Sibutramine results in weight loss by reducing appetite. As a result, the consumption of food is lowered.
Sibutramine has been banned in several countries including the United States, European countries and India due to its cardiovascular side effects like heart attack and stroke.
Sibutramine is prescribed for the treatment of obesity along with diet restrictions and exercise in patients who suffer from obesity-related conditions like high blood pressure, diabetes and high cholesterol.
Sibutramine works by interfering with the chemicals in the brain called as neurotransmitters (norepinephrine, serotonin, dopamine). It thereby promotes the feeling of satiety (fullness) and a decrease in the appetite, finally resulting in a low intake of food.
Sibutramine should not be used in patients with the following conditions:
• Allergy to the drug
• Congestive heart failure, serious abnormal heart rhythms, chest pain, episodes of heart attack and stroke
• Major eating disorder (anorexia nervosa or bulimia nervosa)
• Uncontrolled hypertension
• Overactive thyroid
• History of depressive or maniac illness
• Seizure disorders
• Closed angle glaucoma ( increased pressure in the eye resulting in optic nerve damage)
• Pheochromocytoma (tumor in the adrenal medulla)
• Severe liver damage or kidney damage particularly in patients on dialysis
• Along with medications like monoamine oxide inhibitors I (MAO I) or other centrally acting weight loss drugs
• The initial recommended dosage for adults is 10mg once daily.
• The dosage can be increased to 15mg once a day (only after 4 weeks) particularly in those who do not show a positive response to a low-calorie diet and exercise.
• The dose of 5mg is used in patients who do not tolerate with a usual 10mg dose.
• Sibutramine comes as a capsule or tablet to be taken by mouth. It can be taken either with or without food and should be taken in the morning.
• Sibutramine should not be used for more than two years.
• Blood pressure and pulse should be checked before starting the sibutramine treatment and should be monitored during the treatment at regular intervals.
• Patients should be monitored for symptoms of neuroleptic malignant syndrome which include high body temperature, fluctuation in vital signs, changes in mental state and muscle rigidity.
• Dilatation of pupils is reported; therefore sibutramine must not be used or used with extreme caution in patients with narrow-angle glaucoma.
• Due to a risk for bleeding, sibutramine should be used with caution in patients with bleeding problems or taking drugs that could result in bleeding.
• Patients under sibutramine therapy should not recommend it to other people for its weight loss effect since sibutramine interacts with many drugs and illnesses and should be prescribed on an individual basis.
• Patients should be advised to inform their physician before taking some over-the-counter (OTC) medicines such as decongestants, cough syrups and some weight reducing pills while on sibutramine.
• Women should inform their physician if they are pregnant/breastfeeding, or planning a pregnancy.
• Gastro intestinal: Dry mouth, nausea, vomiting, indigestion, loss of appetite, constipation, gallstone
• Central Nervous System: Insomnia, dizziness, anxiety, depression, drowsiness, sensation of pricking and burning symptoms, headache
• Cardio vascular system: Increased blood pressure, palpitation
• Respiratory: Inflammation of nose, sinuses and throat, shortness of breath, increased coughing
• Genito urinary: Urinary tract infection, painful menstruation with abdominal cramps, abnormal uterus bleeding
• Musculoskeletal: Joint disorder, muscle and joint pain, inflammation of the synovium (the tissue that surrounds tendon), back pain
• Others: Thirst, rashes, acne, problems with vision and speech, allergic reaction
• Sibutramine treatment should only be started at least two weeks after stopping MAOIs such as selegiline, phenelzine and moclobemide.
• Concomitant use of sibutramine with drugs like ketoconazole and erythromycin increases the plasma levels of sibutramine.
• Sibutramine taken along with antidepressant drugs such as selegiline and paroxetine, and migraine drugs such as sumatriptan and zolmitriptan can lead to serotonin syndrome (symptoms of high temperature more than 41.1 °c, agitation, sweating, dilated pupils, seizures and muscle breakdown).
• Sibutramine taken along with opioid drugs such as morphine, codeine and hydrocodone also lead to serotonin syndrome.
• Other drugs such as lithium, tryptophan, ergot drugs, decongestants and cough syrups can also cause interactions with sibutramine.
• The capsules and tablets should be stored at a room temperature and kept in an air tight container.
• They should be protected from excess light and moisture.
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