Interactions between Fenfluramine and Suflave

Fenfluramine has a moderate potential interaction with Alcoholism.

Fenfluramine can cause somnolence, sedation, and lethargy. Central nervous system depressants, including alcohol, could potentiate these effects. Exercise caution when using this agent in alcoholic patients or those at risk of sedation. Close monitoring is advised. Advise patients not to drive or operate machinery until they know how this drug will affect them.

The polyethylene glycol 3350 with electrolytes in Suflave has a moderate potential interaction with Dehydration.

Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.

Fenfluramine has a major potential interaction with Depression.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Fenfluramine has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

The polyethylene glycol 3350 with electrolytes in Suflave has a moderate potential interaction with Esophageal Obstruction.

Patients with impaired gag reflex, unconscious or semi-conscious patients, and patients prone to regurgitation or aspiration should be administered polyethylene glycol (PEG) electrolyte solutions cautiously. Patients experiencing severe bloating, distention or abdominal pain may need to receive PEG electrolyte solutions at a slower rate.

Fenfluramine has a moderate potential interaction with Failure to Thrive.

Fenfluramine can cause decreases in appetite and weight. Exercise care when using this agent in patients at risk of decreased appetite or weight. It is recommended to monitor the growth of pediatric patients carefully. Weight should be monitored regularly during treatment, and dose modifications should be considered if a decrease in weight is observed.

The polyethylene glycol 3350 with electrolytes in Suflave has a major potential interaction with Gastrointestinal Obstruction.

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

The polyethylene glycol 3350 with electrolytes in Suflave has a major potential interaction with Gastrointestinal Obstruction.

The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.

The polyethylene glycol 3350 with electrolytes in Suflave has a major potential interaction with Gastrointestinal Perforation.

The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.

The polyethylene glycol 3350 with electrolytes in Suflave has a moderate potential interaction with Heart Disease.

The use of ionic osmotic laxative products for bowel preparation has been associated with rare reports of serious arrhythmias. Use caution when prescribing PEG electrolyte solutions in patients at increased risk of arrhythmias (e.g., patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, or cardiomyopathy). Clinical monitoring of cardiovascular status is recommended prior to, during, and after therapy.

Fenfluramine has a moderate potential interaction with High Blood Pressure.

Fenfluramine can cause an increase in blood pressure. Exercise care when using this agent in hypertensive patients. It is recommended to monitor blood pressure in patients treated with fenfluramine.

The polyethylene glycol 3350 with electrolytes in Suflave has a moderate potential interaction with Hyponatremia.

PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.

The polyethylene glycol 3350 with electrolytes in Suflave has a major potential interaction with Inflammatory Bowel Disease.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

Fenfluramine has a moderate potential interaction with Liver Disease.

Fenfluramine is primarily metabolized to norfenfluramine in the liver. The maximum daily dosage of 20 mg per day should not be exceeded in patients with mild and moderate liver dysfunction. Patients with severe liver dysfunction should not exceed 17 mg per day. The manufacturer prescribing information should be consulted for dose adjustment information of fenfluramine with other concomitant antiepileptic drugs.

Fenfluramine has a moderate potential interaction with Malnourishment.

Fenfluramine can cause decreases in appetite and weight. Exercise care when using this agent in patients at risk of decreased appetite or weight. It is recommended to monitor the growth of pediatric patients carefully. Weight should be monitored regularly during treatment, and dose modifications should be considered if a decrease in weight is observed.

Fenfluramine has a major potential interaction with Psychosis.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Fenfluramine has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Fenfluramine has a major potential interaction with Pulmonary Arterial Hypertension.

Serotonergic drugs with 5-HT2B receptor agonist activity, including fenfluramine, have been associated with pulmonary arterial hypertension. Exercise care when using this agent in patients with pulmonary disease. Cardiac monitoring is required before starting, during, and after treatment. Cardiac monitoring via echocardiogram can identify evidence of pulmonary arterial hypertension. If pulmonary arterial hypertension is observed on an echocardiogram, the prescriber must consider the benefits versus the risks of initiating or continuing treatment. Echocardiograms should be repeated every six months, and once 3-6 months posttreatment.

Fenfluramine has a moderate potential interaction with Renal Dysfunction.

Fenfluramine has not been studied in patients with end-stage renal disease (eGFR less than 15 mL/min/1.73 m2). In patients with severe renal dysfunction (eGFR 15 to 29 mL/min/1.73 m2) the maximum daily dosage of 20 mg per day should not be exceeded (17 mg per day if concomitant stiripentol is used). No dose adjustments are required for patients with mild and moderate renal dysfunction.

The polyethylene glycol 3350 with electrolytes in Suflave has a moderate potential interaction with Renal Dysfunction.

Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.

The polyethylene glycol 3350 with electrolytes in Suflave has a moderate potential interaction with Seizures.

PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.

The polyethylene glycol 3350 with electrolytes in Suflave has a major potential interaction with Ulcerative Colitis.

The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.

Fenfluramine has a major potential interaction with Valvular Heart Disease.

Serotonergic drugs with 5-HT2B receptor agonist activity, including fenfluramine have been associated with valvular heart disease. Exercise care when using this agent in patients with cardiac disease. Cardiac monitoring is required prior to starting, during, and after treatment. If valvular heart disease is observed on an echocardiogram, the prescriber must consider the benefits versus the risks of initiating or continuing treatment. Echocardiograms should be repeated every six months, and once 3-6 months posttreatment.

Fenfluramine has a moderate potential interaction with Visual Defect/Disturbance.

Fenfluramine can cause mydriasis and can precipitate angle-closure glaucoma. Exercise care when using this agent in patients with visual disturbances. Consider discontinuing treatment in patients with acute decrease in visual acuity or ocular pain.