Qsymia for Weight Loss: Side Effects, Dosage, Cost, & More

What Is Qsymia?

Qsymia is a prescription medication used to achieve weight loss. It is a combination of two drugs, phentermine and topiramate, that help suppress appetite and increase feelings of fullness. Phentermine is a stimulant that acts on the central nervous system, while topiramate is an anticonvulsant that can help reduce food cravings.¹

Qsymia was approved by the FDA in 2012 for use in adults with a body mass index (BMI) of 30 or greater or in those with a BMI of 27 or greater and at least one weight-related health condition. It is meant to be used with a reduced-calorie diet and increased physical activity. Qsymia is not a generic medication and can only be obtained with a prescription from a healthcare provider.

How Does Qsymia Work for Weight Loss?

Qsymia is a weight loss medication that suppresses your appetite and makes you feel full. It also increases the energy your body burns, which can help promote weight loss. The combination of these effects can lead to reduced calorie intake and increased calorie burn, ultimately resulting in weight loss. It’s important to note that Qsymia should be part of a comprehensive weight loss plan that includes a healthy diet and regular exercise.¹

Who Might Benefit From Taking Qsymia for Weight Loss?

Qsymia is a prescription medication approved for weight management in individuals with a body mass index (BMI) of 30 or higher, or those with a BMI of 27 or higher who have at least one weight-related condition, such as type 2 diabetes, high blood pressure, or dyslipidemia (abnormally elevated cholesterol or fats in the blood). Individuals who might benefit from Qsymia typically include those dealing with obesity or overweight conditions, particularly if they have additional health concerns like type 2 diabetes.²

For individuals with type 2 diabetes who are also looking to lose weight, Qsymia may be a potential treatment. Obesity is a common risk factor for the development and exacerbation of type 2 diabetes, and weight loss can contribute to better-controlled blood sugar and overall health in these individuals.

Side Effects of Qsymia for Weight Loss

Qsymia may induce persistent side effects and temporary adjustments as the body gets used to the medication. Qsymia side effects may endure as long as the medication is taken, and some may require medical treatment. Temporary effects often occur during the initial period of adjustment to the medication and may be mild.

Common Side Effects of Qsymia

Common side effects of Qsymia may or may not require medical attention. If individuals experience significant mood changes or suicidal ideation, immediate medical care is required.

Common side effects of Qsymia include:²

• Paraesthesia (feeling “pins and needles”)
• Dysgeusia (altered sense of taste)
• Dizziness
• Insomnia
• Constipation
• Dry mouth

*All medications, including Qsymia, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Qsymia

Serious side effects of Qsymia demand prompt medical attention due to their potential severity.

Serious side effects of Qsymia include:²

• Allergic reactions
• Suicidal ideation
• Acute angle closure glaucoma
• Increased intraocular pressure (pressure in the fluid of the eye)
• Severe skin reactions
• Metabolic acidosis (buildup of acid in the body from kidney problems)
• Decrease in renal function
• Risk of seizures with abrupt withdrawal
• Kidney stones
• Increased body temperature
• Hypokalemia (low potassium levels)

*All medications, including Qsymia, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Qsymia for Weight Loss Warnings & Precautions

Qsymia, a combination of phentermine and topiramate, presents important safety considerations. Patients should be aware of potential risks and adhere to warnings and precautions, as medical attention may be necessary to address certain conditions.

Key safety concerns include the lack of studies on individuals with recent or unstable cardiac or cerebrovascular diseases, highlighting the cautious use of Qsymia in such cases. Patients experiencing palpitations or a sustained increase in resting heart rate should promptly inform their healthcare provider to receive instructions and what to do next.

Warnings and precautions for taking Qsymia include:²

• Risks of thyroid cancer: Qsymia warns about the potential risks of thyroid cancer. This precaution is particularly relevant for individuals with specific risk factors, and regular monitoring may be advised.
• Allergic reactions: Patients must be vigilant for allergic reactions, which can manifest in various symptoms. Immediate medical attention is crucial if signs such as rash, itching, swelling, severe dizziness, or difficulty breathing occur.
• Suicidal behavior and ideation: Antiepileptic drugs, including topiramate in Qsymia, may elevate the risk of suicidal thoughts or behavior. Close monitoring is essential, especially during the early stages of treatment.
• Ophthalmologic adverse reactions: Qsymia usage is associated with an increased risk of ophthalmologic issues, including acute myopia, secondary angle closure glaucoma, and visual field defects. Patients should promptly report any significant changes in vision or persistent eye pain.
• Cognitive impairment: The medication may lead to cognitive difficulties, including confusion and word-finding problems. Patients should exercise caution when consuming alcohol or central nervous system depressants concurrently.
• Hypoglycemia in diabetic patients: Individuals with type 2 diabetes on antidiabetic therapy should monitor blood glucose levels closely, as Qsymia may impact blood sugar. Symptoms of hypoglycemia should be reported to healthcare providers.
• Risk of hypotension: Weight loss associated with Qsymia may increase the risk of hypotension, particularly in patients taking antihypertensive medications.
• Kidney stone formation: Increased fluid intake is advised to decrease the concentration of substances involved in kidney stone formation. Patients should report symptoms of severe side or back pain and/or blood in their urine promptly.
• Oligohidrosis and hyperthermia: Qsymia use, especially in pediatric patients, has been linked to decreased sweating (oligohidrosis) and increased body temperature. Monitoring during physical activity, especially in hot weather, is crucial.
• Serious skin reactions: Patients should be informed about the potential for serious skin reactions and advised to report any signs to their healthcare provider.

