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All about: Meridia

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Generic name: Sibutramine hydrochloride
Brand names: Meridia

Why is Meridia prescribed?

Meridia helps the seriously overweight shed pounds and keep them off. It is especially recommended for those who in addition to being overweight have other health problems such as high blood pressure, diabetes, or high cholesterol. It is used in conjunction with a low-calorie diet.

Meridia works by boosting levels of certain chemical messengers in the nervous system, including serotonin, dopamine, and norepinephrine.

Most important fact about Meridia

Make a point of keeping follow-up appointments with your doctor. Meridia can increase your blood pressure, so it's important to have your blood pressure and pulse monitored at the beginning of therapy and regularly thereafter.

How should you take Meridia?

Meridia can be taken with or without food.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature away from heat and moisture in a tight, light-resistant container.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Meridia.

  • More common side effects may include:
    Abdominal pain, acid indigestion, anxiety, back pain, constipation, cough increase, depression, dizziness, dry mouth, flu symptoms, headache, increased appetite, insomnia, joint pain, loss of appetite, loss of strength, nasal inflammation, nausea, nervousness, painful menstruation, rash, sinus inflammation, stomachache, sore throat

Why should Meridia not be prescribed?

If Meridia gives you an allergic reaction, you won't be able to use it. You should also avoid Meridia (and certainly don't need it) if you suffer from the compulsive dieting disorder known as anorexia nervosa. Do not combine Meridia with other drugs used to suppress appetite, and do not use it within 2 weeks of taking a drug classified as an MAO inhibitor, including the antidepressant medications Marplan, Nardil, and Parnate.

Special warnings about Meridia

Use Meridia with caution if you have uncontrolled high blood pressure or are predisposed to bleeding; the drug could make the problem worse. Avoid Meridia completely if you've had a stroke or suffer from heart disease, heart failure, or irregular heartbeat. Also avoid it if you have severe kidney or liver problems; the drug has not been tested under these conditions. Seizures are a rare, but possible, side effect. If you've had seizures in the past, use Meridia with caution. If you have a seizure while taking the drug, stop using it and call your doctor immediately.

Any drug that acts on the nervous system can theoretically impair judgment, thinking, and motor skills. Meridia does not seem to have this effect, but caution is still in order until you know how the drug affects you.

If you have narrow-angle glaucoma or thyroid problems, make sure the doctor knows; Meridia should be used with caution in these circumstances. If you are prone to gallstones, be aware that weight loss can cause more of them to form. Meridia has not been tested in people under 16 years old. It should be used with caution in those over 65. Although it has been classified as a controlled substance (potentially subject to abuse), the possibility of developing physical or psychological dependence is low.

Possible food and drug interactions when taking Meridia

Remember that Meridia must never be taken within 2 weeks of using an MAO inhibitor such as Marplan, Nardil, or Parnate. The combination could lead to serious, even fatal, overstimulation.

Meridia may also interact with a wide variety of other prescription and over-the-counter drugs, especially weight-reducing agents, decongestants, antidepressants, allergy medications, and cough and cold remedies that contain ephedrine or pseudoephedrine. Among the many drugs that pose a potential problem are the following:

Alcohol (excessive amounts)
Blood thinners such as warfarin (Coumadin)
Dextromethorphan (found in many over-the-counter cough preparations)
Dihydroergotamine (D.H.E. Injection, Migranal Nasal Spray)
Drugs that affect platelet function
Erythromycin (Eryc, Ery-Tab, PCE)
Fentanyl (Duragesic)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Ketoconazole (Nizoral)
Lithium (Eskalith, Lithobid)
Meperidine (Demerol)
Naratriptan (Amerge)
Paroxetine (Paxil)
Pentazocine (Talwin NX, Talacen)
Sertraline (Zoloft)
Stimulants such as amphetamines, Dexedrine, Desoxyn, Adderall, Didrex, and Ionamin
Sumatriptan (Imitrex)
Tryptophan (L-Tryptophan)
Venlafaxine (Effexor)
Zolmitriptan (Zomig)

If you have any doubt about the safety of a combination, be sure to check with your doctor.

Special information if you are pregnant or breastfeeding

The use of Meridia during pregnancy is not recommended. If you are in your child-bearing years, take reliable contraceptive measures while using Meridia. If you do become pregnant, or plan on becoming pregnant, tell your doctor immediately. It is not known whether Meridia appears in breast milk; its use while breastfeeding is not recommended.

Recommended dosage

ADULTS

The starting dose is 10 milligrams once daily. If you have not lost at least 4 pounds after 4 weeks, the doctor may increase the dose to 15 milligrams daily. This is the maximum; if weight loss still fails to appear, Meridia will be discontinued.

For those who experience side effects at the 10-milligram level, a 5-milligram dose may prove sufficient.

Use of Meridia for longer than 1 year has not been studied.

Overdosage

Although doctors have had little experience with overdoses of Meridia, increased heart rate and blood pressure are possible results. Since any medication taken in excess can have serious consequences, seek medical attention immediately if you suspect an overdose.

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