Reductil (sibutramine)

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

This medicine must not be taken at the same time as, or within two weeks of, any of the following medicines:

- monoamine oxidase inhibitor antidepressants (MAOIs)
- medicines acting on the brain for the treatment of psychiatric disorders, eg any antidepressants, antipsychotics
- medicines acting on the brain to aid weight loss (appetite suppressants)
- tryptophan to aid sleep.

Sibutramine should also not be used at the same time as other medicines that increase serotonin levels in the brain, as this may result in a serious side effect called the serotonin syndrome. These medicines include:

- lithium
- SSRI antidepressants such as fluoxetine
- some antimigraine medicines, eg dihydroergotamine or triptans such as sumatriptan
- some opioid painkillers, eg pentazocine, fentanyl, pethidine, tramadol, dextromethorphan
- the herbal remedy St John's wort (Hypericum perforatum).

The following medicines may increase the blood level of sibutramine, which may increase the risk of its side effects:

- the antifungals ketoconazole and itraconazole
- the antibiotics erythromycin and clarithromycin
- ciclosporin.

The following medicines may decrease the blood level of sibutramine, which could make it less effective:

- antiepileptics, eg phenobarbitone, phenytoin, carbamazepine
- rifampicin
- dexamethasone.

Consult your doctor or pharmacist before taking cough, cold or allergy medicines while you are taking sibutramine. This is because the ingredients of some of these medicines, eg pseudoephedrine, ephedrine, xylometazoline, can increase blood pressure and heart rate, and should be used with caution in combination with sibutramine.

There may be an increased risk of bleeding if sibutramine is taken by people who are taking any of the following medicines, which are known to affect the ability of the blood to clot:

- anticoagulant medicines, such as warfarin
- antiplatelet medicines such as aspirin, clopidogrel or dipyridamole
- non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain sibutramine as the active ingredient.

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