Nina Berry <[log in to unmask]> wrote:
  > Does anyone know about RID/ safety of this medication while breastfeeding
> (two year old). 
   
  From MMM online:
   
          SIBUTRAMINE         Trade:  Meridia         Can/Aus/UK:  Meridia           Uses: Appetite suppressant    LRC: L4    AAP: Not reviewed                Sibutramine is a nonamphetamine appetite suppressant. Due to its effect on serotonin and norepinephrine reuptake, it is considered an antidepressant as well. Sibutramine is rather small in molecular weight, active in the CNS, extremely lipid soluble, and has two 'active' metabolites with long half-lives (14-16 hours).[1-3] Although no data are available on its transfer into human milk, the pharmacokinetics of this drug theoretically suggest that it might have a rather high milk/plasma ratio and could enter milk in significant levels. Until we know more, a risk assessment may not support the use of this product in breastfeeding mothers.        Pregnancy Risk Category:  C         Lactation Risk Category:  L4        Adult Concerns: Adult side effects include headache, insomnia, back pain, flu-like syndrome, abdominal
 pain, seizures (rarely), and elevated liver enzymes. Cardiovascular events include tachycardia, hypertension.        Pediatric Concerns: None reported via milk. Caution is recommended.        Drug Interactions: Use of Sibutramine with drugs that may increase blood pressure (decongestants, cough and cold remedies) could be hazardous. Do not use with MAO inhibitors. Do not admix with drugs that inhibit cytochrome P450 enzymes in the liver (ketoconazole, cimetidine, erythromycin (minor effect).        Theoretic Infant Dose:          Relative Infant Dose:        Adult Dose:  5-15 mg daily         Alternatives:  
                T½  =  12.5-21.8 hours   M/P  =      PHL  =    PB  =  94%     Tmax  =  3-4 hours   Oral  =  77%     MW  =  334   pKa  =      Vd  =        
        References:    1.    Lean ME. Sibutramine--a review of clinical efficacy. Int J Obes Relat Metab Disord 1997; 21 Suppl 1:S30-S36.
2.    Stock MJ. Sibutramine: a review of the pharmacology of a novel anti-obesity agent. Int J Obes Relat Metab Disord 1997; 21 Suppl 1:S25-S29.
3.    Pharmaceutical Manufacturer Prescribing Information.

		
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