Sibutramine

=Sibutramine=

How it works
Reductil is a medicine used to help you lose and maintain weight loss. It works by making you feel satisfied with less food. It helps control how much you eat. You should still get hungry but feel full with less food than before. By eating less, it should be easier for you to lose weight - even if you haven’t been able to before. //Inhibits noradrenaline and serotonin reuptake, inducing the sensation of satiety.//

Questions to Ask
What medications? //contraindicated with phentermine and with MAOI (within 14 days), drugs that can cause serotonin toxicity (antidepressants, some opioids - dextromethorphan, stimulants, illicit drugs - ecstasy, lithium), drugs which affect clotting (may increase bleeding), drugs that increase BP or heart rate// - medical conditions? //organic causes of obesity, history of eating disorders (anorexia, bulimia), bipolar disorder, bleeding disorders, haemorrhoids, any condition that may be exacerbated by increased BP or heart rate// - allergies?

Use of weight loss drugs during pregnancy is inappropriate, limited human data. ADEC category C. Avoid use in breastfeeding, no data available.

How to take
Usually 10 mg once daily in the morning; increase to 15 mg daily after 4 weeks if weight loss is <2 kg and 10 mg dose is well tolerated. It does not matter if it is taken with or without food.

Eat a low calorie diet high in fruit and vegetables and with no more than 30% of the calories as fat. This medicine may make you feel light-headed; do not drive or operate machinery if affected

Side effects
increased heart rate, palpitations, raised BP, nausea, constipation, aggravation of haemorrhoids, dry mouth, taste disturbance, vasodilation, insomnia, dizziness, paraesthesia, sweating, headache, anxiety
 * Common**

Other advice?

 * stop treatment if <5% of initial weight is lost by 3 months (6 months for diabetics)
 * monitor BP and heart rate at baseline and every 2 weeks for the first 3 months, then each month for the next 3 months, then at least every 3 months; stop treatment if BP increases
 * efficacy has been demonstrated in adults aged 18–65 years for up to 2 years
 * caloric restriction, increased physical activity and eating behaviour modification should accompany treatment
 * in trials healthy obese patients treated with sibutramine 5–30 mg once daily (optimum dose 10–15 mg) had a mean weight loss of about 3 kg after 8 weeks, 4–9 kg at 24 weeks and 4–5 kg at 1 year; in those with type 2 diabetes mean weight loss is about 2.4 kg at 12 weeks
 * patients may find rate of weight loss disappointing
 * trials have shown statistically significant but clinically modest improvement in blood glucose and lipid control
 * in a single trial intermittent treatment with 15 mg once daily for 12 weeks alternating with placebo for 6 weeks yielded similar weight loss to continuous treatment after 48 weeks

CMI
[|Reductil] [|AMH]