Sibutramine MAOIs

Concurrent monoamine oxidase inhibitors Do not use sibutramine concomitantly with MAOIs. There should be at least a 2-week interval after starting or stopping MAOIs before starting treatment with sibutramine. 

Drugs that may affect venlafaxine include cimetidine, cyproheptadine, and MAOIs. Drugs that may be affected by venlafaxine include clozapine, desipramine, haloperidol, indinavir, St. John s wort, trazodone, sibutramine, sumatriptan, and warfarin. 

MAOIs, metoclopramide, phenytoin, sibutramine, smoking, St. John s wort, tramadol, linezolid, L-tryptophan. 

Dextromethorphan (Mediquell, Benylin DM, PediaCare 1, Delsym, Others) [OTC] [Antitussive] Uses Control nonproductive cough Action Suppresses medullary cough center Dose Adults. 10-30 mg PO q4h PRN (max 120 mg/24 h) Peds. 2-6 y 2.5-7.5 mg q4-8h (max 30 mg/24 h) 7-12 y 5-10 mg q4-8h (max 60 mg/24/h) Caution [C, /-] Not for persistent or chronic cough Contra < 2 y. Disp Caps, lozenges, syrup, Liq SE GI disturbances Interactions T Effects W/ amiodarone, fluoxetine, quinidine, terbinafme T risk of serotonin synd Wf sibutramine, MAOIs T CNS depression Wf antihistamines, antidepressants, sedative, opioids, EtOH EMS Will not affect cough caused by asthma,... 

Antidepressants MAOIs, TCAs, SSRIs, SNRIs, mirtazapine, venlafaxine Amphetamines, phentermine, methylphenidate, sibutramine... 

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

MAOIs ANTIOBESITY DRUGS -SIBUTRAMINE Risk of hypertension and agitation Additive effect on norepinephrine transmission Avoid co-administration. Do not start sibutramine for at least 2 weeks after stopping MAOIs... 

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. 

There are no reports of adverse reactions between sibutramine and the MAOIs. However, sibutramine inhibits serotonin reuptake, and because the serious serotonin syndrome can occur when MAOIs and SSRIs are used together, the manufacturers warn that concurrent use of sibutramine and MAOIs is contraindicated. They say that 14 days should elapse between stopping either drug and starting the other. The US manufacturers included selegUine in this warning. ... 

Because sibutramine inhibits serotonin uptake, and because the serious serotonin syndrome has been seen when serotonergic drugs were taken with SSRIs, the manufacturers say that sibutramine should not be taken with any serotonergic drugs. They name dextromethorphan, dihydroergot-amine, fentanyl, pentazocine, pethidine (meperidine), SSRIs, sumatriptan, and tryptophan. Possible cases have been reported for sibutramine and SSMs , (below).The US manufacturers also include lithium in their list. Note that this list is not exhaustive (see MAOIs under (d) above) and a case of the serotonin syndrome has been seen when venla-faxine was given with sibutramine. ... 

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