Benfluorex

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Benfluorex, sold under the brand name Mediator, is an anorectic and hypolipidemic agent that is structurally related to fenfluramine (a substituted amphetamine). It acts mostly as a prodrug of norfenfluramine. It was fraudulently claimed to improve glycemic control and decrease insulin resistance in people with poorly controlled type-2 diabetes through norfenfluramine acting as a 5-HT2B receptor agonist It was on the market between 1976 and 2009, and is thought to have caused between 500 and 2,000 deaths. It was patented and manufactured by the French pharmaceutical company Servier. However, Servier has wittingly concealed the nature of Benfluorex, so that it would avoid the ban of Fenfluramine-related medications, which were mostly marketed by Servier (Racemic Fenfluramine/Ponderal, Dexfenfluramine/Isomeride) Servier has been found to be aware of the Fenfluramine-structure nature when starting marketing Benfluorex as an anti diabetic. The mechanism of action of Benfluorex was the anoretic property that is shared with the other Fenfluramine-related compounds. In fact, Benfluorex acts as a prodrug to norfenfluramine, a worldwide withdrawn anorectic because of its high incidence of cardiac fibrosis which is completely out of line for treating type 2 diabetes. In 2023, a French court fined Servier €415m on appeal after finding it guilty of deception and manslaughter, as benfluorex's mechanism of action was fraudulently concealed, as Benfluorex was marketed after withdrawal of the any marketed fenfluramine anorectic (fenfluramine/phentermine, dexfenfluramine, clobenzorex, mefenorex, etc) because of their serious side effects like cardiac fibrosis and pulmonary hypertension (Benfluorex also shares the same side effects, but they were completely concealed, even though there was several reports of heart failure).