FDA approved 1997 for the treatment of obesity.
Works by inhibiting the reuptake of both norepinephrine and serotonin, thereby suppressing appetite.
Supplied as 5 mg, 10 mg, and 15 mg capsules (not breakable).
Start with 10 mg QD, titrate up to 15 mg QD if weight loss isn’t adequate.
No dosage adjustment required in mild to moderate renal or hepatic impairment.
One of the most effective weight loss agents, leading to 10 lbs. more weight loss than placebo over one year follow-up, according to meta-analyses.
Common: Headache, insomnia, dry mouth, constipation.
Increased BP and heart rate; should not be used in patients with heart disease.
Since Meridia is a dual reuptake inhibitor, the manufacturer advises that it not be combined with other serotonin or dual reuptake inhibitors, because of a theoretical concern of serotonin syndrome.
Contraindicated with MAOIs.
Contraindicated for patients with anorexia or bulimia nervosa.
Metabolized to active metabolites (M1 and M2) by CYP 3A4, which are further metabolized by conjugation and hydroxylation.
Half-life about 15 hours.