What is Sibutramine?
Sibutramine is a prescription medication (controlled substance in USA Class IV) indicated for the management of obesity and maintenance of weight loss as part of an overall treatment plan. Obese person is the one with a BMI of ≥ 30 kg/m2. For calculation of BMI the following equation can be used: BMI= weight in kg / (height in m)2 OR through this link
Sibutramine was approved by FDA for treatment of obesity in 1997 and is marketed in USA under the trade name Meridia® and Reductil® in Europe.
How does Sibutramine work to reduce weight?
Sibutramine acts mainly on the brain. It is a neurotransmitter reuptake inhibitor that affects two neurotransmitters in the brain namely Noradrenaline and Serotonin leading to the feeling of fullness and decrease in the desire of eating. So its main effect is on the appetite center in the brain.
Is Sibutramine suitable for any obese person?
According to the manufacturer, Sibutramine is indicated as part of an overall treatment plan for the management of obesity for people aged 18-65 years who:
Have a BMI of ≥ 30 kg/m2.Have a BMI of ≥ 27 kg/m2 in addition to other health problems as Diabetes, high blood pressure or high cholesterol.
What is the correct way of taking this medication?
1. Take the dose prescribed to you exactly, do not change the dose by your self.
2. You can take it with or without food.
3. If you miss a dose, take it as soon as you remember. If, however, it is time for the
next dose, just skip it and take the next dose in its time. Do not double the
dose to compensate for the missed one.
How can I know if this medication is working for me appropriately or not?
You should pay regular checks for weight loss and side effects (particularly Blood pressure) while you are taking sibutramine. It is recommended that:
Treatment should not be continued beyond 4 weeks unless there is a weight loss of at least 2kg & re-evaluation of treatment plan should be considered.Treatment should not be continued beyond 3 months unless the re is a weight loss of at least 5% of original body weight (measured from the beginning of treatment) & re-evaluation of treatment plan should be considered.Treatment should not be continued for > 12 months.
Who should not take Sibutramine?
There are some medical conditions for which Sibutramine is considered contraindicated or inappropriate:
Uncontrolled or poorly controlled hypertension.Irregular heart beats (arrhythmias), history of heart attack, congestive heart failure, coronary artery disease and/or who have angina pectoris (heart-related chest pain).Presence of severe liver or kidney disease.History of stroke or stroke symptoms.Suffering from bulimia nervosa or anorexia nervosa.Have an eye problem (Glaucoma).Persons allergic to Sibutramine.Presence of a thyroid problem (hypothyroidism).Suffering or had suffered from a seizure or bleeding problem.Suffering or had suffered from gallstones.Pregnant or planning it or breast feeding.Suffering from depression.
What are the possible side effects of Sibutramine?
The most common side effects reported with Sibutramine use include:
Dry mouth, headache, loss of appetite, trouble sleeping (insomnia), and constipation. Other more serious side effects can develop like increased sweating, an increase in blood pressure, and an increase in heart rate. They tend, however, to be generally mild and do not require drug discontinuation.
A rare, but life-threatening problem called "serotonin syndrome." may occur with Sibutramine. Symptoms include weakness, restlessness, confusion, fever, vomiting, sweating, shivering or shaking, fast heart beats and loss of consciousness.
Certain weight loss medicines have been associated with a rare, but life-threatening condition that affects the blood pressure in lungs (pulmonary hypertension). Because the condition is so rare it is not known if Sibutramine may cause this disease. If you experience new or worsening shortness of breath notify your Doctor immediately.
Can Sibutramine be taken safely with any other medication?
There is a number of significant drug-drug interactions that should be considered while you are using Sibutramine. The following drugs should not be used at the same time with Sibutramine since they can lead to serious effects and can be fatal, inform your Doctor if you are using one of them:
Monoamine oxidase inhibitors (MAOIs) that are used for depression or parkinsonism.Any of the agents used for dieting including over the counter medications and herbal remedies.Medications that affect serotonin activity in the brain, can lead to development of serotonin syndrome, if used concurrently with Sibutramine. They include some of the medications used for depression, migraine headaches, and some pain medications. For a complete list of such medications please refer to Meridia Home Page.Decongestansts and cough suppressants including over the counter preparations might cause increase in heart rate and blood pressure if used concurrently.Ketoconazole (antifungal), and Erythromycin (antibiotic) might affect the way Sibutramine is removed from the body.
How about its concurrent use with nutritional supplements?
The use of Sibutramine does not interfere with the intake of nutritional supplements like vitamins, minerals and amino acids (except tryptophan) generally. However, for your own safety this issue should be discussed with your doctor or pharmacist.
Does Sibutramine interfere with the intake of coffee, tea and caffeinated beverages?
Sibutramine use does not interfere with the intake of coffee, tea and caffeinated beverages. Make sure you have no medical problem that might interfere with the intake of such beverages regardless of Sibutramine intake.
April 15, 2006
National Institute for Health and Clinical Excellence (NICE-UK).
Meridia Home Page
http://www.rxlist.com/cgi/generic/sibutramine_pi.htm last accessed April 9th 2006.
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