The Athlete
Sibutramine (Meridia)
Meridia works by acting on the appetite control center in the brain. The active ingredient in MERIDIA, sibutramine, works in the area of the brain that signals the sense of fullness. Meridia does not suppress appetite, which is your signal to start eating.
Meridia blocks the re-uptake of the brain chemicals serotonin and norepinephrine, which help regulate the sense of fullness. Fullness is your signal to stop eating. Having a sense of fullness, or satiety, means you may feel satisfied with less food.
Meridia is recommended for people with a Body Mass Index (BMI) of over 30. (BMI is calculated by weight in kilograms divided by height in meters squared.
Among adults, Meridia has been found to increase blood pressure or heart rate in some patients. That's one reason why the consumer group Public Citizen has named Meridia to its "worst drugs" list. Public Citizen has twice petitioned the FDA to remove the drug from the market, citing 49 heart disease deaths in people taking Meridia and suggesting that the drug might be linked to fetal defects in four babies born to women taking Meridia.Not everyone agrees with that.
The American Obesity Association has said that death rates seen with Meridia are lower than the overall death rate for obese people. Meridia's maker has noted that heart disease deaths aren't uncommon with obesity. Clinical trials of more than 12,000 people showed no sign that Meridia increased the risk of heart problems. The drug's maker says Meridia's benefits far outweigh any risk, based on clinical trials and post marketing data. This is something you will need to discuss with your doctor before starting this treatment and your blood pressure should be monitored during treatment.
Side Effects
The most common side effects with Meridia are dry mouth, anorexia, constipation and headache. Other side effects not as common include mydriasis and should be used with caution if you have glaucoma.
Precautions
You should not take Meridia if you are currently taking any MAOI's. Because MERIDIA inhibits serotonin reuptake, in general, it should not be taken with other serotonergic agents such as Imitrex or certain opioids, such as dextromethorphan, meperidine, pentazocine and fentanyl, lithium, or tryptophan.
Serotonin syndrome has also been reported with the concomitant use of two serotonin reuptake inhibitors. The syndrome requires immediate medical attention and may include one or more of the following symptoms: excitement, hypomania, restlessness, loss of consciousness, confusion, disorientation, anxiety, agitation, motor weakness, myoclonus (twitching or spasm of a muscle), tremor (shaking), hemiballismus (jerking of one side of the body), hyperreflexia (exaggeration of reflexes), ataxia (failure of muscle coordination), dysarthria (trouble speaking), incoordination, hyperthermia, shivering, pupillary dilation, diaphoresis (excessive sweating), emesis (vomiting), and tachycardia (rapid heartbeat).
Make sure your doctor knows if you are taking any other medication before starting Meridia.
Overdose
There have only been 3 reported cases of Meridia overdose and no serious adverse effects were found.
Pregnancy and Nursing Mothers
No adequate and well controlled studies with MERIDIA have been conducted in pregnant women. The use of MERIDIA during pregnancy is not recommended. Women of childbearing potential should employ adequate contraception while taking MERIDIA. Patients should be advised to notify their physician if they become pregnant or intend to become pregnant while taking MERIDIA.
It is not known if Meridia is excreted into breast milk so women who are nursing are advised not to take it.
Usage in Children
Meridia is not recommended for children under 16 years old.
Geriatric Use
Clinical studies of Meridia did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, caution should be used in elderly patients due to the greater frequency of kidney, liver and heart problems.
Recommended Dosage
The recommended starting dose is 10 mg once a day, with or without food. If there is inadequate weight loss after 4 weeks the dose can be increased to 15 mg a day depending upon blood pressure and heart rate. Of all the prescription weight loss pills available, Meridia has the least amount of side effects for those who are not taking certain other medications, however, as with all weight loss drugs, your doctor should monitor your progress.