Interactions With Qsymia

Qsymia can have potentially harmful interactions with various substances, including foods, medications, and herbs. These interactions may impact the effectiveness of the treatment or lead to adverse effects. It is crucial for individuals taking Qsymia to be aware of these potential interactions and consult with their healthcare providers before introducing new elements to their regimen.

4 substances you should avoid while taking Qsymia include:²

• Monoamine oxidase inhibitors (MAOIs): Combining phentermine with MAOIs increases the risk of hypertensive crisis (sudden, severe increase in blood pressure). It is strongly advised to avoid using Qsymia during MAOI treatment and within 14 days of stopping an MAOI.
• Oral contraceptives: The efficacy of oral contraceptives may be affected by Qsymia.
• Non-potassium-sparing diuretics: Using Qsymia with diuretics (water pills) that are classified as non-potassium sparing may cause low potassium. Regular monitoring of potassium levels is recommended when taking this combination.
• Alcohol and CNS depressant drugs: Qsymia can cause cognitive impairment, and the concomitant use of alcohol or central nervous system (CNS) depressant drugs may increase the risk of dizziness, cognitive adverse reactions, and impaired coordination. Patients should exercise caution and report any changes in attention, concentration, or memory to their healthcare provider.

Qsymia Dosages for Weight Loss

Qsymia is available as extended-release capsules. The medication comes in four strengths, labeled by the ratio of phentermine to topiramate: 3.75 mg/23 mg, 7.5 mg/46 mg, 11.25 mg/69 mg, and 15 mg/92 mg.¹

The recommended dose is determined by factors like metabolism, medical history, and overall health. Physicians carefully assess these variables to determine the most appropriate dosage for each patient, aiming to optimize the benefits of the medication while minimizing potential side effects. Regular monitoring and dosage adjustment may be necessary to ensure the safety and effectiveness of Qsymia throughout treatment.

How Do I Take Qsymia for Weight Loss?

Qsymia is taken daily in the morning, with or without food. However, your prescriber may recommend a different dosing schedule based on your needs and medical history. It’s essential not to exceed the recommended dosage or take Qsymia more often than prescribed. Doing so can increase your risk of side effects and may not improve your weight loss results. Additionally, it’s important not to stop taking Qsymia without first consulting with your prescriber.

Suddenly stopping the medication can cause withdrawal symptoms and may be dangerous. Medications like Qsymia can be an effective tool in weight loss, but they should always be taken as directed by a healthcare professional. If you have any questions or concerns about how to take Qsymia, don’t hesitate to reach out to your prescriber.

What Happens If I Miss a Dose of Qsymia?

If you miss a dose of Qsymia, take it as soon as you remember on the same day. However, if it’s already the next day or close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. It’s crucial not to double up on doses or abruptly stop taking Qsymia, as this can lead to potential health risks. Abrupt discontinuation, especially of topiramate, may increase the risk of seizures, and attempting to catch up with extra doses could result in adverse effects.

How to Get Qsymia for Weight Loss

To get a prescription for Qsymia, you’ll need to speak with a healthcare professional who is licensed to prescribe medication. This could be a doctor, nurse practitioner, or physician assistant. Before prescribing Qsymia, your healthcare provider will want to discuss your medical history, current health status, and weight loss goals. They may also want to review any other medications you’re currently taking to ensure there won’t be any negative interactions.

Your prescriber can help you consider the potential benefits and risks of taking Qsymia and discuss other treatment options that may be appropriate for you. Ultimately, the prescriber will decide based on your individual needs and circumstances. They may recommend Qsymia as part of a comprehensive weight loss plan that includes diet and exercise or as a standalone treatment for obesity.

Qsymia Vs. Other Weight Loss Methods

Qsymia, Wegovy, Ozempic, and other medications are some of the more commonly prescribed FDA-approved drugs for weight loss. These medications reduce appetite, increase satiety, and alter the body’s metabolism. Qsymia combines phentermine and topiramate, effectively reducing body weight in clinical trials. However, it has some side effects, including dry mouth, constipation, and insomnia.

