Dear Reader,

Meridia (from Knoll Pharmaceutical Company) is the brand name for sibutramine, a prescription obesity drug that suppresses appetite. It is a neurotransmitter reuptake inhibitor that helps control appetite by inhibiting the reuptake of serotonin, norepinephrine, and dopamine. By doing this, sibutramine helps increase the levels of these hormones, that control appetite and hunger, in the brain. It's the first selective serotonin reuptake inhibitor (SSRI) to be used for the specific use of weight loss, although many drugs in the same class have been used as anti-depressants (e.g., Prozac, Paxil).

The most common adverse effects of sibutramine include:

• Constipation
• Dry mouth
• Elevated blood pressure
• Headache
• Increased perspiration
• Raised heart rate
• Sleeplessness²

The decision to start this drug should always be a joint one between you and your physician, who will determine whether or not sibutramine is appropriate for you, and if so, s/he will need to supervise you while you're on it.

The manufacturers state that sibutramine should only be prescribed to:

• otherwise healthy obese individuals [body mass index (BMI) > or = 30 kg/m²]
• the morbidly overweight (BMI > or = 27 kg/m² with health risks, such as high blood pressure, diabetes, or high cholesterol)

(Body mass index is calculated as weight measured in kilograms over height in meters squared.)

As with other diet medications, such as the now recalled Fen-Phen combination, use is recommended only after careful consideration of whether or not the benefits of taking the drug would outweigh the possible adverse effects from its use and the health risks from being obese. If you do not meet these criteria, and are interested in losing or managing your weight, then talk with your doctor, a nutritionist, and/or an exercise physiologist or trainer about your eating and exercise options.

For best results, sibutramine is intended to be used as part of a comprehensive weight loss and weight management program that also includes a healthy and appropriate eating and exercise plan. Don't take sibutramine if you:

• Have high blood pressure that's controlled inadequately or not at all. (Sibutramine has been cited to cause a considerable rise in blood pressure in some patients. As a consequence, your doctor must monitor your blood pressure on a regular basis while you're taking sibutramine.)

• Are using any of the following, because of possible negative interactions:

  Other prescription, over-the-counter, and/or herbal weight loss treatments

  Monoamine oxidase inhibitors (MAOIs), because of serious, and possibly dangerous, drug interactions

  Medications that control serotonin levels in the brain, such as serotonergic agents and certain antidepressants, because a serious, but rare, disease called Serotonin Syndrome has developed in persons who take sibutramine in addition to another SSRI

  Decongestants and cough suppressants

  Dihydroergotamine

  Lithium

  Sumatriptan

  Tryptophan

• Have had allergic or other negative reactions to sibutramine in the past
• Are younger than 16 years
• Have anorexia²

Before you consider using this medication, it's in your best interest to be as open and thorough with your doctor as possible so that s/he can understand your medical history and come up with the most appropriate plan for you, whether or not it will include sibutramine. Make sure your doctor knows if any of the following applies to you:

• Treatment of depression with prescription medication(s)
• Bulimia
• Epileptic seizures or convulsions
• Gallstone disease
• Glaucoma
• Heart disease or its signs
• Hypertension
• Kidney disease
• Liver disease
• Migraine headaches
• Osteoporosis
• Parkinson's disease
• Stroke or its signs
• Thyroid problems
• Use of serotonin regulators
• Currently pregnant or plan on becoming pregnant
• Currently breastfeeding
• Any other medical or health conditions²

Considering that sibutramine's long-term safety and effectiveness are still unknown at this time, talk with your doctor to determine whether or not you will need to take sibutramine beyond the short-term.

For more information, visit the:

(1) U.S. Food and Drug Administration (FDA) web site

(2) Meridia home page

Alice

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