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Phentermine and fenfluramine were both prescribed as part of a popular weight loss combination known as "fen-phen." This combination was widely used in the 1990s until it was linked to serious health complications, particularly heart and lung issues, such as pulmonary hypertension and valvular heart disease. As a result of these health risks, the FDA removed fenfluramine from the market in 1997. Phentermine itself is still available but is typically prescribed with caution due to its potential side effects.

In contrast, while the other substances mentioned have faced scrutiny and varying degrees of regulation, they did not have the same level of significant health concerns associated with their combined use as phentermine and fenfluramine did. For instance, lorcaserin was also pulled from the market due to cancer risk, but it is not paired with phentermine in the same notorious weight-loss cocktail. Similarly, sibutramine was withdrawn primarily due to cardiovascular risk but was not a part of the fen-phen phenomenon that specifically highlighted the dangers of the combination of phentermine and fenfluramine. Orlistat, on the other hand, has been used for weight management but has different side effects and has remained available.

Overall, the