Contraindications: Reductil 15mg is absolutely contraindicated in individuals with pre-existing coronary artery disease, arrhythmia, congestive heart failure, or uncontrolled hypertension — conditions that may be subclinical in AAS users without prior cardiac imaging. Co-administration with MAO inhibitors, other centrally acting weight-loss agents, or serotonergic drugs is prohibited. Individuals currently using high-androgenic AAS compounds without recent echocardiographic clearance should not initiate sibutramine without physician oversight.
Side Effects: The most commonly reported effects in controlled trial populations include dry mouth, insomnia, constipation, and headache. In the context of AAS stacking, pressor-related effects — mild increases in systolic pressure and resting heart rate — are of greater clinical concern than in monotherapy use. Rare but serious effects include tachycardia, palpitations, and in susceptible individuals, elevated risk of major adverse cardiovascular events as documented in the SCOUT trial.
Monitoring: Monitor seated blood pressure and resting heart rate at minimum every two weeks. Obtain fasting lipid panels (total cholesterol, LDL, HDL, triglycerides) every four to six weeks during any AAS co-administration. Resting ECG is advisable at cycle initiation and at four-week intervals. Discontinue immediately if resting heart rate increases by more than 10 bpm sustained over three consecutive days, or if systolic pressure rises above individually pre-established safe limits.
PCT: Sibutramine does not require hormonal post-cycle therapy (PCT). However, when combined with AAS, the conclusion of the AAS cycle should incorporate standard PCT protocols (e.g., SERMs such as tamoxifen or clomiphene) independently of sibutramine cessation. Stagger the discontinuation of the two compound categories — cease sibutramine first, allow one week of haemodynamic stabilisation, then initiate AAS PCT — to avoid a sudden drop in sympathetic tone coinciding with the androgen withdrawal phase.