Qsymia

What is Qsymia?

Qsymia is an FDA (U.S. Food and Drug Administration) approved medication manufactured by VIVUS, Inc. Qsymia is used with a reduced-calorie diet and an increase in physical activity for chronic weight management in adults with a body mass index (BMI) of 30 kg/m2 or more (obese), or 27 kg/m2 or more (overweight) with at least one weight-related comorbidity such as hypertension (high blood pressure), type 2 diabetes mellitus, or dyslipidemia (high cholesterol).

How it works

This medication contains phentermine, an appetite suppressant, belonging to a class of drugs called sympathomimetic amines. Topiramate is known as an anticonvulsant or antiepileptic drug. As Qsymia contains phentermine, a Schedule IV drug, it too is controlled in Schedule IV of the Controlled Substances Act.

Typical dosing

• Qsymia is available in capsule form, in the following doses: phentermine mg/topiramate mg extended-release 3.75 mg/23 mg, 7.5 mg/46 mg, 11.25 mg/69 mg, or 15 mg/92 mg.
• The recommended dose of Qsymia is 3.75 mg/23 mg daily for 14 days, then increased to 7.5 mg/46 mg daily. Weight loss should be checked after 12 weeks. If a patient has not lost a minimum of 3% of baseline body weight, stop treatment or reduce the dose as it is unlikely the patient will achieve and maintain clinically meaningful weight loss at this dose.

This is general dosing information, not a prescription. Only your provider determines the dose that’s appropriate for you.

Safety information

The most common side effects of Qsymia in clinical trials compared to placebo include paraesthesia, dizziness, dysgeusia, trouble sleeping, constipation and dry mouth. In rare instances, Qsymia can cause more serious side effects, including fetal toxicity (females of reproductive potential should obtain a negative pregnancy test before treatment and monthly thereafter, and use effective contraception), increase in heart rate, suicidal thoughts, acute myopia and secondary angle-closure glaucoma, mood and sleep disorders, cognitive impairment, metabolic acidosis, elevated creatinine, and sudden changes in vision such as decreased vision, blurred vision, or eye pain/redness. Your doctor will assess the benefits of using Qsymia against your risk of side effects. Patients are encouraged to report negative side effects or adverse events of Qsymia to the FDA at www.fda.gov/medwatch, or by calling 1-800-FDA-1088. Qsymia can interact with other medications, including oral contraceptives, CNS depressants including alcohol, and non-potassium sparing diuretics. This list is not exhaustive and other drugs may interact with Qsymia; tell your healthcare provider about all the medicines you take, including prescription drugs and over-the-counter medicines, vitamins, and herbal supplements. You should not use Qsymia if you: are allergic to the active ingredients phentermine or topiramate; are allergic to any of the other ingredients in Qsymia; have glaucoma; have hyperthyroidism; have taken monoamine oxidase inhibitors within 14 days; have known hypersensitivity or idiosyncrasy to sympathomimetic amines; or are pregnant or are planning to become pregnant (Qsymia may cause birth defects such as cleft lip/cleft palate or harm an unborn baby. Discuss the use of birth control with your doctor). Talk to your doctor before using Qsymia if you: are taking any of the medications that could interact with Qsymia; have heart problems or high blood pressure; have had a heart attack or stroke; have diabetes (weight loss may cause low blood sugar); have metabolic acidosis; have osteomalacia, osteopenia, or osteoporosis; have kidney disease, kidney stones, or dialysis; have liver disease; have depression, suicidal thoughts, or other mental health problems; suffer from seizures; or are breastfeeding or are planning to breastfeed.