Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.triazolamMonitor Closely (1)triazolam increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (2)trifluoperazine, diethylpropion. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. trifluoperazine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.triprolidineMonitor Closely (1)triprolidine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.xylometazolineMonitor Closely (2)diethylpropion and xylometazoline both decrease sedation. Use Caution/Monitor. diethylpropion and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.yohimbeSerious - Use Alternative (1)yohimbe, diethylpropion. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.yohimbineMonitor Closely (2)yohimbine and diethylpropion both decrease sedation. Use Caution/Monitor. diethylpropion and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ziconotideMonitor Closely (1)ziconotide increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziprasidoneMonitor Closely (1)ziprasidone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. 1-10% Increased blood pressure Palpitations Rash Urticaria Constipation Nausea Stomach cramps Vomiting Xerostomia Central nervous system stimulation Dizziness Headache Insomnia Pain Blurred vision Mydriasis Restlessness Menstrual irregularity Impotence, changes in libido <1% Cardiac dysrhythmia Cardiomyopathy Agranulocytosis Leukopenia Cerebral ischemia Cerebrovascular accident Psychotic disorder (rare) Primary pulmonary hypertension Drug dependence (rare) Contraindications Advanced arteriosclerosis Hyperthyroidism Severe hypertension Pulmonary hypertension Hypersensitivity to sympathomimetic amines Glaucoma Agitated state History of drug abuse Pregnancy (especially first trimester) Within 14 days of MAOI Concurrent use with other anorectic agents Cautions Therapy may impair ability of patient to engage in potentially hazardous activities such as operating machinery or driving motor vehicle; the patient should be cautioned accordingly Prolonged use may induce dependence with withdrawal syndrome on cessation of therapy Hallucinations have occurred rarely following high doses of the drug Several cases of toxic psychosis reported following excessive use of drug; some have been reported in which recommended dose appears not to have been exceeded; new onset of mania may occur with stimulant use; ovserve for symptoms of aggression and/or hostility; psychosis has been abated after drug discontinued When central nervous system active agents used, consideration must always be given to possibility of adverse interactions with alcohol Reports suggest the drug may increase convulsions in some patients with seizure disorders; therapy should be carefully monitored; titration of dose or discontinuance of therapy may be necessary Stimulants may unmask tics in Tourette’s syndrome; use with caution Use caution in patients with diabetes mellitus; requirements of antidiabetic agents may be altered with anorexiants and concomitant dietary restrictions Pulmonary hypertension Use of anorectic agents, including diethylpropion, associated with increased risk of developing pulmonary hypertension, a rare, but often fatal disorder; use of anorectic agents for > 3 months associated with 23-fold increase in risk of developing pulmonary hypertension; increased risk of pulmonary hypertension with repeated courses of therapy cannot be excluded Onset or aggravation of exertional dyspnea, or unexplained symptoms of angina pectoris, syncope, or lower extremity edema suggest possibility of occurrence of pulmonary hypertension; if patient develops these symptoms discontinue therapy, and evaluate patient for pulmonary hypertension Valvular heart disease Valvular heart disease associated with use of some anorectic agents reported; possible contributing factors include use for extended periods of time, higher than recommended dose, and/or use in combination with other anorectic drugs Valvulopathy has been very rarely reported with monotherapy; potential risk of possible serious adverse effects such as valvular heart disease and pulmonary hypertension should be assessed carefully against potential benefit of weight loss; consider baseline cardiac evaluation to detect preexisting valvular heart diseases or pulmonary hypertension prior to initiation of treatment Therapy not recommended in patients with known heart murmur or valvular heart disease; echocardiogram during and after treatment could be useful for detecting any valvular disorders which may occur To limit unwarranted exposure and risks, treatment should be continued only if patient has satisfactory weight loss within first 4 weeks of treatment (eg, weight loss of at least 4 pounds, or as determined by physician and patient); therapy not recommended for patients who used any anorectic agents within prior year If tolerance develops, do not exceed recommended dose in attempt to increase effect; discontinue drug instead Pregnancy Category: B Lactation: Excreted in breast milk, use cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Amphetamine-related anorexigenic agent; action in reducing apetite may be secondary to CNS effects that may involve stimulation of hypothalamus to