Sibutramine
(Brand names: Meridia in the US or Reductil in other countries)

Pros

Studies have shown that on average, people lose weight with Meridia. Within 1 year, there may be a 9.8 lb (4.45 kg) weight loss. One study showed that sibutramine in combination with lifestyle changes caused a weight loss of 26.6 lbs compared to the drug (11 lbs) or lifestyle changes (14.8 lbs) alone.

There also appears to be a reduction in triglycerides and bad (or LDL) cholesterol. People with diabetes may see a decrease in their blood sugar (glucose) and hemoglobin A1c levels (a longer term measure of blood sugar control). Diabetics may also see an increase in their good (or HDL) cholesterol. Meridia causes weight loss in adolescents.

Cons

By 2004, in a hearing that prompted the withdraw of Vioxx, an FDA officer testified to the US Senate that sibutramine was potentially dangerous. In the fall of 2010 at the request of the FDA, Abbott Laboratories withdrew Meridia from the US market based on analysis of the SCOUT (Sibutramine Cardiovascular OUTcome Trial) study which showed a "16 percent increase in the risk of serious heart events, including non-fatal heart attack, non-fatal stroke, the need to be resuscitated once the heart stopped, and death, in a group of patients given sibutramine compared with another given placebo." [ref.] The European Medicines Agency (EMA) had already suspended marketing authorization for all anti-obesity medicines containing sibutramine in January of 2010

Meridia increases blood pressure by 1-3 points (mmHg) and heart rate by about 4-5 beats per minute. Diabetics need good control of their blood pressure in order to prevent kidney or other organ damage. In one study among adolescents, the dose of sibutramine had to be decreased or the drug had to be stopped because of increases in blood pressure or heart rate. The effect on increased blood pressure is most in people weighing 203 lbs or more and in people younger than 44 years old.

Before its withdraw, this drug was already to be be avoided in people with coronary heart disease (CHD or CAD), congestive heart failure (CHF), heart rhythm problems, or people who have had a stroke. There is a risk of developing something called serotonin syndrome in people who take Meridia along with a monoamine oxidase inhibitor (MAOI) or selective serotonin reuptake inhibitor (SSRI), both of which are mainly antidepressants but can be use for other conditions. Erythromycin, ketoconazole, or other medicines that affect the enzyme cytochrome P450 (CYP450) can affect the body’s metabolism of sibutramine. You should discuss all of this with your doctor.

Other Comments

In nearly all studies, giving the drug was also accompanied by making a change in the person’s diet. Diet and exercise are the cornerstones of any weight loss program.

Return to Weight Loss Drugs or Home Page.

Last updated: 1/11/11