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Diabetes Medications and New Drugs

Sibutramine

This information is based on the NICE (National Institute for Clinical Excellence) Guidelines on the uses of sibutramine for the treatment of obesity in adults. The National Institute for Clinical Excellence (NICE) is a part of the NHS. It produces guidance for both the NHS and patients on medicines, medical equipment, diagnostic tests and clinical & surgical procedures and where they should be used.

What is Sibutramine?

Sibutramine (Reductil) works in the brain by altering appetite.  It mainly affects two chemicals called noradrenaline and serotonin and promotes a feeling of being full or having eaten enough.

Are there any risks associated with Sibutramine?

Sibutramine causes increases in the blood pressure of some of the people who take it. People who are prescribed sibutramine must have their blood pressure checked before starting treatment and at intervals during treatment. People with high blood pressure should not take sibutramine.

Who should take Sibutramine?

NICE has recommended that sibutramine should be prescribed only as part of an overall treatment plan for the management of obesity for people with diabetes aged 18-65 years who:

  • have a body mass index (BMI) of 27.0 kg/m2 or more
  • have made serious attempts to lose weight by dieting, exercise and/or other changes in their behaviour

When people are prescribed sibutramine they should also be offered advice, support and counselling on diet, exercise and behaviour changes.

What precautions should be taken?

  • Sibutramine is not recommended for patients who already have high blood pressure (145/90 or above).  Because sibutramine can cause increases in blood pressure, people taking it should have their blood pressure checked regularly. Increases in blood pressure should be considered carefully, and may be a reason to stop treatment.
  • People taking sibutramine should only continue with treatment for more than 4 weeks if they have lost 2 kg in weight. Sibutramine should be stopped if patients do not lose weight as described above.
  • People should only continue on this treatment beyond 3 months if they have lost at least 5% (5kg for each 100kg) of their body weight from the start of the drug treatment.

How long is treatment continued for?

Treatment is not recommended for more than 12 months.

Is it worthwhile combining this with other drug for weight loss?

There is no evidence to show that prescribing sibutramine with other drugs used to treat obesity has any benefits.

 

Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospital Diabetes Service
October 2002

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