Diethylpropion (Anorex) is a stimulant drug that causes decreases appetite via central mechanisms. It is used for the short-term treatment of exogenous obesity.

Diethylpropion Uses:

• Obesity:
  • It is indicated for the short-term treatment of obesity as an adjunct to diet and exercise.
• Weight loss treatment is indicated in patients who have a body mass index of 30 kg/m² or more or 27 kg/m² or more in the presence of other metabolic risk factors like hypertension, diabetes, and/or dyslipidemia or a high waist circumference.
• Weight loss treatment must be used in conjunction with a comprehensive weight management program.

Diethylpropion (Anorex) Dose in Adults:

Diethylpropion (Anorex) Dose in the treatment of Obesity: Oral:

• Immediate release:
  • 25 mg thrice daily or four times a day.
• Controlled release:
  • 75 mg once a day.

Use in Children:

Refer to adults dosing.   

Pregnancy Risk Factor B

• It can also cross the placental boundary. Animal reproduction studies have not shown any adverse events.
• After the mother has given the drug, withdrawal symptoms may occur in neonates.

Diethylpropion use during breastfeeding:

• It can be excreted from breast milk. It is recommended that it be used with caution by lactating mothers.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer's labeling. It should be used with caution.   

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling.   

Side effects of Diethylpropion (Anorex):

• Cardiovascular:
  • Cardiac Arrhythmia
  • Cerebrovascular Accident
  • ECG Changes
  • Heart Valve Disease
  • Hypertension
  • Palpitations
  • Tachycardia
• Central Nervous System:
  • Anxiety
  • Depression
  • Dizziness
  • Drowsiness
  • Dysphoria
  • Euphoria
  • Headache
  • Insomnia
  • Jitteriness
  • Malaise
  • Nervousness
  • Overstimulation
  • Precordial Pain
  • Psychosis
  • Restlessness
  • Seizure
• Dermatologic:
  • Alopecia
  • Diaphoresis
  • Ecchymoses
  • Erythema
  • Skin Rash
  • Urticaria
• Endocrine & Metabolic:
  • Changes In Libido
  • Gynecomastia
  • Menstrual Disease
• Gastrointestinal:
  • Abdominal Distress
  • Constipation
  • Diarrhea
  • Dysgeusia
  • Nausea
  • Vomiting
  • Xerostomia
• Genitourinary:
  • Dysuria
  • Impotence
• Hematologic & Oncologic:
  • Agranulocytosis
  • Bone Marrow Depression
  • Leukopenia
• Neuromuscular & Skeletal:
  • Dyskinesia
  • Myalgia
  • Tremor
• Ophthalmic:
  • Blurred Vision
  • Mydriasis
• Renal:
  • Polyuria
• Respiratory:
  • Dyspnea
  • Pulmonary Hypertension
• Miscellaneous:
  • Tachyphylaxis

Contraindications to Diethylpropion (Anorex):

• Allergies or idiosyncrasies to diethylpropion and other sympathomimetic antiamines
• Advanced arteriosclerosis
• Hypertension severe
• Hypertension in the lungs
• Hyperthyroidism
• Glaucoma
• History of drug abuse and agitated states
• Within 14 days of MAO inhibitor therapy.
• Use with other anorectic drugs concurrently

Warnings and precautions

• CNS effects
  • Stimulant drugs and amphetamines can affect thought and decision making.
  • The drug should be used with caution by patients who use heavy machinery or are driving.
• Heart failure:
  • Patients with heart disease should avoid the drug as it has been shown to cause myocardial toxicity.
• Primary pulmonary hypertension (PPH).
  • Patients who are taking anorexigenic drugs have a high risk of developing primary hypertension. 
  • This condition can lead to death. The risk of developing pulmonary hypertension may be 23 times higher if these medicines are used for more than three months.
  • If the patient experiences pulmonary hypertension, such as angina, exertional dyspnea or syncope, the treatment should be stopped immediately.
• Heart disease of the valvular kind:
  • Patients on anorexigenic medications are at high risk for developing valvular diseases. 
  • Patients who take high doses of anorexigenic drugs for prolonged periods of time or with concomitant use other anorexigenic medications are at greater risk.
  • Patients with severe structural heart conditions such as rhythm abnormalities or cardiomyopathy should avoid stimulant drugs.
• Diabetes:
  • Patients with diabetes should be cautious when taking the drug. 
  • Diabetes patients may experience an increase in blood sugar levels if they take drugs that alter their appetite. Hypoglycemia episodes should be closely monitored.
• Hypertension:
  • Hypertension patients and those with heart disease should not use it. It can cause elevation of blood pressure and heart rate, and worsen angina.
• Psychiatric disorders
  • Patients suffering from mania, bipolar disorder, and preexisting psychosis are advised to avoid stimulant drugs. They may experience manic episodes.
  • Patients without a history of schizophrenia or mania may experience a new-onset. Be on the lookout for signs of aggression or behavioral changes in patients.
  • Psychotic patients can experience a worsening psychosis or develop thought and behavioral disorders.
• Seizure disorders:
  • Patients with seizures should use it with caution.
• Tourette's syndrome
  • Stimulant drugs may unmask tics. Tourette's patients should be cautious about taking stimulant drugs.

Diethylpropion: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring parameters:

• Cardiac evaluation is required before treatment initiation for preexisting valvular heart disease and pulmonary hypertension.
• An echocardiogram should be performed at regular intervals during the treatment.
• Monitor weight, BMI, waist circumference, and blood pressure.
• Monitor renal functions in elderly patients.

How to administer Diethylpropion (Anorex)?

Immediate release:

• It should be administered before meals (at least one hour before meals). One tablet may be administered in the midevening in patients who develop night hunger.

Controlled release:

• The tablets should be swallowed whole without chewing or crushing. Administer at midmorning.

Mechanism of action of Diethylpropion (Anorex):

• It is a sympathomimetic drug with properties similar to amphetamines and has a structural similarity to bupropion.
• It is unknown what the exact mechanism of action works. 
• It may act through the centra pathways, stimulating the hypothalamus to release norepinephrine.
• This causes a loss of appetite.

Metabolism:

• It is metabolized by N-dealkylation, and reduced to its active metabolites.

Half-life elimination:

• Aminoketone metabolites: About 4-6 hours

Excretion:

• Urine

International Brand Names of Diethylpropion:

• Anorex
• Apisate
• Atractil
• Bonumin
• Delgamer
• Dietil Retard
• Dietil-retard
• Dipion
• Dobesin
• Linea
• Lipomin
• Moderatan
• Nulobes
• Prefamone
• Prefamone Chronule
• Prothin
• Regenon
• Regenon Retard
• Tenuate
• Tenuate Dospan

Diethylpropion Brand Names in Pakistan:

No Brands Available in Pakistan.