Qsymia – What Is It?

​Qsymia is a prescription weight loss drug approved by the FDA that contains a combination of immediate-release Phentermine and extended-release Topiramate (Topamax) in an extended-release capsule.  Originally developed by Vivus.

​Phentermine is labeled as an appetite suppressor that has some similarities to amphetamines and Topiramate is a seizure drug (anticonvulsant). Qsymia is a mixture of these drugs and used as a chronic weight management program along with behavior changes, diet restrictions and exercise.

​Two large clinical trials (1 year each) were conducted for 56 weeks on Qsymia that involved 3,754 patients who had BMIs (Body Mass Index) of 30 or greater, or 27 or greater with two or more weight-related issues such as diabetes type-2, hypertension or dyslipidemia (high cholesterol). Patient’s weight loss and waist circumference were recorded. A subset of patients (N=2,076) with a baseline BMI of 30 or greater were reported. The patients were randomized to a placebo, Phentermine 3.75 mg/Topiramate 23 mg, Phentermine 7.5 mg/Topiramate 46 mg, or Phentermine 15 mg/Topiramate 92 mg. These patients were recommended to eat a well-balanced diet and to reduce their caloric intake by 500 Calories a day. Qsymia is reported to help you lose 24 pounds or more and help you keep it off, lose 4 inches or more off your waist and achieve 10 percent average percent weight loss. Keep in mind that your results may vary depending on your particular BMI, exercise, diet, dosage, age and gender.

​Ultimately, Qsymia helps you in two ways to meet your weight loss goals. It helps to decrease hunger that is to say take away your cravings for food while making you feel full throughout the day. This helps to keep you from snacking and overeating when you have meals. How Qsymia works is not well understood at this time.

Those Who Should Not Take Qsymia

  • Pregnancy – do not take Qsymia if you are pregnant, planning to become pregnant or breastfeeding. This drug is listed as an FDA pregnancy Category X. Qsymia may pass into breast milk and potentially harm your newborn. Qsymia can pass into the fetus and potentially cause birth defects such as cleft palate.
  • Glaucoma – serious eye problems may occur while on Qsymia if you have glaucoma. Look for any sudden decrease in vision with or without eye pain and redness. Qsymia can cause blockage of fluid in the eye which can cause an increase in eye pressure (secondary angle closure glaucoma). These symptoms can lead to permanent vision loss if not treated promptly.
  • Thyroid problems – if you have hyperthyroidism, you should not take Qsymia.
  • Monoamine oxidase inhibitors – if you are taking monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days, do not take Qsymia.
  • Allergies – do not take Qsymia if you are allergic to cold medications, dyes, Phentermine or related amines, Topiramate or any other ingredients that may be in Qsymia such as binders and fillers.
  • Stroke – if you’ve had a heart attack or stroke in the past, Qsymia may not be for you. Talk with your healthcare provider and see what he/she says.

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