sibutramine hydrochloride

CLINICAL USE

Treatment of obesity for patients who have not responded to appropriate weight reducing methods

DOSE IN NORMAL RENAL FUNCTION

10–15 mg daily

PHARMACOKINETICS

Molecular weight :334.3

%Protein binding :97

%Excreted unchanged in urine : Only inactive metabolites

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :14–16

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function. Use with caution

10 to 20 : Dose as in normal renal function. Use with caution

<10 : Dose as in normal renal function. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antidepressants: increased risk of CNS toxicity; avoid concomitant administration with MAOIs and moclobemide – avoid for at least 2 weeks after stopping sibutramine; increased CNS toxicity with noradrenaline re-uptake inhibitors, tricyclics, SSRIs, mirtazapine and tryptophan – avoid concomitant use with tryptophan

Antipsychotics: increased risk of CNS toxicity – avoid concomitant useAvoid use with drugs which increase heart rate or blood pressure

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Do not use in patients with uncontrolled hypertension, i.e. BP >145/90 mmHgInitiation of therapy is associated with a mean increase in resting systolic and diastolic BP of 2–3 mmHg

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