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Slenfig-10

( Sibutramine Hydrochloride Monohydrate Capsules, 10 mg )

DESCRIPTION

Each capsule contains sibutramine HCI monohydrate 10 mg.

Sibutramine HCI monohydrate is a racemic mixture of the (+) and (-) enantiomers of N-(1-[1-(4--chlorophenyl) cyclobutyl]-3-methylbutyl)-N, N-dimethylamine hydrochloride monohydrate, and has an empirical formula of C₁₇H₂₈CI₂NO. Its molecular weight is 334.33.

PROPERTIES

Sibutramine is an anti-obesity agent with selective serotonin & norepinephrine reuptake inhibitor activity.

INDICATIONS

Adjunctive therapy within a weight management programme for patients with nutritional obesity and a body mass index ( BMI ) of ≥ 30 kg/m²; or patients with nutritional excess weight and a BMI of ≥ 27 kg/m², if other obesity-related risk factors eg, type II diabetes or dyslipidaemia are present.

Note : Slenfig may only be prescribed to patients who have not adequately responded to an appropriate weight-reducing regimen alone ie, patients who have difficulty achieving or maintaining > 5% weight loss within 3 months. Treatment with Slenfig should only be given as part of a long-term integrated therapeutic approach for weight reduction under the care of  physician experienced in the treatment of obesity. An appropriate approach to obesity management should include dietary and behavioural modification as well as increased physical activity. This integrated approach is essential for a lasting change in eating habits and behaviour which is fundamental to the long-term maintenance of the reduced weight level once Slenfig is stopped. Patients should change their lifestyle while on Slenfig so that they are able to maintain their weight once drug treatment has ceased. They should be informed that if they fail to do so, they may regain weight. Even after cessation of Slenfig, continued monitoring of the patient by the physician should be encouraged.

DOSAGE

Adults : Initial Dose : One 10-mg cap swallowed whole once daily, in the morning, with liquid ( eg, a glass of water ). The capsule can be taken with or without food.

In those patients with an inadequate response to Slenfig 10mg ( defined as < 2 kg weight loss in 4 weeks treatment ), the dose may be increased to one 15-mg cap once daily, provided that Slenfig 10mg was well tolerated.

Treatment must be discontinued in patients who have responded inadequately to Slenfig 15mg ( defined as < 2 kg weight loss in 4 weeks treatment ). Non-responders are at a higher risk of undesirable effects ( see Side Effects ). Duration of Treatment : Treatment must be discontinued in patients who have not responded adequately ie, whose weight loss stabilises at < 5% of their initial body weight or whose weight loss within 3 months after starting therapy has been < 5% of their initial body weight. Treatment should not be continued in patients who regain ≥ 3kg after having previously achieved weight loss. In patients with associated co-morbid conditions, it is recommended that treatment with Slenfig should only be continued if it can be shown that the weight loss induced is associated with other clinical benefits eg, improvements in lipid profile in patients with dyslipidaemia or glycaemic control of type II diabetes. Slenfig should only be given for periods up to 2 years. Data on use over 2 years is limited.

CONTRAINDICATIONS

Known hypersensitivity to sibutramine HCI monohydrate or any other component of Slenfig. Organic causes of obesity; history of major eating disorders eg, anorexia nervosa and bulimia nervosa ( No data are available for sibutramine in the treatment of patients with binge (compulsive) eating disorder ); psychiatric illness ( Sibutramine has shown potential antidepressant activity in animal studies. Therefore, it cannot be excluded that sibutramine could induce a manic episode in bipolar patients. ); Gilles de la Tourette's syndrome. Concomitant use, or use during the past 2 weeks, of MAOIs or of other centrally-acting drugs for the treatment of psychiatric disorders ( eg, antidepressants, antipsychotics ) or for weight reduction, or tryptophan for sleep disturbances. History of coronary artery disease, congestive heart failure, tachycardia, peripheral arterial occlusive disease, arrhythmia or cerebrovascular disease ( stroke or TIA ). Inadequately controlled hypertension ( >145/90 mm Hg ) ( see Precautions ); hyperthyroidism; severe hepatic and renal impairment; benign prostatic hyperplasia with urinary retention; phaeochromocytoma; narrow angle glaucoma; history of drug, medication or alcohol abuse.

Use in pregnancy : Sibutramine should not be used during pregnancy. It is generally considered inappropriate for weight-reducing drugs to be used during pregnancy, so women of childbearing potential should employ an adequate method of contraception while taking sibutramine and notify a physician if they become pregnant or intend to become pregnant during therapy. No controlled studies with Sibutramine have been conducted in pregnant women. Studies in pregnant rabbits have shown effects on reproduction at maternally toxic doses ( see Toxicology : Preclinical Safely Data under Actions ). The relevance of these findings to humans is unknown.

Use in lactation : It is not whether sibutramine is excreted in human breast milk and therefore administration of Sibutramine is contraindicated during lactation.

Use in children : Not to be used in children and young adults up to 18 years, owing to insufficient data. Use in the elderly : Not to be used in patients > 65 years, owing to insufficient data.

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