Pharm
Sibutramine
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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
Arrhythmia
s
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
Triptan
s (for
Migraine Headache Management
)
Dihydroergotamine
(DHE)
Dextromethorphan
Meperidine
Pentazocine
Fentanyl
Lithium
MAO Inhibitor
s
Guanethidine
Tricyclic Antidepressant
s
Alcohol
Centrally acting stimulants or
Anorexia
nts
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