Redux Redux

Timothy B. McCall, M.D.

Earlier this week, at the request of the Food and Drug Administration, two highly-popular weight loss drugs, Redux and fenfluramine, were pulled from the market after reports in leading medical journals called the drugs’ safety into question. Marketplace medical commentator, Dr. Timothy McCall, says we’ve seen it all before.

The definition of the word redux is brought back; returned. That’s apropos for the drug Redux, and its chemical cousin fenfluramine of fen-phen fame. Once again we’ve witnessed the meteoric rise and equally meteoric fall of pharmaceutical “magic bullets.”

When it was introduced last year, Redux had the fastest launch of any drug in history. Within weeks it hit an annualized sales rate of over $200 million.

What was conveniently forgotten was that a similar drug, aminorex, was pulled from the market in the 70s, after causing fatal pulmonary hypertension--one of Redux’s side effects.

What’s also forgotten is that anytime you take a drug that’s brand new, you’re acting a guinea pig. By definition, you don’t know its long-term safety or whether it will clash with other drugs.

Think of the antihistamine Seldane. It was five years before the first reports trickled in of fatal interactions with commonly prescribed antibiotics.

The lesson is this: Unless a new drug promises to cure cancer, it shouldn’t be prescribed to millions of people in its first few years on the marke

That’s not what happens, though, and there’s plenty of blame to go around:

Drug companies relentlessly promote their brand new and highly-profitable drugs.

Too many doctors uncritically absorb these promotions and prescribe new drugs when the potential benefits are meager.

Journalists, looking for hot stories--and some physician-authors who ought to know better--shamelessly hype the “breakthrough.”

Highly-profitable weight-loss centers hand out prescriptions like candy at Halloween, often to people who only want to lose a few pounds.

And, of course, there’s our never-ending desire for a quick-fix: weight-loss, beauty, peace of mind--even low cholesterol--all without any work.

Then there’s the FDA. The agency brushed aside safety concerns and approved Redux. Speeding up the pipeline may make sense for AIDS drugs, but not for yet another pain-reliever or weight-loss pill

In life, we’re often presented with the same problem again and again until we finally learn our lesson. Call me a pessimist, but given our short memories, I’m just waiting for Redux redux.

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