Sibutramine is a synthetic medication used in the treatment of alimentary obesity .
Sibutramine with the same active component refers to drugs that accelerate the onset of satiety. This leads to a decrease in food intake without psychological stress, and, as a result, to weight loss.
Medications containing sibutramine do not release monoamines and do not belong to MAO inhibitors. Also, the drug does not have an affinity for adrenergic, serotonergic, muscarinic, dopaminergic, benzodiazepine, histamine, and NMDA receptors.
Analogues of Sibutramine
Analogues of Sibutramine on the active substance are the medications Goldline , Meridia , Lindax and Slimia.
If necessary, the doctor can replace the medication with one of the analogues of Sibutramine with a similar therapeutic effect. These include Reduxin , containing as active components sibutramine and cellulose microcrystalline, and Fepranon with the active substance ampepramone.
Indications for use of Sibutramine
Medication Sibutramine, according to the instructions, is prescribed as part of a comprehensive maintenance therapy for excess body weight:
- With alimentary obesity (body mass index – from 30 kg / m2 and more);
- With alimentary obesity (body mass index – from 27 kg / m2 and more), if there are other risk factors associated with excess body weight, including hyperlipidemia and type 2 diabetes mellitus .
Apply Sibutramine for weight loss contraindicated:
- In severe eating disorders, for example, with bulimia nervosa or anorexia nervosa;
- For organic reasons, obesity;
- Against the background of Tourette’s syndrome;
- Against the background of mental illness;
- With occlusive diseases of peripheral arteries;
- Against the background of coronary heart disease, congenital heart disease, chronic heart failure in the stage of decompensation;
- With uncontrolled arterial hypertension;
- Against the background of arrhythmia, tachycardia and various disorders of cerebral circulation, including transient;
- Against the background of severe violations of the liver and kidneys;
- With hyperthyroidism;
- Against the background of pheochromocytoma;
- With benign prostatic hyperplasia with the formation of residual urine;
- During pregnancy and during lactation;
- With established pharmacological, drug or alcohol dependence;
- Against the background of glaucoma;
- When hypersensitivity to the same active substance or other components that make up the drug.
Sibutramine, according to the instructions, is contraindicated to apply simultaneously with certain medicines, namely:
- With MAO inhibitors;
- With antidepressants, neuroleptics, tryptophan or other drugs that have an inhibitory effect on the central nervous system;
- With any other medications, whose action is aimed at reducing body weight.
Special care requires the appointment of Sibutramine for weight loss:
- Against the background of hypokalemia and hypomagnesemia;
- Simultaneously with medications that help increase the QT interval;
- Against the background of violations of the liver and kidneys, occurring in mild and moderate severity;
- With epilepsy;
- Simultaneously with drugs that can cause high blood pressure and heart rate, including a number of medications for colds, coughs and allergies.
Due to the lack of necessary research, Sibutramine is not prescribed by instructions to people over 65 years of age.
Method of administration of Sibutramine
Sibutramine, as a rule, is prescribed in an initial dose of 10 mg per day. If the weight loss is too slow (less than 2 kg per month), in the absence of severe side effects associated with taking the medication, the daily dosage is increased to 15 mg. If the rate of weight loss does not increase at this dosage, the use of Sibutramine is canceled.
As a rule, the medicine is used for at least a year. If during the first three months of therapy it is not possible to achieve a sufficient level of weight loss (at least 5% of the baseline), Sibutramine is canceled. Also, the medicine is canceled in the event that a set of body weight is observed during therapy.
Sibutramine is prescribed only in cases where any other measures taken do not lead to weight loss (less than 5 kg in three months).
Treatment should be carried out in a comprehensive manner. It should include changing the nutritional diet and increasing physical activity. It is the change in the habitual way of life that caused obesity is a prerequisite for maintaining the achieved weight loss result with the use of Sibutramine.
During therapy, blood pressure and changes in heart rate should be monitored. Also, during the examination should pay attention to pain in the chest, edema, progressive dyspnea.
It is not recommended to drink alcohol while using Sibutramine.
Side effects of Sibutramine for weight loss
Of the disorders of the digestive system, most often when Sibutramine is used, there is loss of appetite, dry mouth, constipation and nausea, and a transient increase in hepatic enzyme activity may develop somewhat less frequently.
Also, against the background of taking Sibutramine reviews may occur disorders of other systems, which are expressed as:
- Increased sweating, insomnia, headaches, anxiety, dizziness, paresthesia , seizures and changes in taste (central and peripheral nervous system);
- Purple Shenlaine-Genocha and thrombocytopenia (blood coagulation system);
- Heart palpitations, tachycardia , a slight increase in blood pressure, redness of the skin with a sense of heat, exacerbation of hemorrhoids(cardiovascular system).
In some cases, the use of Sibutramine in reviews can cause acute interstitial nephritis , a more pronounced increase in blood pressure and mesangiocapillary glomerulonephritis .
In most cases, the occurrence of side effects when using Sibutramine for weight loss is observed in the first month of therapy, and their frequency and severity decrease with time.
During treatment, it should be noted that when Sibutramine is used together with ketoconazole, erythromycin, troleandomycin, cyclosporine and other drugs that inhibit the activity of the CYP3A4 isoenzyme, plasma concentrations of Sibutramine metabolites may increase, which contributes to an insignificant increase in the QT interval.
The risk of developing serotonin syndrome increases with simultaneous use of Sibutramine with:
- 5-HT1 receptor agonists;
- Selective serotonin reuptake inhibitors, for example, with fluoxetine, citalopram, sertraline, and paroxetine;
- Opioid analgesics;
- Derivatives of ergot alkaloids;
- Antitussive medicines of central action.
Sibutramine refers to prescription medicines with standard storage conditions.