1. 1.Problems with the valves in the heart (valvular heart disease) and high blood pressure in the arteries of the lungs (pulmonary arterial hypertension) have been associated with FINTEPLA. Your healthcare provider will do a test called an echocardiogram to check your heart and to evaluate for high blood pressure in the arteries of the lungs before you start taking FINTEPLA, again every 6 months during treatment, and one time 3 to 6 months after you take your last dose of FINTEPLA.

   Call your healthcare provider right away if you develop any of these signs and symptoms of heart or lung problems during treatment with FINTEPLA:

   • shortness of breath
   • tiredness or weakness, especially with increased activity
   • lightheadedness or fainting
   • swollen ankles or feet
   • chest pain
   • sensations of a rapid, fluttering heartbeat (palpitations)
   • irregular pulse
   • bluish color of your lips and skin (cyanosis)

   Because of the risk of heart valve problems (valvular heart disease) and high blood pressure in the arteries of the lungs (pulmonary arterial hypertension), FINTEPLA is only available through a restricted program called the FINTEPLA Risk Evaluation and Mitigation Strategy (REMS). Before you or your child receives FINTEPLA, your healthcare provider or pharmacist will make sure you understand how to take FINTEPLA safely. If you have any questions about FINTEPLA, ask your healthcare provider, visit www.FinteplaREMS.com, or call 1-877-964-3649.

2. 2. Decreased appetite and decreased weight. Decreased appetite and decreased weight are serious and common side effects of FINTEPLA.

   • Your weight should be checked regularly during your treatment with FINTEPLA.
   • Your healthcare provider may need to make changes to your FINTEPLA dose if your weight decreases. In some cases, FINTEPLA may need to be stopped.

3. 3. Sleepiness, sedation, and lack of energy (lethargy). These are serious and common side effects of FINTEPLA. Taking FINTEPLA with central nervous system (CNS) depressants, including alcohol, may increase sleepiness. Do not drive, operate heavy machinery, or do other dangerous activities until you know how FINTEPLA affects you.

4. 4. Like all other antiepileptic drugs, FINTEPLA may cause suicidal thoughts or actions in a very small number of people (about 1 in 500). Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; trouble sleeping (insomnia); attempts to commit suicide; new or worse irritability; new or worse depression; acting aggressive, being angry or violent; new or worse anxiety; acting on dangerous impulses; feeling agitated or restless; an extreme increase in activity and talking (mania); panic attacks; other unusual changes in behavior or mood.

   How can I watch for early symptoms of suicidal thoughts and actions?

   Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled.

   Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

5. 5. Do not stop taking FINTEPLA without first talking to your healthcare provider. Stopping a seizure medicine such as FINTEPLA can suddenly cause you to have seizures more often or seizures that do not stop (status epilepticus).

   Do not take FINTEPLA if you:

   • are allergic to fenfluramine or any of the ingredients in FINTEPLA. See the Medication Guide for a complete list of ingredients in FINTEPLA.
   • are taking or have stopped taking medicines called monoamine oxidase inhibitors (MAOIs) in the last 14 days. This may cause a serious or life-threatening problem called serotonin syndrome. If you are not sure whether or not you are taking one of these medicines, contact your healthcare provider.

   Before taking FINTEPLA, tell your healthcare provider about all of your medical conditions, including heart problems; weight loss; depression, mood problems, or suicidal thoughts or behavior; kidney problems; liver problems; are pregnant or plan to become pregnant; are breastfeeding or plan to breastfeed.

   Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

   What are the possible side effects of FINTEPLA?

   FINTEPLA may cause serious side effects, including:

   • See “FINTEPLA can cause serious side effects” above

   • Serotonin syndrome. Serotonin syndrome is a life-threatening problem that can happen in people taking FINTEPLA, especially if FINTEPLA is taken with certain other medicines, including anti-depressant medicines called SSRIs, SNRIs, TCAs, and MAOIs; tryptophan; lithium; antipsychotics; St. John’s Wort; dextromethorphan; tramadol.

     Call your healthcare provider right away if you have any of the following symptoms of serotonin syndrome: mental status changes such as seeing things that are not there (hallucinations), agitation, or coma; changes in blood pressure; tight muscles; fast heartbeat; nausea, vomiting, or diarrhea; high body temperature; trouble walking.

   • High blood pressure (hypertension). Hypertension is a serious and common side effect. FINTEPLA can cause your blood pressure to increase even if you have never had high blood pressure before.

   • Increased pressure in your eyes (glaucoma). Symptoms of glaucoma may include red eyes, seeing halos or bright colors around lights, nausea or vomiting, decreased vision, eye pain or discomfort, blurred vision.

     If you have any of these symptoms, call your healthcare provider right away.

The most common side effects of FINTEPLA when used to treat patients with Dravet syndrome (DS) include decreased appetite; diarrhea; low energy; respiratory infection; decreased weight; fever; constipation; abnormal echocardiogram; sleepiness; problems with movement, balance, and walking; increased drooling; increased blood pressure; vomiting; falls; seizures that do not stop; weakness.

The most common side effects of FINTEPLA when used to treat patients with Lennox-Gastaut syndrome (LGS) include diarrhea; tiredness; vomiting; sleepiness; decreased appetite.