release norepinephrine Pharmacokinetics Metabolism: Undergoes reduction and N-dealkylation to form active metabolites Duration: 4 hr Half-life elimination: 4-6 hr (aminoketone metabolites) Excretion: primarily urine (>75%) BRAND FORM. UNIT PRICE PILL IMAGE diethylpropion oral- 25 mg tabletdiethylpropion oral- 25 mg tabletdiethylpropion oral- 75 mg tabletCopyright © 2010 First DataBank, Inc.Print Patient Educationdiethylpropion oral DIETHYLPROPION - ORAL (dye-ETH-il-PROE-pee-on) COMMON BRAND NAME(S): Tenuate USES: Diethylpropion is used along with a doctor-approved, reduced-calorie diet, exercise, and behavior change program to help you lose weight. It is used in people who are significantly overweight (obese) and have not been able to lose enough weight with diet and exercise alone. Losing weight and keeping it off can reduce the many health risks that come with obesity, including heart disease, diabetes, high blood pressure, and a shorter life.It is not known how this medication helps people to lose weight. It may work by decreasing your appetite, increasing the amount of energy used by your body, or by affecting certain parts of the brain. This medication is an appetite suppressant and belongs to a class of drugs called sympathomimetic amines. HOW TO USE: Take the immediate-release form of this medication by mouth as directed by your doctor, usually 3 times a day (1 hour before meals). If late-night eating is a problem, your doctor may direct you to take another dose in the evening. Taking this medication late in the day may cause trouble sleeping (insomnia).The extended-release form of diethylpropion is usually taken once a day in the mid-morning. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Swallow the tablets whole.The dosage is based on your medical condition and response to therapy. Your doctor will adjust the dose to find the best dose for you. Use this medication regularly and exactly as prescribed in order to get the most benefit from it. To help you remember, take it at the same time(s) each day.Diethylpropion is usually taken for only a few weeks at a time. It should not be taken with other appetite suppressants (see also Drug Interaction section). The possibility of serious side effects increases with longer use of this medication and use of this drug along with certain other diet drugs.If you suddenly stop using this medication, you may have withdrawal symptoms (such as depression, severe tiredness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used diethylpropion for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Do not increase your dose, take it more often, or use it for a longer time than prescribed. Properly stop the medication when so directed.You should see some weight loss soon after you start this medication. Tell your doctor if you do not see at least 4 pounds of weight loss within 4 weeks of starting this medication. This medication may stop working well after you have been taking it for a while. Talk with your doctor if this medication stops working well. Do not increase the dose unless directed by your doctor. Your doctor may direct you to stop taking this medication. SIDE EFFECTS: Dizziness, dry mouth, difficulty sleeping, irritability, nausea, vomiting, diarrhea, or constipation may occur. If these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: fast/irregular/pounding heartbeat, mental/mood changes (such as agitation, uncontrolled anger, hallucinations, nervousness), uncontrolled muscle movements, change in sexual ability/interest.Get medical help right away if you have any very serious side effects, including: severe headache, trouble speaking, seizure, weakness on one side of the body, vision changes (such as blurred vision).This drug may rarely cause serious (sometimes fatal) lung or heart problems (pulmonary hypertension, heart valve problems). The risk increases with longer use of this medication and use of this drug along with other appetite-suppressant drugs/herbal products. If you notice any of the following serious side effects, stop taking this medication and consult your doctor or pharmacist right away: chest pain, difficulty breathing with exercise, decreased ability to exercise, fainting, swelling of the legs/ankles/feet.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking diethylpropion, tell your doctor or pharmacist if you are allergic to it; or to any other sympathomimetic amines (for example, decongestants such as pseudoephedrine, stimulants such as amphetamine, appetite suppressants such as phentermine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, glaucoma, high blood pressure, high blood pressure in the lungs (pulmonary hypertension), heart problems (such as fast/irregular heartbeat, heart valve problems, previous heart attack), kidney disease, mental/mood problems (such as anxiety, bipolar disorder, psychosis, schizophrenia), seizure, stroke, overactive thyroid (hyperthyroidism), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol).This drug may make you dizzy or blur your vision. It may also rarely make you drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).If you have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication during treatment