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Sibutramine is a centrally acting antiobesity drug that functions primarily as a serotonin and noradrenaline reuptake inhibitor, enhancing satiety and potentially increasing energy expenditure. It is metabolized by cytochrome P450 enzymes, particularly CYP2B6, which catalyzes the formation of its active metabolites, desmethylsibutramine (M1) and didesmethylsibutramine (M2). Genetic polymorphisms in CYP2B6, CYP3A5, and CYP2C19 can influence the pharmacokinetics and clinical outcomes of sibutramine treatment, affecting weight loss efficacy and the occurrence of adverse events. Sibutramine is available in different formulations, such as sibutramine hydrochloride monohydrate and sibutramine mesylate hemihydrate, which may vary in solubility and absorption rates, impacting their pharmacological profiles.
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