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Interactions
Sibutramine has a number of clinically significant interactions. The concomitant use of Sibutramine and monoamine oxidize inhibitors (MAOIs, such as selegiline) is not indicated, as it may increase the risk of serotonin syndrome, a somewhat rare but serious adverse drug reaction. Sibutramine should not be taken less than two weeks after stopping or before starting use of an MAOI. Taking both Sibutramine and certain medications used in the treatment of migraines such as ergo lines and trip tans, as well as opioids, may also increase the risk for serotonin syndrome, as may the use of more than one serotonin reuptake inhibitor at the same time.
Dosage
10 mg once daily (usually in the morning), if this proves insufficient the dose may be increased to 15 mg daily after 4 weeks
PRECAUTION:
Before taking Sibutramine, tell your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: eating disorders (e.g., anorexia nervosa, bulimia nervosa), uncontrolled or poorly controlled high blood pressure, heart or blood vessel disease (e.g., coronary artery disease, history of heart attack or angina, congestive heart failure, abnormal heart rhythms, poor circulation in the arms/legs), stroke or TIA (transient ischemic attack).
SIDE EFFECTS OF SIBUTRAMINE:
If you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using Sibutramine if:
* Flu symptoms;
* Fast or pounding heartbeats;
* Dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, chest pain, uneven heartbeats);
* New or worsening shortness of breath;
* Seizure (convulsions)
* Easy bruising or bleeding (nosebleeds, bleeding gums, or any bleeding that will not stop);
* Blood in your urine or stool;
* Weakness, restless feeling, confusion, anxiety, agitation, fever, overactive reflexes, joint pain, sweating, vomiting, tremors; or
* Very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, feeling like you might pass out.
Less serious side effects may include:
* Dry mouth, upset stomach;
* Loss of appetite;
* Dizziness;
* Runny or stuffy nose, sore throat, coughs;
* Headache, back pain;
* Trouble sleeping (insomnia),
* Constipation.
* Hunger;
* Mild skin rash; or
* Changes in your menstrual period.
This is not a complete list of side effects and others may occur.
CONTRADICTION:
Sibutramine is contraindicated in patients with:
* Psychiatric conditions as bulimia nervosa, anorexia nervosa, serious depression or preexisting mania
* Patients with a history of or a predisposition to drug or alcohol abuse
* Hypersensitivity to the drug or any of the inactive ingredients
* Patients below 18 and above 65 years of age
* Concomitant treatment with a MAO inhibitor, antidepressant or other centrally active drugs, particularly other anorectics
* History of peripheral arterial disease
* Hypertension that is not sufficiently controlled (e.g., > 145/90 mmHg), caution in controlled hypertension
* Existing pulmonary hypertension
* Existing damage on heart valves, coronary heart disease, congestive heart failure, serious arrhythmias, previous myocardial infarction
* A history of coronary artery disease (e.g., angina, history of myocardial infarction), congestive heart failure, tachycardia, peripheral arterial occlusive disease, arrhythmia or cerebrovascular disease (stroke or transient ischemic attack (TIA))[13]
* Stroke or transient ischemic attack (TIA)
* Hyperthyroidism (overactive thyroid gland)
* Closed angle glaucoma
* Seizure disorders
* Enlargement of the prostate gland with urinary retention (relative C.I.)
* Pheochromocytoma
* Pregnant and lactating women (relative C.I.)
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