Diet pills from Brazil pose health risks: report

NEW YORK (Reuters Health) - A new report highlights the potentially serious health risks of using imported Brazilian-made prescription diet pills that combine amphetamines and other prescription medicines, such as anti-anxiety agents and antidepressants.

Banned amphetamine-based weight loss pills are easily available via the Internet and are being illicitly imported into the United States, warns the report's author, Massachusetts-based internist Dr. Pieter A. Cohen from Cambridge Health Alliance, Cambridge and Harvard Medical School, Boston.

Cohen became concerned about the pills' use when he noticed that many patients were experiencing unexplained chest pain and other symptoms, a statement from Cambridge Alliance explains. Eventually, some of these patients admitted that they were using the imported diet pills.

In the Journal of General Internal Medicine, Cohen describes one patient -- a 26-year-old woman -- who made several trips to her doctor complaining of chest pain, palpitations, headaches, insomnia, nausea and fatigue.

Her symptoms started soon after she began taking Brazilian-made diet pills in an effort to lose weight after her daughter was born. Amphetamines (stimulants) and benzodiazepines (anti-anxiety drugs) were detected in her urine and the specific stimulant fenproporex, which is banned in the US, and the anti-anxiety drug chlordiazepoxide, were identified in her diet pills.

After the woman lost 30 pounds, she stopped taking the pills and her symptoms disappeared, although she said she had cravings for the diet pills. When the woman started to regain the lost weight, she restarted the diet pills at which point her symptoms returned.

Another patient, a 38-year-old municipal truck driver who admitted to using imported diet pills, was suspended from work after testing positive for amphetamine on a routine occupational drug screen. Fenproporex and the antidepressant fluoxetine (Prozac) were identified in his pills. While taking the pills he experienced insomnia and palpitations. He reported losing 12 pounds in 2 weeks.

In both cases, according to Cohen, the pills were acquired from an acquaintance and written on the pill vials were another patient's name, a physician's name and a pharmacist's name, as well as a regional council of pharmacists' license number.

"Since the pills are prescribed by physicians, some people assume they must be safe," Cohen said in a statement. "In fact, since the labels are misleading, people have no idea what dangerous cocktail of medications they are actually using."

In Brazil, prescriptions for these "compounded" diet pills are usually obtained from doctors in private practices who often market themselves as obesity experts, Cohen also notes. However, "none of the medications included in these diet pills are indicated for the treatment of obesity according to commonly accepted practice guidelines."

SOURCE: Journal of General Internal Medicine, December 2008.