Current status of fenfluramine/dexfenfluramine-induced cardiac valvulopathy

Since publication of the U.S. Department of Health and Human Services' interim recommendations in November 1997 for the management of patients having taken certain appetite suppressants, a number of studies evaluating the prevalence of cardiac valvular pathology in such individuals have been published. These studies generally support the association of fenfluramine/dexfenfluramine with cardiac valvulopathy but with significant differences in risk assessment. The analysis of these studies has produced two new guidelines for the management of such patients, including the appropriate use of antibiotic prophylaxis in these individuals. These studies are presented along with a comparison of the three present recommendations and their impact on dental practice.