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Buy Sibutramine online: facts you should know
Sibutramine, usually available as sibutramine hydrochloride monohydrate, is an orally administered agent for the treatment of obesity, as an appetite suppressant.
Patients taking sibutramine may achieve a 5-10% reduction from their baseline weight. Additionally, sibutramine-assisted weight loss has been accompanied by improvement in blood lipids (e.g, cholesterol). Sibutramine was approved by the FDA in 1997.
Sibutramine is used in combination with a reduced calorie diet and exercise to help people who are overweight lose weight and maintain their weight loss. Sibutramine is in a class of medications called appetite suppressants. It works by acting on appetite control centers in the brain to decrease appetite.
Sibutramine is a neurotransmitter reuptake inhibitor that reduces the reuptake of serotonin (by 53%), norepinephrine (by 54%), and dopamine (by 16%), thereby increasing the levels of these substances in synaptic clefts and helping enhance satiety; the serotonergic action, in particular, is thought to influence appetite. Older anorectic agents such as amphetamine and fenfluramine force the release of these neurotransmitters rather than affecting their reuptake.
Despite having a mechanism of action similar to tricyclic antidepressants, sibutramine has failed to demonstrate antidepressant properties in animal studies. It was approved by the U.S. Food and Drug Administration (FDA) in November 1997 for the treatment of obesity.
Dosage of Sibutramine
Sibutramine is taken once daily, generally in the morning. Therapy usually is started with one 10mg tablet per day. The dose may be increased to 15mg by the physician after several weeks to achieve the desired effect. Doses of up to 60mg have been studied. Sibutramine may be taken with or without food.
Sibutramine comes as a capsule to take by mouth. It is usually taken with or without food once a day. To help you remember to take sibutramine, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sibutramine exactly as directed. Sibutramine can be habit forming. Do not take more or less of it or take it more often or for a longer time than prescribed by your doctor.
Your doctor may start you on a low dose of sibutramine and increase your dose, after you have been taking sibutramine for at least 4 weeks. Your doctor may decrease your dose if you experience certain side effects while you are taking your starting dose.
You will probably lose weight soon after you begin taking sibutramine and following your diet and exercise program. Be sure to monitor your weight, and call your doctor if you do not lose at least 4 pounds (1.8 kilograms) during your first 4 weeks of therapy. Your doctor may wish to change your dose of sibutramine.
You may not continue to lose weight after your first 6 months of treatment. However, you should continue to take sibutramine even if you have stopped losing weight. If you stop taking sibutramine, you may gain weight. Do not stop taking sibutramine without talking to your doctor.
Sibutramine Contraindications
Sibutramine is contraindicated in patients with:
* Psychiatric conditions as bulimia nervosa, anorexia nervosa, serious depression or preexisting mania
* Patients with a history of or a predisposition to drug or alcohol abuse
* Hypersensitivity to the drug
* Patients below 18 years of age
* Concomitant treatment with a MAO inhibitor, antidepressant or other centrally active drugs, particularly other anoretics
* History of peripheral arterial disease
* Hypertension that is not sufficiently controlled (e.g., > 145/90 mmHg), caution in controlled hypertension
* Existing pulmonary hypertension
* Existing damage on heart valves, coronary heart disease, congestive heart failure, serious arrhythmias, previous myocardial infarction
* Stroke or transient ischemic attack (TIA)
* Hyperthyroidism (overactive thyroid gland)
* Closed angle glaucoma
* Seizure disorders
* Enlargement of the prostate gland with urinary retention (relative C.I.)
* Pheochromocytoma
* Pregnant and lactating women (relative C.I.)
Sibutramine side effects
In general, sibutramine is well-tolerated. The most common side effects have been constipation, inability to sleep, headache, and dry mouth. Other side effects include abdominal pain, acne, rash, chest pain, anxiety, joint pain, back pain, excitation, depression, sweating, dizziness, drowsiness, changes in taste, irregular or painful menstrual periods, flu-like syndrome, increased cough, muscle pain, nausea, vomiting, neck pain, nervousness, palpitations, tingling of the extremities, sore throat, and sinus congestion.
Abnormal liver tests have been reported in 1 in 60 persons who receive sibutramine.
