Reductil (sibutramine) produces weight loss by reducing appetite and by reducing the usual fall in resting metabolic weight seen on an energy reduced diet.

Reductil is used to assist with weight reduction for patients who;

• Have a body mass index of 30 or higher
• Have a body mass index of 27 or higher with other obesity related factors such as diabetes or raised lipids.

It is recommended that reductil is prescribed only for patients who have failed to lose 5% of their weight within 3 months after tried dieting with exercise.

The dose is 10 mg taken once daily with or without food. If patients fail to lose 2Kg after 4 weeks then the dose may be increased to 15mg per day provided that the dose of 10mg was well tolerated. If then the patient still fails to lose 2kg after a further 4 weeks then Reductil should be discontinued.

Reductil should also be discontinued if patients do not lose 5% or more weight after 3 months OR having lost this weight then regain 3Kg.

Reductil should not be given for more than 1 year.

Who must not take Reductil?

• History of severe eating disorders such as anorexia nervosa and bulimia nervosa
• Psychiatric illness; Reductil could induce a manic episode in those with manic/depressive disorders
• History of coronary heart disease (angina, previous myocardial infarct, CABG or angioplasty) heart failure, stroke or TIA, dysrthymias and peripheral arterial disease.
• Inadequately controlled hypertension i.e. BP >145/90
• Hyperthyroidism
• Severe liver impairment
• Severe renal impairment
• Benign prostatic hyperplasia with urinary retention
• Phaeochromocytoma
• Glaucoma
• Pregnancy and lactation
• Alcohol and drug abuse
• Children and young adults up to age 18 years
• Above 65 years of age

Are there any precautions during therapy?

• Blood pressure can rise on Reductil and needs monitoring. Reductil should be discontinued if Systolic / diastolic pressure rises 10mmHg on two consecutive readings.
• In well controlled hypertensive patients Reductil should cease if BP >145/90 on two consecutive readings.
• Heart rate may also rise and if resting rate rises >10 beats per minute on two consecutive occasions then Reductil should cease.
• Both BP rise and heart rate rise tend to occur in first 12 weeks of therapy
• Reductil is eliminated from the body by liver metabolism and certain other medicines may alter its biological effectiveness such as ketoconazole, itraconazole, erythromycin, clarithromycin, cyclosporin and troleandomycin.

Fast heart rate
Palpitations
Raised blood pressure
Hot flushes
Constipation
Nausea
Aggravates piles
Dry mouth
Insomnia
Light headness
Paraesthesia (Tingling sensations)
Headache
Anxiety
Sweating
Taste perversion
Very rarely it can result in kidney disease (nephritis), fits, and bone marrow depression (thrombocytopenia)

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Ó NHS Tayside; 2006; version 1.0

Disclaimer; no liability whatsoever is accepted for information given and all such information, especially with regard to drug usage (UK version provided), must be checked with a person’s health provider.