II. Background
- Sibutramine taken off the market October 2010 in United States due to risk of serious cardiovascular events
- Listed for historical purposes only
III. Contraindications
- Severe Renal Insufficiency
- Hepatic insufficiency
- Cerebrovascular Accident
- Hypertension
- Advanced cardiovascular disease
- Hyperthyroidism
- Narrow-Angle Glaucoma
- Substance Abuse history
IV. Dosing
- Continuous: Sibutramine 15 mg qd
- Intermittent (similar weight loss, less side effects)
- Weeks 1-12: Sibutramine 15 mg qd
- Weeks 19-30: Sibutamine 15 mg qd
- Weeks 37-48: Sibutramine 15 mg qd
- No medication taken in other weeks
- Wirth (2001) JAMA 286:1331-9 [PubMed]
V. Efficacy: One year study
- Placebo group weight loss: 3.8 kg in 48 weeks
- Continuous Sibutramine: 7.9 kg in 48 weeks
- Intermittent Sibutramine: 7.8 kg in 48 weeks
- Wirth (2001) JAMA 286:1331-9 [PubMed]
VI. Mechanism
- Monoamine reuptake inhibitor Antidepressant
- Serotonin and Norepinephrine reuptake inhibitor
- Similar to Effexor
- Effects (dose dependent)
- Enhances satiety
- Increases Energy Expenditure (metabolic rate)
VII. Adverse effects (Very similar to Effexor)
- Reduced adverse effects with intermittent treatment
- Common
- Diastolic Hypertension (2-10 mmHg increase)
- Optimize Blood Pressure control before use
- Tachycardia
- Insomnia
- Diastolic Hypertension (2-10 mmHg increase)
- Less common
VIII. Drug Interactions: Mixed Noradrenergic-Serotonergic Agent
- SSRI
- Triptans (for Migraine Headache Management)
- Dihydroergotamine (DHE)
- Dextromethorphan
- Meperidine
- Pentazocine
- Fentanyl
- Lithium
- MAO Inhibitors
- Guanethidine
- Tricyclic Antidepressants
- Alcohol
- Centrally acting stimulants or Anorexiants
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Related Studies
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C058254 |
SnomedCT | 371164009, 108373009, 386838007 |
LNC | LP100053-0, MTHU035870 |
English | sibutramine, SIBUTRAMINE, sibutramine [Chemical/Ingredient], Sibutramine product (product), Sibutramine product, Sibutramine (product), Sibutramine (substance), Sibutramine |
Spanish | sibutramina, producto (producto), sibutramina, producto, sibutramina (producto), sibutramina (sustancia), sibutramina |
Ontology: Meridia (C0635898)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C058254 |
English | Meridia, sibutramine hydrochloride (Meridia), meridia |