chapter
Antiobesity drugs
Pages 3

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

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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