Qsymia is a weight loss drug that allows patients to lose weight and manage their obesity as a chronic condition.
It earned FDA approval in 2012 and is now widely-available in the United States, but only under a doctor’s prescription and supervision. This is because clinical trials have proven the medication's impressive results, but also revealed a notable risk for serious side effects [1,2].
As of 2017, over two million Qsymia prescriptions had been filled in registered pharmacies .
Qsymia is a prescription weight loss medication that contains a combination of phentermine HCL (Adipex) and topiramate extended-release (Topamax).
Qsymia is prescribed for the management of exogenous obesity in adults with a body mass index (BMI) greater than 30 kg/m2. It is indicated for overweight adults with a BMI greater than 27 kg/m2 who suffer from an additional weight-related complication such as type 2 diabetes or high blood pressure.
Unlike traditional phentermine pills, which can only be taken for up to 12 weeks, Qsymia has been approved for the chronic management of obesity (up to 3 years).
The medication is prescribed alongside healthy diet and regular exercise .
Qsymia, like other prescription weight loss drugs, is generally regarded as safe when used as directed. However, this medication is not appropriate for everyone.
Qsymia is contraindicated (not safe) in the presence of:
In addition to outright contraindications, use of Qsymia is prefaced by a number of warnings and precautions. Tell your doctor if you have, or have ever had:
Due to the high potential for drug interactions, your doctor and pharmacist need to know about all prescription or OTC medications, herbal supplements, vitamins and drugs that you take right now, or have taken in the last 14 days. Take extra care to mention any birth control pills, diuretics, carbonic anhydrase inhibitors, seizure medications, or any other drugs that impair thinking, concentration or coordination .
Qsymia is currently available in 4 different doses.
All four doses are available as capsules, and contain varying amounts of phentermine hydrochloride and topiramate extended-release. Daily dosage ranges from 3.75/23 (3.75mg phentermine plus 23mg topiramate) to 15/92 (15mg phentermine plus 92mg topiramate) .
|Capsule Color||Phentermine HCL||Topiramate Extended-Release|
|1. Purple||3.75 mg||23 mg|
|2. Purple & Yellow||7.5 mg||46 mg|
|3. Yellow||11.25 mg||69 mg|
|4. Yellow & White||15 mg||92 mg|
Doctors typically start patients on the lowest strength possible, and then gradually increase dosage according to a set schedule. However, individual dosing schedule can only be determined by a medical professional.
That being said, here is a standard Qsymia dosage progression :
Start treatment with one 3.75mg/23mg capsule each morning for 2 weeks. Starting in week 3, take one 7.5mg/46mg capsule each morning. At 3 months, the doctor should either stop the medication (if it’s not proving effective) or increase dosage to 11.25mg/69mg once per day. After 2 weeks on 11.25mg/69mg, daily dosage will be increased to the maximum of Qsymia 15mg/92mg.
Always take Qsymia EXACTLY as prescribed. Never take a different dose, or take the medication more or less often, than prescribed.
If you miss a dose of Qsymia, it is best to skip the missed dose and then continue taking the medication normally the following day. NEVER take a double dose to make up for a missed pill.
Taking more medicine than directed can lead to a dangerous, potentially fatal overdose.
Possible side effects of Qsymia range from relatively minor to very severe.
Contact a doctor if you experience any serious side effects, or if any side effect bothers you or does not go away.
Some patients to experience serious - sometimes life threatening - side effects to this medication.
Seek immediate medical attention if you experience any of the following symptoms while taking Qsymia :
Contact a doctor if you experience ANY side effect that does not go away, proves severe or interferes with your daily life.This list does NOT contain all possible side effects of Qsymia.
If you are interested in exploring potential pharmaceutical weight loss options, schedule an appointment with your primary care doctor. If he or she does not prescribe Qsymia, consider speaking with a weight loss clinic or specialist (e.g. a bariatric doctor or gynecologist).
Qsymia is a schedule IV-controlled substance, so it is NOT available without a prescription.
Qsymia is available from most major pharmacies in the United States, including certified mail-order pharmacies.
Due to its drug schedule, these capsules are not available from all online pharmacies. At this time, Qsymia prescriptions can only be filled in-person or through the following certified mail-order pharmacies: Walgreens, Walmart and Kaiser Permanente [7,8].
Qsymia costs around $200 per month before discounts.
The table below provides the estimated cost for a 30-day supply of Qsymia before tax, insurance and manufacturer coupons.
|Dose||Estimated Monthly Cost|
|3.75mg / 23 mg||$187||$198|
|7.5mg / 46mg||$193||$205|
|11.25mg / 69mg||$205||$219|
|15mg / 96mg||$206||$220|
NOTE: These prices are only estimates and do not represent any type of guarantee or coupon. Updated March 2019 .
Thankfully, VIVUS, Inc. offers a generous manufacturer’s discount. The Qsymia Advantage program entitles you to two weeks free of the starter dose (3.75mg/23mg), caps the monthly cost of Qsymia at $98 for any dose and provides an at-home delivery service.
Will Qsymia really help you reach your weight loss goals? Find out more in our extensive review section:
The Phentermine.com Facebook group is also a great source of information for anything Qsymia and phentermine related: Losing Weight with Phentermine.
This medication is manufactured by VIVUS, Inc. – a California-based pharmaceutical company. They currently produce medications related to obesity, sleep and sexual health .
Please find their contact information below:
1172 Castro Street
Mountain View, CA 94040
Company Phone: 650-934-5200
Medical Information Phone: 1-888-998-4887
Corporate website: www.vivus.com
Medication Website: www.qsymia.com
Informational resources for further reading:
1. U.S. Food & Drug Administration. (2012, July 17). Drug Approval Package: Qsymia (phentermine and topiramate extended-release) Capsules CIV. Drug Approvals and Databases.
3. VIVUS, Inc. (2018). Lose weight and keep it off with Qsymia.
4. Drugs.com. (2019, January 15). Phentermine and Topiramate (Professional Patient Advice).
5. VIVUS, Inc. (2014, September). Medication Guide: Qsymia® (Kyoo sim ee’ uh) (phentermine and topiramate extended-release) Capsules CIV.
6. VIVUS, Inc. (2017). Medication Guide.
7. VIVUS, Inc. (2014). Risk Evaluation and Mitigation Strategy (REMS).
8. U.S. National Library of Medicine. (2006, January 12). Hazardous Substances Data Bank (HSDB): Phentermine.
9. GoodRx. (2019, March). Qsymia: Phentermine and Topiramate.
10. Gomez, G., & Stanford, F. C. (2017). US health policy and prescription drug coverage of FDA-approved medications for the treatment of obesity. International Journal of Obesity, 42(3), 495-500. doi:10.1038/ijo.2017.287
11. VIVUS Inc. (2018). VIVUS: About VIVUS Inc.