From the Guidelines
Phentermine should be avoided in patients with mitral valve prolapse due to its potential to increase heart rate and blood pressure, which could worsen symptoms. When considering the use of phentermine in patients with mitral valve prolapse, it is essential to weigh the potential benefits against the risks. According to the AGA clinical practice guideline on pharmacological interventions for adults with obesity 1, phentermine monotherapy is approved by the FDA for short-term use (12 weeks), but it should be avoided in patients with a history of cardiovascular disease. Mitral valve prolapse is a condition that affects the heart, and patients with this condition may be more susceptible to the cardiovascular effects of phentermine. Some key points to consider when evaluating the use of phentermine in patients with mitral valve prolapse include:
- The potential for phentermine to increase heart rate and blood pressure, which could exacerbate symptoms in patients with mitral valve prolapse 1
- The need for regular cardiac monitoring, including blood pressure checks and possibly echocardiograms, to assess valve function in patients taking phentermine 1
- The potential for alternative weight loss approaches, such as lifestyle modifications or non-stimulant medications, to be safer options for patients with mitral valve prolapse In light of these considerations, the use of phentermine in patients with mitral valve prolapse is not recommended due to the potential risks to cardiovascular health. Instead, alternative weight loss approaches that do not involve the use of stimulant medications like phentermine may be a safer and more effective option for these patients.
From the FDA Drug Label
5.3 Valvular Heart Disease Serious regurgitant cardiac valvular disease, primarily affecting the mitral, aortic and/or tricuspid valves, has been reported in otherwise healthy persons who had taken a combination of phentermine with fenfluramine or dexfenfluramine for weight loss The possible role of phentermine in the etiology of these valvulopathies has not been established and their course in individuals after the drugs are stopped is not known. The possibility of an association between valvular heart disease and the use of phentermine alone cannot be ruled out; there have been rare cases of valvular heart disease in patients who reportedly have taken phentermine alone.
The use of phentermine in patients with mitral valve prolapse is not directly addressed in the label. However, the label does mention that valvular heart disease, including mitral valve issues, has been reported in patients taking phentermine, especially in combination with other weight loss drugs.
- Key points:
- Phentermine may be associated with an increased risk of valvular heart disease.
- The label does not provide specific guidance on the use of phentermine in patients with mitral valve prolapse.
- Given the potential risks, it is recommended to exercise caution when considering the use of phentermine in patients with mitral valve prolapse 2.
From the Research
Mitral Valve Prolapse and Phentermine
- There are no direct studies on the use of phentermine with mitral valve prolapse 3, 4, 5, 6, 7.
- Mitral valve prolapse is a condition where the mitral valve does not close properly, causing blood to flow backward into the heart 3.
- The use of phentermine, an appetite suppressant, is not mentioned in the provided studies as a treatment or interaction with mitral valve prolapse.
Exercise and Mitral Valve Prolapse
- Studies suggest that aerobic exercise can be beneficial for patients with mitral valve prolapse, improving symptoms and quality of life 5, 6.
- However, high-intensity exercise may be contraindicated in patients with certain markers of increased arrhythmic risk 6.