Benfluorex

Benfluorex is an anorectic and hypolipidemic small molecule drug structurally related to fenfluramine. It was developed and manufactured by Servier and marketed primarily in France under the brand name Mediator from 1976 until its withdrawal in 2009 due to serious cardiovascular side effects, including valvular heart disease and pulmonary hypertension[2][3][5]. Benfluorex was indicated as an adjunct treatment for type 2 diabetes mellitus and hyperlipidemia. Its mechanism of action involves decreasing intestinal absorption of triglycerides, inhibiting hepatic lipogenesis, reducing hepatic gluconeogenesis (partly via inhibition of mitochondrial β-oxidation), lowering acetyl-CoA concentration (thus reducing pyruvate carboxylase activity), and facilitating cellular glucose utilization[4][5][6]. Unlike metformin, benfluorex’s effect on gluconeogenesis is linked to changes in cellular redox state rather than direct inhibition of mitochondrial respiration[5][6]. The main bioactive metabolite is S 422-1. Benfluorex was never approved in the United States but was widely used in Europe before being withdrawn after it was linked to hundreds or possibly thousands of deaths due to cardiac toxicity[3].

Brand names

MediatorMediaxal