Check with your doctor as soon as possible if any of the following side effects occur:
Less common
Achiness; chills; fast or irregular heartbeat; increased blood pressure; mental depression; painful menstruation; swelling of body or of feet and ankles
Rare
Bruising or red spots or patches on skin; convulsions (seizures); excessive bleeding following injury; headache (severe); rapidly changing moods; skin rash; weight gain (unusual)
Cautions and Warnings
It is important that your doctor check your progress at regular visits . Sibutramine may increase blood pressure or heart rate and your doctor will check for these effects. Your doctor may need to adjust your dose.
If sibutramine does not seem to be working well, do not increase your dosage . Check with your doctor.
Do not take sibutramine while you are taking or within 2 weeks of taking medicines with monoamine oxidase (MAO) inhibitor activity , such as isocarboxazid (e.g., Marplan), phenelzine (e.g., Nardil), procarbazine (e.g., Matulane), selegiline (e.g., Eldepryl), or tranylcypromine (e.g., Parnate). Do not take an MAO inhibitor within 2 weeks of taking sibutramine . To do so may cause severe seizures, extremely high blood pressure, or a life-threatening adverse effect called the serotonin syndrome.
Do not drink excess alcohol while taking sibutramine.
Notify your doctor as soon as possible if you develop a skin rash, hives, or other allergic symptoms .
Sibutramine may cause dizziness, drowsiness, or poor judgment. Be sure you know how you react to this medicine before you drive, operate machinery, or do other things that could be dangerous if you are not alert and able to think clearly .
Sibutramine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sibutramine, it is especially important that your health care professional know if you are taking any of the following:
Appetite suppressants, other (benzphetamine [e.g., Didrex], diethylpropion [e.g., Tenuate], mazindol [e.g., Sanorex], phendimetrazine [e.g., Phendiet], phentermine [e.g., Ionamin])—The effects of using sibutramine in combination with another appetite suppressant are not known
Bromocriptine (e.g., Parlodel) or
Buspirone (e.g., BuSpar) or
Certain tricyclic antidepressants (amitriptyline [e.g., Elavil], clomipramine [e.g., Anafranil], imipramine [e.g., Tofranil]) or
Dextromethorphan (cough medicine) or
Levodopa (e.g., Sinemet) or
Lithium (e.g., Eskalith) or
Meperidine (e.g., Demerol) or
Nefazodone (e.g., Serzone) or
Pentazocine (e.g., Talwin) or
Selective serotonin reuptake inhibitors (citalopram [e.g., Celexa], fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft]) or
Street drugs (LSD, MDMA [e.g., ecstasy], marijuana) or
Sumatriptan (e.g., Imitrex) or
Tramadol (e.g., Ultram) or
Trazodone (e.g., Desyrel) or
Tryptophan or
Venlafaxine (e.g., Effexor)—Using these medicines with sibutramine may increase the chance of developing a rare, but very serious, unwanted effect known as the serotonin syndrome. Symptoms of this syndrome include confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, or twitching. If you develop these symptoms, contact your doctor as soon as possible
Moclobemide (e.g., Manerex)—Taking moclobemide and sibutramine together or less than 3 days apart may increase the chance of developing serious unwanted effects, including the serotonin syndrome, and is not recommended
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])— Do not take sibutramine while you are taking or within 2 weeks of taking an MAO inhibitor, and do not take an MAO inhibitor within 2 weeks of taking sibutramine . If you do, you may develop severe seizures, extremely high blood pressure, or the serotonin syndrome. Allow at least 2 weeks to pass between taking one of these medicines (sibutramine or an MAO inhibitor) and taking the other
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