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Sibutramine
Aka: Sibutramine, Meridia
- See Also
- Medications Associated with Weight Gain
- Orlistat (Xenical)
- Lorcaserin (Belviq)
- Phentermine (Ionamin, Fastin)
- Phentermine and Topiramate (Qsymia, Qnexa)
- Obesity
- Obesity in Children
- Obesity Evaluation
- Obesity Measurement (or Obesity Screening)
- Obesity Risk (or Obesity Comorbid Conditions)
- Obesity Management
- Obesity Medication
- Dietary Supplements in Obesity
- Exercise in Obesity
- Obesity Resources
- Background
- Sibutramine taken off the market October 2010 in United States due to risk of serious cardiovascular events
- Listed for historical purposes only
- Contraindications
- Severe Renal Insufficiency
- Hepatic insufficiency
- Cerebrovascular Accident
- Hypertension
- Advanced cardiovascular disease
- Coronary Artery Disease
- Congestive Heart Failure
- Arrhythmias
- Hyperthyroidism
- Narrow-Angle Glaucoma
- Substance Abuse history
- 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]
- 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]
- Mechanism
- Monoamine reuptake inhibitor Antidepressant
- Serotonin and Norepinephrine reuptake inhibitor
- Similar to Effexor
- Effects (dose dependent)
- Enhances satiety
- Increases Energy Expenditure (metabolic rate)
- 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
- Less common
- Headache
- Irritability
- Dry Mouth
- Dry Skin or rash
-
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