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How does it work?

Reductil capsules contain the active ingredient sibutramine hydrochloride monohydrate, which is a type of anti-obesity medicine. It works by affecting neurotransmitters in the brain.

Neurotransmitters are natural body chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. They are released from nerve cells as a message is transmitted. Once the message has been transmitted, the nerve cells then reabsorb the neurotransmitter.

Sibutramine prevents two of these neurotransmitters, noradrenaline and serotonin, from being reabsorbed back into the nerve cells. Noradrenaline and serotonin are responsible for moderating mood and various other processes in the brain.

It is thought that sibutramine helps people to lose weight by increasing the amount of noradrenaline and serotonin free to act in the brain. This enhances the feeling of fulfillment from eating, and so makes you feel satisfied after eating less food.

You will need to continue with an appropriate diet and exercise programme while taking this medicine, so that you are able to maintain your new weight after you have stopped treatment. Your doctor should give you advice to assist you with this.

What is it used for?

- Obesity

Reductil is only licensed to aid weight loss in people with a body mass index (BMI) of 30 or higher, and people with a BMI of 27 or higher who also have other obesity related risk factors, such as type 2 diabetes or high cholesterol. It is only prescribed to people in these categories who have had difficulty achieving or maintaining weight loss of more than five per cent of their body weight over three months, using conventional weight loss programmes alone (eg diet and exercise).

Warning!

 - Reductil capsules should be swallowed whole with a drink in the morning. They can be taken with or without food.
- This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- You should change your lifestyle in terms of eating habits and physical activity while taking this medicine, so that you are able to maintain your new weight after you have stopped treatment. Your doctor should advise you on the changes you need to make and continue to monitor your weight after you stop treatment. If you don't change your lifestyle you may regain the weight you have lost.
- Your weight should be monitored while you are taking this medicine. If you are not responding adequately to this medicine, ie if you have not lost at least five per cent of your body weight within three months, or if you put on more than 3kg at any stage after previously losing weight, you will need to stop taking this medicine. This medicine should not be taken for longer than one year.
- Your blood pressure and pulse rate should be monitored while you are taking this medication; every two weeks for the first three months, then once a month for the next three months, then regularly at maximum intervals of three months after that. Your doctor may ask you to stop taking this medicine if your blood pressure or pulse rate increase too much.
- Consult your doctor if you experience shortness of breath, chest pain or ankle swelling while taking this medicine.
- If you experience any mood changes, depression, or distressing thoughts or feelings while taking this medicine then it is very important to talk to your doctor.
- This medicine may be harmful to an unborn baby. Women who could get pregnant should use a reliable method of contraception to prevent pregnancy while using this medicine.

Use with caution in

- Mild to moderately decreased kidney function
- Mild to moderately decreased liver function
- High blood pressure
- Epilepsy
- Open angle glaucoma
- Family history of glaucoma
- Family history of involuntary, recurrent muscle twitches or vocalisations (motor or verbal tics)
- History of depression
- People at increased risk of bleeding
- People taking medicine to prevent blood clotting (anticoagulants, eg warfarin)
- Syndrome involving short spells when breathing stops during sleep.

Not to be used in

- People over 65 years of age
- Children and adolescents under 18 years of age
- Obesity caused by a medical condition
- Severely decreased kidney function
- Severely decreased liver function
- Uncontrolled high blood pressure
- History of coronary artery disease
- History of heart failure
- History of increased heart rate (tachycardia)
- History of irregular heart beats (arrhythmias)
- History of stroke or small temporary strokes
- History of blocked arteries in the extremities
- Closed angle glaucoma
- Overactive thyroid gland
- Tumour of the adrenal gland (phaeochromocytoma)
- Urinary retention caused by an enlarged prostate gland
- Psychiatric illness
- Syndrome characterised by involuntary repetition of speech, particularly obscene or vulgar words (Gilles de la Tourette's syndrome)
- History of anorexia nervosa
- History of bulimia nervosa
- History of drug, alcohol or medication dependence or abuse
- People who have taken antidepressant, antipsychotic or appetite suppressant medicines, or tryptophan to aid sleep, in the last 14 days
- Pregnancy
- Breastfeeding
- Rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption (Reductil capsules contain lactose).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine must not be used during pregnancy. Women who could get pregnant should use an effective method of contraception to prevent pregnancy while taking this medicine. Seek further medical advice from your doctor. If you do get pregnant during treatment, stop taking this medicine and consult your doctor immediately.
- It is not known if this medicine passes into breast milk. For this reason, the manufacturer states that it should not be used by women who are breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Dry mouth
- Difficulty in sleeping (insomnia)
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
- Headache
- Pins and needles (paraesthesia)
- Lightheadedness
- Anxiety
- Sweating
- Alteration in taste
- Aggravation of haemorrhoids
- Hot flushes
- Awareness of your heartbeat (palpitations)
- Increased heart rate (tachycardia)
- Raised blood pressure (hypertension)
- Depression
- Menstrual cycle disorders
- Impotence
- Seizures
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Kidney disorders

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.