ABSTRACT
These agents are used often in patients with type II diabetes who are on hypoglycaemic therapy. Need to monitor blood sugars twice weekly until stable. Advise self-monitoring and warn about symptoms of hypoglycaemia. Watch for and warn patients about symptoms of hypoglycaemia. Avoid coadministration of acarbose and orlistat ➣ For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia
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NERVOUS SYSTEM DRUGS ANTIOBESITY DRUGS Rimonabant
Uncertain at present Monitor BP at least weekly until stable
ORLISTAT ANGIOTENSIN II RECEPTOR ANTAGONISTS
Cases of ↓ efficacy of losartan Uncertain at present Monitor BP at least weekly until stable
ORLISTAT BETA-BLOCKERS Case of severe ≠ BP when orlistat is started in a patient on atenolol
Uncertain at present Monitor BP at least weekly until stable
ORLISTAT CALCIUM CHANNEL BLOCKERS
Case report of ≠ BP when orlistat was started in a patient on amlodipine
Uncertain at present Monitor BP at least weekly until stable
ORLISTAT THIAZIDES Case report of ≠ BP when orlistat was started in a patient on thiazides
Uncertain at present Monitor BP at least weekly until stable
RIMONABANT
RIMONABANT ANTIDIABETIC DRUGS – ACARBOSE, INSULIN, NATEGLINIDE, REPAGLINIDE, SULPHONYLUREAS
Tendency for blood glucose levels to fluctuate
Antiobesity drugs change the dietary intake of carbohydrates and other foods, and the risk of such fluctuations is greater if there is a concurrent dietary regimen. A side-effect of orlistat is hypoglycaemia
These agents are used often in patients with type II diabetes who are on hypoglycaemic therapy. Need to monitor blood sugars twice weekly until stable. Advise self-monitoring and warn about symptoms of hypoglycaemia. Watch for and warn patients about symptoms of hypoglycaemia ➣ For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia
N ER
V O
U SSY
STEM D
R U
G S
A N
TIO B
ESITY D
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G S
Mechanism Precautions
Ketoconazole inhibits CYP3A4-
mediated metabolism of rimonabant
Avoid co-administration
SIBUTRAMINE
SIBUTRAMINE ANALGESICS – NSAIDs ≠ risk of bleeding Additive effect Avoid co-administration SIBUTRAMINE ANTICOAGULANTS –
HEPARINS Possible ≠ risk of bleeding Uncertain Monitor APTT closely
SIBUTRAMINE ANTIDIABETIC DRUGS – ACARBOSE, INSULIN, NATEGLINIDE, REPAGLINIDE, SULPHONYL UREAS
Tendency for blood glucose levels to fluctuate
Antiobesity drugs change the dietary intake of carbohydrates and other foods, and the risk of such fluctuations is greater if there is a concurrent dietary regimen. A side-effect of orlistat is hypoglycaemia
These agents are used often in patients with type II diabetes who are on hypoglycaemic therapy. Need to monitor blood sugars twice weekly until stable. Advise self-monitoring and warn about symptoms of hypoglycaemia. Watch for and warn patients about symptoms of hypoglycaemia ➣ For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia
SIBUTRAMINE ANTIPLATELET AGENTS – ASPIRIN
Risk of bleeding Additive effect; sibutramine may cause thrombocytopenia
Warn the patient to report any signs of ≠ bleeding
SIBUTRAMINE ANTIDEPRESSANTS
SIBUTRAMINE MAOIs Risk of hypertension and agitation Additive effect on norepinephrine transmission
Avoid co-administration. Do not start sibutramine for at least 2 weeks after stopping MAOIs
