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
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