DIETHYLPROPION HYDROCHLORIDE

(dye-eth-il-proe'pee-on)

Nobesine

, Propion, Ten-Tab, Tenuate, Tenuate Dospan, Tepanil
Classifications: anorexiant;
Therapeutic: anorexiant
Pregnancy Category: B
Controlled Substance: Schedule IV

Availability

25 mg tablets; 75 mg sustained release tablets

Action

Sympathomimetic amine chemically related to amphetamine. Has lower incidence of amphetamine-type adverse effects but reportedly is less effective as an appetite suppressant. Anorexigenic action probably secondary to direct (CNS) stimulation of appetite control center in hypothalamus and limbic regions. Also produces mild psychic stimulation and vasopressor effects.

Therapeutic Effect

Suppresses appetite as a result of drug action on CNS appetite control center.

Uses

Used solely in management of exogenous obesity as short-term (a few weeks) adjunct in a regimen of weight reduction based on caloric restriction.

Contraindications

Known hypersensitivity or idiosyncrasy to sympathomimetic amines; severe hypertension, advanced arteriosclerosis, valvular heart disease; hyperthyroidism; glaucoma; history of drug abuse; anorexia nervosa; symptomatic cardiovascular disease, arrhythmias; MAOI therapy; pulmonary hypertension; children <6 y.

Cautious Use

Hypertension, psychosis, mania, agitated states, epilepsy; diabetes mellitus; elderly, renal failure or impairment; seizure disorder; pregnancy (category B), lactation.

Route & Dosage

Obesity
Adult: PO 25 mg t.i.d. 30–60 min a.c. or 75 mg sustained release q.d. midmorning

Administration

Oral

Give on an empty stomach, ?–1 h before meals.
Note: Additional dose sometimes prescribed in midevening to control nighttime hunger. Rarely causes insomnia except in high doses.
Titrate dosage carefully in patients with diabetes.
Store between 15°–30° C (59°–86° F) in well-closed container unless otherwise specified.

Adverse Effects (≥1%)

Body as a Whole: Hypersensitivity (urticaria, rash, erythema); muscle pain, dyspnea, hair loss, blurred vision, severe dermatoses (chronic intoxication), increased sweating. CNS: Mild euphoria, restlessness, nervousness, dizziness, headache, irritability, hyperactivity, insomnia, drowsiness, mood changes, lethargy, increase in convulsive episodes in patients with epilepsy. CV: Palpitation, tachycardia, precordial pain, rise in BP. GI: Nausea, vomiting, diarrhea, constipation, dry mouth, unpleasant taste. Urogenital: Impotence, changes in libido, gynecomastia, menstrual irregularities; polyuria, dysuria.

Interactions

Drug: Acetazolamide, sodium bicarbonate decreases diethylpropion elimination; ammonium chloride, ascorbic acid increases diethylpropion elimination; a barbiturate and diethylpropion taken together may antagonize the effects of both drugs; furazolidone may increase blood pressure effects of amphetamines, and interaction may persist for several weeks after discontinuation of furazolidone; guanethidine antagonizes antihypertensive effects; mao inhibitors, selegiline can cause hypertensive crisis (fatalities reported)—amphetamines should not be administered at the same time as or within 14 days of these drugs; phenothiazines may inhibit mood elevating effects of amphetamines; tricyclic antidepressants enhance amphetamines' effects by increasing norepinephrine release; beta agonists increase cardiovascular adverse effects.

Pharmacokinetics

Absorption: Readily from GI tract. Duration: 4 h, regular tablets; 10–14 h, sustained release. Elimination: In urine. Half-Life: 4–6 h.

Nursing Implications

Assessment & Drug Effects

Observe patients with epilepsy closely for reduction in seizure control.
Anorexigenic effect seldom lasts more than a few weeks. Discontinue if tolerance develops.
Note: Varying degrees of psychologic and rarely physical dependence can occur.

Patient & Family Education

Swallow sustained release tablets whole; do NOT chew.
Do not drive or engage in other potentially hazardous activities until reaction to drug is known.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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