Sibutramine Appetite suppressants

The newest appetite suppressant, sibutramine (Meridia), works by blocking the reuptake of both serotonin and norepinephrine. It does not stimulate nerve cells to release serotonin, as do fenfluramine and dexfenfluramine. Administered at 20 mg/ day, sibutramine effectively reduces weight in obese patients, but its use has not been assessed in eating disorder patients. The most common side effects of this medication are insomnia, dry mouth, and constipation. It has not been associated with the more serious heart and lung complications observed with fenfluramine and dexfenfluramine. Because sibutramine acts in part through modulation of norepinephrine, there is no rational basis for coadministering phentermine, which acts via this same mechanism. 

The FDA approves the prescription appetite suppressant sibutramine (brand name Meridia), the first prescription weight loss drug of its kind. 

Appetite suppression sibutramine Increases heart rate and blood pressure... 

Cocaine metabolites were detected in nrine by solid phase extraction (SPE) IMS with detection limits of 10 and 4 ng/mL for BE and cocaethylene, respectively. The analytes are retained on the SPE cartridge, while salts and polar compounds that may interfere with the analysis remain in solntion. Sweat samples have also been examined by ion trap mobility spectrometry (ITMS), and traces of 6-acetylmorphine, heroin, and cocaine were detected. Not only illicit drugs can be detected by IMS, but also food additives or supplements that are undeclared, like the appetite suppressant sibutramine. ... 

Thyroid supplement Blood pressure medications Beta blockers Thiazide diuretics Alpha methyl DOPA Appetite suppressants Phentermine Sibutramine Other Alcohol Caffeine Cocaine Nicotine... 

Sibutramine is a centrally acting appetite suppressant used as an adjunct in the management of obesity. It inhibits the re-uptake of noradrenaline and serotonin. 

Contraindications Anorexia nervosa, concomitant MAOI use, concomitant use of centrally acting appetite suppressants, hypersensitivity to sibutramine or any component of the formulation... 

In 1997, the FDA approved sibutramine, a medication sold under the brand name Meridia. Sibutramine is an appetite suppressant prescribed for long-term treatment of severely obese patients. However, safety and effectiveness had not been determined when the sibutramine was taken for more than one year. 

The two best-known prescription diet pills being sold today are sibutramine (brand name Meridia) and orlistat (Xenical). Sibutramine is an appetite suppressant. Orlistat prevents the intestines from absorbing fat. Other medications exist, but they are less common, and people are only supposed to use them for short periods of time. 

Orlistat (Xenical /Roche) is a reversible gastric and pancreatic lipase inhibitor. The compound has no effect on appetite suppression but rather acts by inhibiting dietary fat absorption from the GI tract. Sibutramine (Meridia /Abbott) and its major active metabolites are re-uptake... 

Sibutramine is an appetite suppressant that inhibits the re-uptake of noradrenaline and serotonin. It is used in the adjunctive management of obesity in individuals with a body mass index (BMI) of 30kg/m or more (and no associated co-morbidity) or in individuals with a BMI of 27 kg/m or more in the presence of other risk factors such as type 2 diabetes or hypercholesterolemia. 

Centrally acting appetite suppressant drugs approved for longer term use Sibutramine (Meridia)... 

The adverse effects of amphetamine and related sympathomimetic appetite suppressants are well documented. All of these agents are classified by the U.S. Drug Enforcement Administration (DEA) as controlled substances (classes II-IV) according to their potential for causing addiction (see Table 15.4). Class II agents such as amphetamine are highly abused, with prescription restricted to speeial circumstances class TV anorectic drugs such as sibutramine, phentermine, di-ethylpropion, and mazindol have minimal abuse potential. 

Appetite suppressants such as amphetamine, fen-flurainine, and sibutramine stimulate 5-HT, NE, and/or DA release or inhibit their reuptake by... 

Sibutramine hydrochloride is an anorexiant that inhibits reuptake of norepinephrine, serotonin and dopamine. It may stimulate the satiety center in brain, causing appetite suppression. It is indicated as an adjunct to a reduced calorie diet for the management of obesity, including weight loss and maintenance of weight loss. Recommended for patients with an initial body mass index greater than 30 kg/m2 or greater than 27 kg/m in the presence of other risk factors (e.g., hypertension, diabetes, dyslipidemia). 

Sibutramine (meridia), an inhibitor of the reuptake of 5-HT, ME, and DA, is used as an appetite suppressant in the management of obesity two active metabolites probably account for sibu-tramine s therapeutic effects. Whether effects on a single neurotransmitter system are primarily responsible for sibutramine s effects in obese patients is unclear. 

Sibutramine (Meridia), an appetite suppressant, to a client receiving fluoxetine (Prozac) for depression. 

On theoretical grounds the manufacturers contraindicate the concurrent use of sibutramine with MAOIs, and they say that it should not be given with serotonei ic drugs because of the risk of the serious serotonin syndrome. The manufacturers say that the use of sibutramine with other centrally acting appetite suppressants is contraindicated and they caution the use of cold and flu remedies. No clinically relevant interactions have been seen between sibutramine and cimetidine, and no interaction occurs with oral contraceptives. 

The UK manufacturers say that the concurrent use of sibutramine and other centrally acting appetite suppressants is contraindicated. No work appears to have been done to see what happens if sibutramine is given with decongestants, cough, cold and allergy medications, but the manufacturers advise caution because of the risk of raised blood pressure or heart rate. The manufacturers in the UK and US both list ephedrine and pseu-doephedrine, while in the UK sylometazoline is also specifically named. ... 

In the BNF there are only two appetite suppressants (Fig. 20.8) indicated as anti-obesity dmgs, namely Rimo-nabant and Sibutramine. Rimonabant has been marketed as an anti-obesity dmg for several years in the UK, although it never received FDA clearance. It is a cannabi-noid receptor antagonist, which blocks binding to neuronal GBl receptors. This inhibition of binding of endogenous cannabinoids prevents an increase in appetite. This dmg has recently had its market authorisation in the UK suspended due to concerns regarding psychiatric problems associated with its use. 

Sibutramine (hydrochloride) is stmcturally related to the amfetamines, which were at one stage marketed as appetite suppressant dmgs. These dmgs were removed from the market due to their increased use as recreational dmgs and because of the serious side effects of their use, e.g. tachycardia, hypertension and addiction. Sibutramine... 

Sibutramine and its two active metabolites (Mj and M2) exert their effect by inhibiting the reuptake of serotonin, norepinephrine, and dopamine.29 Appetite becomes suppressed because patients feel a sense of satiety. 

Amphetamine stimulates the central nervous system, which suppresses the appetite. Most diet pills are sympathomimetics. They are similar to amphetamines, but are less powerful and have less potential for addiction. The sympathomimetics are benzphetamine, diethylpropion, mazindol, methamphetamine, phendimetrazine, phentermine, and sibutramine. 

As previously discussed, two weight loss medications are currently available by prescription. Sibutramine (Meridia), which suppresses appetite, is approved for use in obese patients age 16 or older. Orlistat (Xenical), a fat blocker, is approved for children 12 and older and adults. Candidates for these medications are not simply people who want to lose a few pounds, even if their doctors tell them they should lose weight. A patient must be severely overweight and meet certain other criteria before a doctor will consider prescribing medication. 

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