Qsymia is a brand-name oral prescription weight-loss medication approved for weight loss in adults. In clinical trials, people taking it lost up to 10% of their initial body weight in 56 weeks.
Qsymia is one option for weight loss, but is it right for you? Talk to a weight loss provider and find out in as little as 24 hours.*
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Providers on Klarity Health are independent practitioners with clinical autonomy; a diagnosis, treatment, or prescription is not guaranteed.
Qsymia is a brand-name oral prescription weight-loss medication. It was approved by the U.S. Food and Drug Administration (FDA) for weight management in adults in 2012. It combines phentermine, a popular short-term weight loss medication, and topiramate ER (extended-release), a medication used to treat epilepsy and migraines.
Qsymia is different from popular weight-loss injections, like Zepbound (tirzepatide), Wegovy (semaglutide), and Saxenda (liraglutide). It’s a once-daily capsule taken in the morning. It’s similar in that if you take it, you should have a qualifying body mass index (BMI) and combine it with diet and exercise.
One of the active ingredients in Qsymia, phentermine, is an appetite suppressant. It may also increase metabolism.
How topiramate, Qsymia’s other active ingredient, affects appetite and weight isn’t known. But it may act on neurotransmitters (chemical messengers) in the brain to reduce appetite and make you feel more full. It may also help reduce leptin (a hormone that helps regulate weight and appetite by signaling to the brain when you’re full) and blood sugar levels.
Qsymia’s maker, Vivus, says that it offers all-day hunger control, makes you feel full all day to reduce cravings, and changes how some foods taste so you don’t want to eat as much.
In clinical trials, people taking Qsymia lost weight and had reductions in waist size, blood pressure, blood glucose, triglycerides, and cholesterol levels. Those taking higher doses had the greatest reductions in weight and other measures.
Qsymia is FDA-approved for adults who:
– Have a body mass index (BMI) of 30 or more, which is medically obese.
– Have a BMI of 27 or more and at least one weight-related health problem, like high blood pressure, type 2 diabetes, high cholesterol levels, or heart problems.
If you take it, you also need to eat a reduced-calorie diet and be more physically active.
Qsymia is also approved for children 12 and older who fall into the obese range, which is a BMI in the 95th percentile or higher for their age and sex.
To take Qsymia, you need a prescription. To get a prescription, you need to work with a licensed healthcare provider who can prescribe weight loss medication. Providers who can write prescriptions include medical doctors (MDs), physician assistants/associates (PAs), and nurse practitioners (NPs).
You can find a licensed, board-certified provider to discuss a medical weight loss program that may include medication, like Qsymia, on Klarity Health.
Once you have a prescription, you can fill it at any pharmacy — online or local — that has Qsymia in stock.
Unlike some popular weight loss injections Zepbound and Wegovy, Qsymia hasn’t had supply shortage issues.
You take Qsymia one each day in the morning. It comes as a capsule that you swallow whole and can take with or without food.
Capsules come in 4 strengths:
The first number is the amount of phentermine in each capsule. The second is the amount of topiramate ER.
Most people start with the 3.75 mg/23 mg capsule and stay at that dose for 14 days. After that, they increase to the 7.5 mg/46 mg dose. If after 12 weeks (3 months), they haven’t lost at least 3% of their body weight, providers might increase the dose to 11.25 mg/69 mg a day for 14 days and then increase it to 15 mg/92 mg once a day. If after 12 weeks at the highest dose, someone hasn’t lost at least 5% of their starting weight, it’s recommended to gradually stop taking Qsymia and consider an alternative.
For people who lose more than 2 pounds a week, the provider may decrease the dose.
The most common side effects experienced by adults taking Qsymia are numbness or tingling in hands, feet, or face (called paraesthesia), dizziness, headache, a change in the way foods taste or a loss of taste, insomnia, constipation, and dry mouth. They’re more common at higher doses and may diminish or go away with time as your body gets used to Qsymia.
For a complete list of side effects, including serious side effects, contraindications, drug interactions, and side effects in children, see the Qsymia medication guide or talk to your provider or pharmacist.
Know that because Qsymia contains phentermine, it’s a controlled substance and may be abused or cause dependence.
Qsymia is less costly than popular weight-loss injections and oral Contrave (bupropion-naltrexone). A 30-day supply costs between $210 and $232 according to drugs.com and with its discount applied. That’s without insurance. If you have insurance that covers Qsymia, you’ll pay only your drug copay cost.
But, like most weight loss medications, you’ll probably need a prior authorization before your insurance will pay for it, even if it’s on their approved drug list.
