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Table 1 List of anti-obesity drugs withdrawn from the market because of adverse drug reactions

From: Post-marketing withdrawal of anti-obesity medicinal products because of adverse drug reactions: a systematic review

Medicinal product Primary mechanism of action Therapeutic indication Launch date Year of first ADR report Year first withdrawn Countries withdrawn Primary reason for withdrawal Level of evidencea
Amfepramone (diethylpropion)b SNDRA Obesity 1957 1974 1975 Turkey, Sweden, Oman, UAE, Norway, Venezuela, EU, France, UK, Brazil Cardiotoxicity 4
Amphetamine SNDRA Obesity, narcolepsy 1939 1957 1973 USA, UAE, Turkey, Oman, Malaysia, Nigeria Drug abuse and dependence 4
Aminorex fumaratec SRI Obesity 1962 1967 1967 Germany, Venezuela, Switzerland, Austria Cardiotoxicity 4
Benfluorexc SRI Obesity, diabetes 1976 2003 2009 Europe Cardiotoxicity 3
Chlorphentermine SRI Obesity 1962   1969 Germany, Venezuela Cardiotoxicity 5
Clobenzorex SNDRA Obesity 1966 1986 2000 Mauritius, USA, Oman Drug abuse, psychiatric 4
Cloforex SRI Obesity 1965 1967 1967 Germany, Sweden, Venezuela Cardiotoxicity 4
Cyclovalone + retinol + tiratricol Bile acid secretion Hyperlipidemia, dyspepsia, obesity 1964 1984 1988 France Liver toxicity 4
Dexfenfluramine SRI Obesity 1995 1995 1997 Worldwide Cardiotoxicity 4
Fenbutrazate NDRA Obesity 1957 1963 1969 Europe Drug abuse, psychiatric 2
Fenfluraminec SRI Obesity 1973 1981 1997 Worldwide Cardiotoxicity 3
Fenproporex (perphoxene) NRA Obesity, narcolepsy, ADHD 1966 1997 1999 Europe, Brazil Drug abuse, psychiatric 4
Iodinated casein strophanthin Thyroxine analogue Obesity 1944 1964 1964 USA Endocrine, metabolism 4
Levamphetamine SNDRA Obesity 1944 1954 1973 USA, Oman, UAE Drug abuse and dependence 4
Mazindol NRDA Obesity 1970 1980 1987 Oman, Brazil Drug abuse, psychiatric (interaction with lithium) 4
Mefenorex (methylphenethylamine) SNDRA Obesity 1966 1995 1999 Europe, Oman Drug abuse, psychiatric 4
Methamphetamine (desoxyephedrine)c SNDRA ADHD, obesity 1944 1971 1973 USA, Turkey, Oman, Nigeria Drug abuse, drug dependence 4
Phendimetrazine NDRA   1961 1979 1982 Turkey Drug abuse 4
Phenmetrazine NDRA Obesity 1956 1959 1982 Turkey, Oman, Nigeria Drug abuse 4
Phentermineb,c NDRA Obesity 1959 1964 1981 Sweden, UAE, Mauritius, Turkey, Oman, UK, Venezuela Drug abuse 4
Phenylpropanolamine (norpseudoephedrine) NDRA Nasal decongestion, obesity 1947 1985 1987 Germany, Brazil, Malaysia, Singapore, USA, Oman, Canada, Cuba, India Hemorrhagic stroke 4
Pipradrol NDRI Obesity, narcolepsy, ADHD 1953 1968 1982 USA, Turkey, Denmark, Venezuela Drug abuse 4
Pyrovalerone NDRA Obesity, chronic fatigue syndrome 1974 1975 1979 France Drug abuse 4
Rimonabantc CB1 antagonist/inverse agonist Obesity 2006 2006 2007 Europe, India Psychiatric 1
Sibutraminec SNRI Obesity 2001 2002 2002 EU; 4 Asian countries; Australia; Canada; Mexico; New Zealand; USA Cardiotoxicity, psychiatric 4
  1. ADHD attention deficit hyperactivity disorder, ADR adverse drug reaction, CB 1 cannabinoid 1 (receptors), EU European Union, NRA norepinephrine releasing agent, NDRA norepinephrine-dopamine releasing agent, NDRI norepinephrine-dopamine re-uptake inhibitor, SNDRA serotonin-norepinephrine-dopamine releasing agent, SNRI serotonin-norepinephrine re-uptake inhibitor, SRI serotonin re-uptake inhibitor, UAE United Arab Emirates
  2. aBased on the Oxford Centre for Evidence-Based Medicine Levels of Evidence [17]. Level 1: systematic review of randomized trials, systematic review of nested case-control studies, Level 2: individual randomized trial or (exceptionally) observational study with dramatic effect; Level 3: non-randomized controlled cohort/follow-up study (post-marketing surveillance); Level 4: case-series, case-control, or historically controlled studies; Level 5: mechanism-based reasoning
  3. bRe-introduced in the EU based on long-standing legal action unrelated to either new safety or new efficacy information
  4. cReported to have caused deaths