Pharm

Sibutramine

search

Sibutramine, Meridia

  • Background
  1. Sibutramine taken off the market October 2010 in United States due to risk of serious cardiovascular events
  2. Listed for historical purposes only
  • Contraindications
  • Dosing
  1. Continuous: Sibutramine 15 mg qd
  2. Intermittent (similar weight loss, less side effects)
    1. Weeks 1-12: Sibutramine 15 mg qd
    2. Weeks 19-30: Sibutamine 15 mg qd
    3. Weeks 37-48: Sibutramine 15 mg qd
    4. No medication taken in other weeks
    5. Wirth (2001) JAMA 286:1331-9 [PubMed]
  • Efficacy
  • One year study
  1. Placebo group weight loss: 3.8 kg in 48 weeks
  2. Continuous Sibutramine: 7.9 kg in 48 weeks
  3. Intermittent Sibutramine: 7.8 kg in 48 weeks
  4. Wirth (2001) JAMA 286:1331-9 [PubMed]
  • Mechanism
  1. Monoamine reuptake inhibitor Antidepressant
    1. Serotonin and Norepinephrine reuptake inhibitor
    2. Similar to Effexor
  2. Effects (dose dependent)
    1. Enhances satiety
    2. Increases energy expenditure (metabolic rate)
  • Adverse effects (Very similar to Effexor)
  1. Reduced adverse effects with intermittent treatment
  2. Common
    1. Diastolic Hypertension (2-10 mmHg increase)
      1. Optimize Blood Pressure control before use
    2. Tachycardia
    3. Insomnia
  3. Less common
    1. Headache
    2. Irritability
    3. Dry Mouth
    4. Dry Skin or rash
  • Drug Interactions
  • Mixed Noradrenergic-Serotonergic Agent