Sibutramine
Pronunciation:sih-BYOO-tra-meen
Chemical Abstracts Service Registry Number:106650-56-0. (Hydrochloride an-
hydrous form 84485-00-7; Hydrochloride monohydrate form 125494-59-9)
Formal Names:Meridia, Reductil
Type:Stimulant (anorectic class).Seepage 15
Federal Schedule Listing:Schedule IV (DEA no. 1675)
USA Availability:Prescription
Pregnancy Category:C
Uses.This weight control medicine appears to work by making people feel
more full while eating a meal, thereby reducing appetite. People using sibu-
tramine eat less regardless of whether they are trying to lose weight. In rats
the drug increases the rate at which the body consumes stored energy, burning
off calories. A similar action has been measured in humans. Sibutramine has
also been used for treating nerve pain caused by diabetes. One research study
found that the drug improved attention and muscular coordination.
A given dose of the drug tends to produce higher drug levels in women
than in men, but the difference is not considered significant enough to affect
calculation of dosage. Blood levels from a given dose also tend to be higher
in blacks than in whites, but again the difference is considered insignificant.
Drawbacks.The drug elevates heart rate and blood pressure. Headache,
insomnia, dry mouth, and constipation are typical unwanted effects. The med-
icine may promote bleeding. Sibutramine is not recommended for persons
suffering from narrow-angle glaucoma or for persons who have had seizures.
Abuse factors.Although chemical details are highly technical, sibutramine
operates in ways fundamentally different from the weight-loss drugsfenflur-
amineanddextroamphetamine, differences that may make abuse of sibutra-
mine less likely. Volunteers with a history of drug abuse were paid to
participate in a study. They found sibutramine unpleasant (causing confusion,
unease, and loss of energy), so unpleasant that in order to avoid a high dose
they were willing to accept reduction in the fee. In another study, examining
how recreational stimulant users react to sibutramine, researchers concluded
the drug had no more appeal than a placebo.
Drug interactions.Sibutramine should normally be avoided if a person is
taking a monoamine oxidase inhibitor (MAOI—found in some antidepressants