On the other hand, Wegovy and Ozempic are GLP-1 receptor agonists that effectively reduce body weight and have fewer side effects than Qsymia. Patients taking Wegovy or Ozempic in clinical trials lost more weight than those taking Qsymia. While these medications may help with weight loss, it is important to consider the long-term health outcomes. Weight loss achieved through medication can be difficult to maintain after the medication is discontinued.

Qsymia in Combination With Lifestyle Changes

Combining Qsymia with lifestyle interventions, such as a healthy diet and regular exercise, may offer enhanced benefits for weight loss. Qsymia, combined with phentermine and topiramate, reduces appetite and promotes a feeling of fullness, potentially making it easier for individuals to adhere to a calorie-controlled diet.

When paired with lifestyle changes, including a well-balanced and nutritious diet and regular physical activity, individuals may experience synergistic effects contributing to more sustainable and substantial weight loss. However, it’s important to note that lifestyle interventions alone often can be effective for weight management, and adding medication like Qsymia should be carefully considered under the guidance of a healthcare professional.

FAQs About Qsymia

You likely have some questions if you’re considering using Qsymia for weight loss. Below, we address common queries to help you better understand this medication.

Frequently Asked Questions

How Long Can You Use Qsymia For?

Individuals can use Qsymia as a chronic weight management solution. The duration of use may vary, and it’s essential to follow healthcare provider guidance. Clinical studies have demonstrated the effectiveness and safety of Qsymia over the long term. Some patients have experienced sustained weight loss when used with a reduced-calorie diet and increased physical activity.

How Effective Is Qsymia for Weight Loss?

Qsymia has shown effectiveness in promoting weight loss when used as directed. Clinical studies in adults have shown Qsymia’s benefits when combined with reduced caloric intake and increased physical activity. Patients typically experience significant weight loss compared to those following a diet and exercise regimen alone.

How Much Weight Can You Lose With Qsymia?

Weight loss outcomes with Qsymia can vary, but clinical trials have shown it to be effective for weight loss. In adults, one year of Qsymia therapy resulted in a notable reduction in body mass index (BMI), with a mean percent change ranging from 11.7% to 27.4%, compared to placebo. The dosage ranged from Qsymia 3.75 mg/23 mg to 15 mg/92 mg orally once daily. Pediatric patients aged 12 to 17 years, with BMI in the 95th percentile or greater, also experienced positive outcomes, with a mean percent change in BMI ranging from 10.6% to 24.4%.²

Is Qsymia Better Than Phentermine?

Qsymia contains phentermine as one of its components. While phentermine is also a standalone medication, Qsymia combines phentermine with topiramate to promote weight loss through multiple mechanisms. The effectiveness may differ for individuals, and the choice between Qsymia and phentermine alone depends on factors such as medical history and treatment goals.

Can Individuals With Certain Medical Conditions Use Qsymia?

Qsymia is not recommended for individuals who are pregnant, who may become pregnant, or for those with glaucoma. Discussing existing medical conditions with your healthcare provider before starting Qsymia is crucial.

Will I Regain Weight After Stopping Qsymia?

It is possible to regain weight after stopping Qsymia. Sustained weight management involves maintaining a healthy lifestyle after completing the medication course.

Questions to Ask Your Healthcare Provider About Qsymia for Weight Loss

If you have been diagnosed with obesity and have been unable to lose enough weight through lifestyle changes alone, Qsymia may be a treatment option to consider. Individuals interested in Qsymia should ask their doctor about its potential benefits, risks, and side effects.

Questions to ask your care team about Qsymia include:

• How safe is Qsymia?
• How long will it take for me to adjust to taking Qsymia?
• Am I at risk for more serious symptoms if I am already taking other medications?
• Will Qsymia allow me to lose weight and keep it off long-term?
• What lifestyle changes should I make while on Qsymia?
• Are there specific dietary restrictions or considerations?
• How often should I follow up with my healthcare provider while on Qsymia?
• Are there any interactions between Qsymia and my current medications?
• What should I do if I experience side effects while taking Qsymia?
• Can I take Qsymia if I have a history of certain medical conditions?
• How will Qsymia fit into my overall weight loss plan?
• What support or resources are available to help me on my weight loss journey with Qsymia?
• Is Qsymia a good alternative to phentermine for weight loss?

How to Know if Qsymia Is Right for You

Talk with your healthcare provider about whether Qsymia may be right for you. Your prescriber will consider your health history, weight loss goals, overall health, and what treatments or interventions you have tried already. Each person may respond differently to a medication, and each treatment has its merits and risks.