Sibutramine (
Reductil, Abbott-Knoll, 10 mg and 15 mg) is a new appetite regulator recommended in the treatment of
obesity. It is a
noradrenaline and
5-hydroxytryptamine reuptake inhibitor which exerts its effects in vivo predominantly via its secondary and primary
amine metabolites.
Sibutramine is indicated as an adjunctive
therapy within a weight management programme in patients with
obesity (BMI > or = 30 kg/m2) or in
overweight subjects (BMI > or = 27 kg/m2) if other eight-related risk factors are present (dyslipidaemias,
diabetes mellitus). In those patients with an inadequate response on initial dose of 10 mg per day (suggested as less than 2 kg
weight loss in four weeks), the dose may be increased to 15 mg once daily, providing that
sibutramine is well tolerated. Several large-scale randomized clinical trials demonstrated the efficacy of long-term (at least one year) treatment with
sibutramine in obese subjects with or without
type 2 diabetes.
Sibutramine was also shown to help in maintaining long-term
weight reduction. Most frequent side-effects are dry mouth and
constipation, as well as mild increase in heart rate and arterial blood pressure. The impact of
sibutramine on cardiovascular morbidity and mortality of obese nondiabetic and diabetic patients will be studied soon in a large international prospective clinical trial.