Sibutramine

What is Sibutramine

NOTE: This drug is discontinued in the U.S.

Sibutramine was an oral weight-loss/anti-obesity agent that inhibited dopamine, norepinephrine, and serotonin reuptake.

The drug was previously approved in 1997 and historically recommended for adult obese patients with an initial body mass index (BMI) of 30 kg/m² or more.

Sibutramine was also used in overweight patients with a BMI of 27 mg/m² or more in the presence of other weight-related risk factors(e.g.,  diabetes mellitus, dyslipidemia, hypertension).

Patients taking sibutramine achieved a 5% to 10% reduction from their baseline weight. 

Brand Name

Meridia

Indications & Dosage

• obesity

For the adjunctive management of obesity in conjunction with a reduced-calorie diet and increased exercise

Side Effects

1. abdominal pain
2. acne vulgaris
3. agitation
4. alopecia
5. amblyopia
6. amnesia
7. anaphylactic shock
8. anaphylactoid reactions
9. anemia
10. angina
11. angioedema
12. anorexia
13. anxiety
14. appetite stimulation
15. arthralgia
16. asthenia
17. atrial fibrillation
18. back pain
19. bleeding
20. blurred vision
21. bradycardia
22. bullous rash
23. candidiasis
24. cardiac arrest
25. cholecystitis
26. cholelithiasis
27. confusion
28. constipation
29. cough
30. depression
31. diaphoresis
32. diarrhea
33. dizziness
34. drowsiness
35. dysgeusia
36. dysmenorrhea
37. dyspepsia
38. dyspnea
39. ecchymosis
40. edema
41. elevated hepatic enzymes
42. emotional lability
43. epistaxis
44. eructation
45. fever
46. flatulence
47. gastritis
48. GI bleeding
49. GI obstruction
50. goiter
51. headache
52. heart failure
53. hematuria
54. hyperglycemia
55. hypertension
56. hyperthyroidism
57. hypoglycemia
58. hypothyroidism
59. impotence (erectile dysfunction)
60. insomnia
61. interstitial nephritis
62. laryngitis
63. leukopenia
64. libido decrease
65. libido increase
66. lymphadenopathy
67. mania
68. migraine
69. muscle cramps
70. myalgia
71. mydriasis
72. myocardial infarction
73. nasal congestion
74. nausea
75. neuroleptic malignant syndrome
76. nightmares
77. ocular pain
78. otalgia
79. palpitations
80. paresthesias
81. peptic ulcer
82. peripheral edema
83. petechiae
84. pharyngitis
85. photosensitivity
86. pruritus
87. psychosis
88. rash
89. rhinitis
90. seizures
91. serotonin syndrome
92. sinus tachycardia
93. sinusitis
94. stroke
95. suicidal ideation
96. supraventricular tachycardia (SVT)
97. syncope
98. thrombocytopenia
99. tinnitus
100. torsade de pointes
101. tremor
102. urinary retention
103. urticaria
104. ventricular fibrillation
105. vertigo
106. visual impairment
107. vomiting
108. xerophthalmia
109. xerostomia
110. yawning

Monitoring Parameters

• laboratory monitoring not necessary
• weight

Contraindications

• angina
• anorexia nervosa
• anxiety
• bleeding
• breast-feeding
• bulimia nervosa
• cardiac arrhythmias
• cardiac disease
• children
• cholelithiasis
• closed-angle glaucoma
• contraception requirements
• coronary artery disease
• dental disease
• depression
• geriatric
• heart failure
• hepatic disease
• hypertension
• hypothyroidism
• MAOI therapy
• migraine
• myocardial infarction
• neurological disease
• Parkinson’s disease
• peripheral vascular disease
• pregnancy
• pulmonary hypertension
• renal disease
• renal failure
• renal impairment
• seizure disorder
• seizures
• stroke
• substance abuse
• suicidal ideation
• valvular heart disease

Sibutramine is contraindicated in patients with a known intolerance or hypersensitivity to the drug.

Interactions

• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Pentazocine
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acrivastine; Pseudoephedrine
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamine; Dextroamphetamine Salts
• Aripiprazole
• Articaine; Epinephrine
• Asenapine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
• Atazanavir; Cobicistat
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• atypical antipsychotic
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzphetamine
• Boceprevir
• Bosentan
• Brexpiprazole
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Buspirone
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Cetirizine; Pseudoephedrine
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Cimetidine
• Clarithromycin
• Clomipramine
• Clozapine
• Cobicistat
• Cocaine
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Conivaptan
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Delavirdine
• Desipramine
• Desloratadine; Pseudoephedrine
• Desvenlafaxine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmethylphenidate
• Dextroamphetamine
• Dextromethorphan
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diethylpropion
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dobutamine
• Dopamine
• Doxepin
• Duloxetine
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elbasvir; Grazoprevir
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Ephedrine
• Epinephrine
• Ergot alkaloids
• Erythromycin
• Erythromycin; Sulfisoxazole
• Fentanyl
• Fexofenadine; Pseudoephedrine
• Fluconazole
• Fluoxetine; Olanzapine
• Fosamprenavir
• grapefruit juice
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Phenylephrine
• Guaifenesin; Pseudoephedrine
• Haloperidol
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Pseudoephedrine
• Idelalisib
• Iloperidone
• Imatinib
• Imipramine
• Indinavir
• Isavuconazonium
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isoproterenol
• Itraconazole
• Ketoconazole
• Letermovir
• Levomilnacipran
• Linezolid
• Lisdexamfetamine
• Lithium
• Lopinavir; Ritonavir
• Loratadine; Pseudoephedrine
• Lorcaserin
• Lumateperone
• Lurasidone
• Mecamylamine
• Meperidine
• Meperidine; Promethazine
• Methamphetamine
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methylene Blue
• Methylphenidate
• Midodrine
• Mifepristone
• Milnacipran
• Mirtazapine
• Mitotane
• Monoamine oxidase inhibitors
• Naproxen; Pseudoephedrine
• Nefazodone
• Nelfinavir
• Norepinephrine
• Nortriptyline
• Olanzapine
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Oritavancin
• Paliperidone
• Pentazocine
• Pentazocine; Naloxone
• Perphenazine; Amitriptyline
• Phendimetrazine
• Phenoxybenzamine
• Phentermine
• Phentermine; Topiramate
• Phentolamine
• Phenylephrine
• Phenylephrine; Promethazine
• Pimozide
• Posaconazole
• Prilocaine; Epinephrine
• Procarbazine
• Promethazine
• Protriptyline
• Pseudoephedrine
• Quetiapine
• Rasagiline
• Risperidone
• Ritonavir
• Rufinamide
• Saquinavir
• Selective serotonin reuptake inhibitors
• Serotonin norepinephrine reuptake inhibitors
• Serotonin-Receptor Agonists
• Simeprevir
• St. John’s Wort, Hypericum perforatum
• Tedizolid
• Telaprevir
• Telithromycin
• Telotristat Ethyl
• Tramadol
• Trazodone
• Tricyclic antidepressants
• Trimipramine
• Venlafaxine
• Vilazodone
• Voriconazole
• Vortioxetine
• Ziprasidone