Sibutramine (Systemic)

Brand Names : Meridia

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sibutramine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to sibutramine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - You must follow a reduced-calorie diet while taking sibutramine in order to lose weight and keep the lost weight from returning.

Pregnancy - Sibutramine has not been studied in pregnant women. However, studies in animals have shown that sibutramine causes birth defects when used in doses many times higher than the usual human dose. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - It is not known whether sibutramine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. A mother who is taking this medicine and who wishes to breast-feed should discuss this with her doctor.

Children - Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of sibutramine in children with use in other age groups.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of sibutramine in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sibutramine, it is especially important that your health care professional know if you are taking any of the following:

• Appetite suppressants, other (benzphetamine [e.g., Didrex], diethylpropion [e.g., Tenuate], mazindol [e.g., Sanorex], phendimetrazine [e.g., Phendiet], phentermine [e.g., Ionamin]) - The effects of using sibutramine in combination with another appetite suppressant are not known

• Bromocriptine (e.g., Parlodel) or
• Buspirone (e.g., BuSpar) or
• Certain tricyclic antidepressants (amitriptyline [e.g., Elavil], clomipramine [e.g., Anafranil], imipramine [e.g., Tofranil]) or
• Dextromethorphan (cough medicine) or
• Levodopa (e.g., Sinemet) or
• Lithium (e.g., Eskalith) or
• Meperidine (e.g., Demerol) or
• Nefazodone (e.g., Serzone) or
• Pentazocine (e.g., Talwin) or
• Selective serotonin reuptake inhibitors (citalopram [e.g., Celexa], fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft]) or
• Street drugs (LSD, MDMA [e.g., ecstasy], marijuana) or
• Sumatriptan (e.g., Imitrex) or
• Tramadol (e.g., Ultram) or
• Trazodone (e.g., Desyrel) or
• Tryptophan or
• Venlafaxine (e.g., Effexor) - Using these medicines with sibutramine may increase the chance of developing a rare, but very serious, unwanted effect known as the serotonin syndrome. Symptoms of this syndrome include confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, or twitching. If you develop these symptoms, contact your doctor as soon as possible

• Moclobemide (e.g., Manerex) - Taking moclobemide and sibutramine together or less than 3 days apart may increase the chance of developing serious unwanted effects, including the serotonin syndrome, and is not recommended

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Do not take sibutramine while you are taking or within 2 weeks of taking an MAO inhibitor, and do not take an MAO inhibitor within 2 weeks of taking sibutramine . If you do, you may develop severe seizures, extremely high blood pressure, or the serotonin syndrome. Allow at least 2 weeks to pass between taking one of these medicines (sibutramine or an MAO inhibitor) and taking the other

Other medical problems - The presence of other medical problems may affect the use of sibutramine. Make sure you tell your doctor if you have any other medical problems, especially:

• Anorexia nervosa (an eating disorder) or
• Glaucoma, narrow angle or
• High blood pressure (or history of) - Sibutramine may make these conditions worse

• Brain disease or damage, or mental retardation or
• Seizures (history of) - Sibutramine may increase the chance of having seizures

• Gallstones (or history of) - Weight loss may make this condition worse

• Heart disease (or history of) or
• Stroke (or history of) - Increased blood pressure or heart rate caused by sibutramine may make these conditions worse

• Kidney disease (severe) or
• Liver disease (severe) - Higher blood levels of sibutramine may occur, increasing the chance of having unwanted effects