Qsymia’s manufacturer, Vivus, offers 3 ways to save too:
1 — with the Qsymia Savings Card, you can save $65 a month if you have and use insurance and cover the first $70 of your copay
2 — you can save $75 per month if you pay cash or don’t have insurance
3 — you can pay just $98 if you don’t have insurance or don’t want to use it and choose home delivery from Vivus through the Qsymia Engage program
See the Qsymia website for full details and quantity limits.
You can use a prescription or drug discount card from drugs.com, GoodRx, SingleCareRx,WellRx, and others to save on your cost with and without insurance too.
Qsymia and Contrave are 2 of the oldest weight loss medications available. Qsymia was approved in 2012 and Contrave in 2014. Both are combinations of other medications. Both result in up to a 10% loss in body weight in 56 weeks. Both are oral pills. Qsymia is taken once a day; Contrave twice a day.
Newer prescription options for weight loss are GLP-1 agonists, including Zepbound, Wegovy, and Saxenda. All are taken as weekly injections rather than daily pills. People lose more weight on Zepbound or Wegovy than other weight loss solutions. Up to 20.9% on Zepbound and 14.% on Wegovy. Weight loss on Saxenda is the same as with Qsymia and Contrave at 10% in 56 weeks.
All of these medications are intended to be used with diet and exercise and for people who are medically obese or overweight. Many insurance companies require prior authorization before paying for any of them. And some require you try a less-expensive solution before they’ll cover the higher price for injections.
Which medication is right for you depends on you, your health history, your goals, and other factors. To find the right weight-loss solution, talk to a licensed, board-certified weight-loss provider.
Qsymia | Phentermine | Contrave | Zepbound | Wegovy | Saxenda | |
% body weight loss | Up to 10% | a least 3% | up to 10% | up to 20.9% | up to 14.9% | up to 10% |
Average monthly cost* | $210 to $232 | $48 to $76 | $668 | $1,126 | $1,126 | $1,430 |
*Costs are based on full maintenance doses when applicable without insurance or manufacturer savings and per drugs.com with its discount applied.
Testimonials from real patients who see healthcare providers on Klarity Health.
Providers on Klarity are licensed, board-certified, and offer a personalized approach to your unique weight-loss needs. See detailed profiles for each provider and find an approach that’s best for you. (Costs for treatment options may vary.)
Your journey to losing weight starts with an initial consultation Your provider will go over your goals and medical history to recommend a program that’s right for you and may or may not include prescription medication.
Your initial consultation is just the beginning. You and your provider will follow up to make sure you’re doing okay and that you’re reaching your goals. You stay on track with easy medication refills and ongoing support from your provider.
If you have questions or need assistance, the Klarity Patient Support team is here to help. Along with your provider, they’re committed to making sure you have the best care and support throughout your weight loss journey.
Sources
Clinical Trials Arena, Contrave for the Treatment of Obesity, Oct. 2014, https://www.clinicaltrialsarena.com/projects/contraveforthetreatm/?cf-view
Diabetes, Metabolic Syndrome, and Obesity, Clinical utility of phentermine/topiramate (Qsymia) combination for the treatment of obesity, Jin Hee Shin and Kishore M. Gadde, Apr. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626409/
DailyMed, Label: Qsymia- phentermine and topiramate capsule, extended release, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=40dd5602-53da-45ac-bb4b-15789aba40f9&audience=consumer
JAMA Network, Continued Treatment with Tirzepatide for Maintenance of Weight Reduction in Adults with Obesity: The SURMOUNT-4 Randomized Clinical Trial, Louis J. Aronne, MD, et.al., Dec. 2023, https://jamanetwork.com/journals/jama/article-abstract/2812936
NIH, National Library of Medicine, Phentermine/Topiramate Extended-Release Capsules (Qsymia) for Weight Loss, David J. Lonneman Jr, Jose A. Rey, MS, Pharm D, BCPP, and Brian D. McKee, PharmD, Aug. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814438/
NIH, National Library of Medicine, Topiramate (Topamax): Evolving Role in Weight Reduction Management: A Narrative Review, Irsa Wajid et al, Aug. 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532729/
The New England Journal of Medicine, A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management, Xavier Pi-Sunyer, MD, et al., Jul. 2015, https://www.nejm.org/doi/full/10.1056/nejmoa1411892
The New England Journal of Medicine, Once-weekly Semaglutide in Adults with Overweight or Obesity, John P.H. Wilding, DM, et al., Feb. 2021, https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
*Appointments are generally available within 24 hours. Prescriptions, particularly for controlled substances, may require an in-person evaluation depending on the state of residence and current federal regulations.
The information provided in this article is for educational purposes only and should not be construed as medical advice. Controlled substances like Qsymia may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with clinical autonomy. Nothing in this article is intended to diagnose or treat any condition, including guaranteeing prescription medication of any kind or dosage.
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