive procedures for which the American Heart Association recommends antibacterial prophylaxis to prevent the development of bacterial endocarditis. This will determine whether or not the patient requires antibacterial prophylaxis prior to the invasive procedure. These recommendations may be updated as new information becomes available....