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Cardiovascular Safety Pharmacology of Sibutramine

  • Yun, Jaesuk (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Chung, Eunyong (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Choi, Ki Hwan (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Cho, Dae Hyun (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Song, Yun Jeong (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Han, Kyoung Moon (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Cha, Hey Jin (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Shin, Ji Soon (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Seong, Won-Keun (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Kim, Young-Hoon (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety) ;
  • Kim, Hyung Soo (National Institute of Drug and Safety Evaluation, Ministry of Food and Drug Safety)
  • Received : 2015.03.25
  • Accepted : 2015.04.27
  • Published : 2015.07.01

Abstract

Sibutramine is an anorectic that has been banned since 2010 due to cardiovascular safety issues. However, counterfeit drugs or slimming products that include sibutramine are still available in the market. It has been reported that illegal sibutramine-contained pharmaceutical products induce cardiovascular crisis. However, the mechanism underlying sibutramine-induced cardiovascular adverse effect has not been fully evaluated yet. In this study, we performed cardiovascular safety pharmacology studies of sibutramine systemically using by hERG channel inhibition, action potential duration, and telemetry assays. Sibutramine inhibited hERG channel current of HEK293 cells with an $IC_{50}$ of $3.92{\mu}M$ in patch clamp assay and increased the heart rate and blood pressure ($76{\Delta}bpm$ in heart rate and $51{\Delta}mmHg$ in blood pressure) in beagle dogs at a dose of 30 mg/kg (per oral), while it shortened action potential duration (at $10{\mu}M$ and $30{\mu}M$, resulted in 15% and 29% decreases in $APD_{50}$, and 9% and 17% decreases in $APD_{90}$, respectively) in the Purkinje fibers of rabbits and had no effects on the QTc interval in beagle dogs. These results suggest that sibutramine has a considerable adverse effect on the cardiovascular system and may contribute to accurate drug safety regulation.

Keywords

References

  1. Heal, D. J., Aspley, S., Prow, M. R., Jackson, H. C., Martin, K. F. and Cheetham, S. C. (1998) Sibutramine: a novel anti-obesity drug. A review of the pharmacological evidence to differentiate it from damphetamine and d-fenfluramine. Int. J. Obes. Relat. Metab. Disord. 22, S18-28.
  2. Heo, S. H. and Kang, M. H. (2013) A case of dilated cardiomyopathy with massive left ventricular thrombus after use of a sibutraminecontaining slimming product. Korean Circ. J. 43, 632-635. https://doi.org/10.4070/kcj.2013.43.9.632
  3. James, W. P., Caterson, I. D., Coutinho, W., Finer, N., Van Gaal, L. F., Maggioni, A. P., Torp-Pedersen, C., Sharma, A. M., Shepherd, G. M., Rode, R. A., Renz, C. L. and Investigators, S. (2010) Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N. Engl. J. Med. 363, 905-917. https://doi.org/10.1056/NEJMoa1003114
  4. Kim, E. J., Seo, J. W., Hwang, J. Y. and Han, S. S. (2005) Effects of combined treatment with sildenafil and itraconazole on the cardiovascular system in telemetered conscious dogs. Drug Chem. Toxicol. 28, 177-186. https://doi.org/10.1081/DCT-52525
  5. Kim, K. S., Park, S. J., Lee, H. A., Kim, D. K. and Kim, E. J. (2008) Electrophysiological safety of sibutramine HCl. Hum. Exp. Toxicol. 27, 553-558. https://doi.org/10.1177/0960327108095991
  6. Muller, D., Weinmann, W. and Hermanns-Clausen, M. (2009) Chinese slimming capsules containing sibutramine sold over the Internet: a case series. Dtsch. Arztebl. Int. 106, 218-222.
  7. Perrio, M. J., Wilton, L. V. and Shakir, S. A. (2007) The safety profiles of orlistat and sibutramine: results of prescription-event monitoring studies in England. Obesity 15, 2712-2722. https://doi.org/10.1038/oby.2007.323
  8. Scheen, A. J. (2010) Cardiovascular risk-benefit profile of sibutramine. Am. J. Cardiovasc. Drugs 10, 321-334. https://doi.org/10.2165/11584800-000000000-00000
  9. Seop Kim, D., Kim, K. S., Hwan Choi, K., Na, H., Kim, J. I., Shin, W. H. and Kim, E. J. (2006) Electrophysiological safety of novel fluoroquinolone antibiotic agents gemifloxacin and balofloxacin. Drug Chem. Toxicol. 29, 303-312. https://doi.org/10.1080/01480540600652996
  10. Tang, M. H., Chen, S. P., Ng, S. W., Chan, A. Y. and Mak, T. W. (2011) Case series on a diversity of illicit weight-reducing agents: from the well known to the unexpected. Br. J. Clin. Pharmacol. 71, 250-253. https://doi.org/10.1111/j.1365-2125.2010.03822.x

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