contraindications: Absolute contraindication with MAO inhibitors — dangerous serotonergic and adrenergic potentiation
Contraindicated alongside any prescription sympathomimetic (e.g., pseudoephedrine-class decongestants at therapeutic doses)
Do not use with active hyperthyroidism or during dual T3/T4 thyroid protocols
Contraindicated in uncontrolled hypertension, established coronary artery disease, or prior stroke
Not suitable for individuals with a history of eating disorders involving stimulant misuse
side_effects: Dry mouth and insomnia are the most commonly reported dose-dependent effects
Elevated resting pulse — particularly relevant when any adrenergic compound is present in the stack
Constipation and reduced appetite beyond target levels may occur at 20mg
Headache during the first week often reflects dopaminergic adjustment, not toxicity
monitoring: Measure resting heart rate and blood pressure at least twice weekly throughout the cycle
If resting heart rate consistently exceeds 90 bpm, reduce to half dose and remove all co-stimulants immediately
Track body weight weekly as a proxy for whether caloric deficit is appropriate — not a substitute for cardiovascular checks
Any palpitations, chest tightness, or sudden BP spike are grounds for immediate discontinuation
pct: Sibutramine does not suppress the hypothalamic-pituitary-gonadal axis — standard hormonal PCT is not required
If sibutramine was co-administered with anabolic agents, PCT for those agents should follow their own established protocol independently
Appetite may temporarily increase after stopping — plan dietary structure in advance to avoid rebound intake