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Tepanil (Diethylpropion Hydrochloride) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Drug Interactions:

Antidiabetic drug requirements, i.e., insulin, may be altered in association with the use of Diethylpropion hydrochloride and the concomitant dietary regimen. Concurrent use with general anesthetics may result in arrhythmias. The presser effects of diethylpropion and those of other drugs may be additive when the drugs are used concomitantly; conversely, diethylpropion may interfere with antihypertensive drugs, i.e., guanethidine, a-methyldopa. Concurrent use of phenothiazines may antagonize the anorectic effect of diethylpropion.

OVERDOSAGE

The reported oral LD50, for diethylpropion hydrochloride in mice is 620 mg/kg. In rats 250 mg/kg and in dogs 225 mg/kg.

Symptoms:

Manifestations of acute overdosage include restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, panic states.

Fatigue and depression usually follow the central stimulation.

Cardiovascular effects include arrhythmias, hypertension or hypotension, and circulatory collapse. Gastrointestinal symptoms include nausea, vomiting, diarrhea, and abdominal cramps. Overdose of pharmacologically similar compounds has resulted in fatal poisoning, usually terminating in convulsions and coma.

Treatment:

Management of acute Diethylpropion hydrochloride intoxication is largely symptomatic and includes lavage and sedation with a barbiturate. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendation in this regard: Intravenous phentolamine (Regitine®) has been suggested on pharmacologic grounds for possible acute, severe hypertension. If this complicates diethylpropion hydrochloride overdosage.

CONTRAINDICATIONS

Diethylpropion hydrochloride should not be used in patients with advanced arteriosclerosis, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines, glaucoma, severe hypertension, a history of drug abuse, or those in an agitated state (see PRECAUTIONS).

Diethylpropion hydrochloride should not be given during, or within fourteen days following, the administration of monoamine oxidase inhibitors; hypertensive crises may result.

DRUG ABUSE AND DEPENDENCE:

Controlled Substance:

Diethylpropion is a schedule IV controlled substance.

Abuse:

Diethylpropion has some chemical and pharmacologic similarities to the amphetamines and other related stimulant drugs that have been extensively abused. The possibility of abuse should be kept in mind when evaluating the desirability of including a drug as part of a weight reduction program. Abuse of amphetamines and related drugs may be associated with varying degrees of psychologic dependence and social dysfunction which, in the case of certain drugs, may be severe. There are reports of patients who have increased the dosage to many times that recommended.

Dependence:

There have been reports of subjects becoming psychologically dependent on diethylpropion. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. Manifestations of chronic intoxication with anorectic drugs include severe dermatoses, marked insomnia, irritability, hyperactivity, and personality changes. The most severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia.

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