Endocrinology Book

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Sibutramine

Aka: Sibutramine, Meridia
  1. See Also
    1. Medications Associated with Weight Gain
    2. Orlistat (Xenical)
    3. Lorcaserin (Belviq)
    4. Phentermine (Ionamin, Fastin)
    5. Phentermine and Topiramate (Qsymia, Qnexa)
    6. Obesity
    7. Obesity in Children
    8. Obesity Evaluation
    9. Obesity Measurement (or Obesity Screening)
    10. Obesity Risk (or Obesity Comorbid Conditions)
    11. Obesity Management
    12. Obesity Medication
    13. Dietary Supplements in Obesity
    14. Exercise in Obesity
    15. Obesity Resources
  2. 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
  3. Contraindications
    1. Severe Renal Insufficiency
    2. Hepatic insufficiency
    3. Cerebrovascular Accident
    4. Hypertension
    5. Advanced cardiovascular disease
      1. Coronary Artery Disease
      2. Congestive Heart Failure
      3. Arrhythmias
    6. Hyperthyroidism
    7. Narrow-Angle Glaucoma
    8. Substance Abuse history
  4. 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]
  5. 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]
  6. 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)
  7. 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
  8. Drug Interactions: Mixed Noradrenergic-Serotonergic Agent
    1. SSRI
    2. Triptans (for Migraine Headache Management)
    3. Dihydroergotamine (DHE)
    4. Dextromethorphan
    5. Meperidine
    6. Pentazocine
    7. Fentanyl
    8. Lithium
    9. MAO inhibitors
    10. Guanethidine
    11. Tricyclic Antidepressants
    12. Alcohol
    13. Centrally acting stimulants or anorexiants

sibutramine (C0074493)

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
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Meridia (C0635898)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C058254
English Meridia, sibutramine hydrochloride (Meridia), meridia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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