Depression, psychosis, mania, suicidal thoughts and suicide have been reported rarely during treatment with sibutramine; however, it has not been established that sibutramine caused these events. If any of these events occur during treatment, sibutramine probably should be discontinued.
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Sibutramine
Sibutramine is a drug for the treatment of obesity. It is a centrally acting stimulant chemically related to amphetamines. Sibutramine is classified as a Schedule IV controlled substance in the United States. Sibutramine acts by increasing serotonin and norepinephrine levels in the brain. The serotonergic action, in particular, is thought to influence appetite.
Sibutramine is a neurotransmitter reuptake inhibitor that helps enhance satiety by inhibiting the reuptake of serotonin (by 53%), norepinephrine (by 54%), and dopamine (by 16%). It was approved by the U.S. Food and Drug Administration (FDA) in November 1997 for the treatment of obesity.
Frequently encountered side effects are: dry mouth, paradoxically increased appetite, nausea, strange taste in the mouth, anorgasmia and delayed ejaculation, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/muscle pain.
Safety concerns when buy sibutramine
Studies are ongoing into reports of sudden death, heart failure, renal failure and gastrointestinal problems. Despite a petition by Ralph Nader-founded NGO Public Citizen, the FDA made no attempts to withdraw the drug, but was part of a Senate hearing in 2005. Similarly, Dr. David Graham, FDA “whistleblower”, testified before a Senate Finance Committee hearing that sibutramine may be more dangerous than the conditions it is used for.
A large randomized-controlled study with 10,742 patients (SCOUT) examined whether or not sibutramine administered within a weight management program reduces the risk for cardiovascular complications in people at high risk for heart disease and concluded that “Six-week treatment with sibutramine appears to be efficacious, tolerable and safe in this high-risk population for whom sibutramine is usually contraindicated.”
The FDA is reviewing preliminary data from a recent study suggesting that patients using sibutramine have a higher number of cardiovascular events (heart attack, stroke, resuscitated cardiac arrest, or death) than patients using a placebo. The preliminary data shows that cardiovascular events were reported in 11.4% of patients using sibutramine compared to 10% of patients using a placebo. This difference is higher than expected, suggesting that sibutramine is associated with an increased cardiovascular risk in the study population. The analysis of these data is ongoing and FDA is making no conclusions about the preliminary findings at this time. These findings highlight the importance of avoiding the use of sibutramine in patients with a history of coronary artery disease (heart disease), congestive heart failure (CHF), arrhythmias, or stroke, as recommended in the current sibutramine labeling.
On January 21, 2010, the European Medicines Agency recommended suspension of marketing authorizations for Sibutramine following a six-year study which showed an increased risk of non-fatal but serious cardiovascular events in patients with a known or high risk for cardiovascular disease.
The European Medicines Agency (EMA) has recommended that all medicines containing the drug sibutramine should no longer be prescribed or dispensed in European Union (EU) member countries, as well as Iceland and Norway. Abbott is complying with the agency’s recommendation and has suspended marketing of medicines containing sibutramine.
Abbott offers sibutramine medicines under the brand name, Reductil, in the UK. Sibutramine is also marketed under other names by other companies.
Below you will find answers to some of the most frequently asked questions about the EMA recommendation and sibutramine. For additional information, we would suggest you consult your physician or contact Abbott at the number listed below.
What are the recommendations for prescribers and patients?
The EMA recommends in Europe that:
- Doctors should stop prescribing sibutramine-containing medicines to obese or overweight patients. They should also review the treatment of patients currently treated with the medicine.
- Pharmacist should no longer dispense sibutramine-containing medicines
- Patients who are taking a medicine containing sibutramine to help them lose weight should make an appointment with their doctor at the next convenient time to discuss alternative measures to lose weight.
- Patients who wish to stop treatment before seeing their doctor can do so at any time.
- Patients who have any questions should speak to their doctor or pharmacist.
What should I do if I’m currently taking sibutramine?
- Please contact your doctor. See also EMA and MHRA recommendation
Why was sibutramine suspended in Europe?
- The Committee for Medicinal Products for Human Use (CHMP) of the EMA voted to recommend that suspension of marketing authorisations for all medicines containing sibutramine in the EU, as well as Iceland and Norway.
- The CHMP’s recommendation was based on a review of results from the SCOUT study (Sibutramine Cardiovascular OUTcome Trial), which became available in November 2009.
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