Qsymia Overview: Side Effects, Uses, Dosage, and More

Uses for Qsymia

Qsymia is used to help with weight loss and long-term weight management in:

• adults and children ages 12 years and older with obesity
• adults with overweight who also have a weight-related health condition, such as type 2 diabetes, high cholesterol, or high blood pressure

Qsymia should be used with a low calorie diet and regular exercise. Your doctor or nutritionist can help you create a long-term weight management plan that works for you.

The terms “overweight and obesity” are usually defined by using your height and weight to calculate your body mass index (BMI). Having a BMI of 25 to 30 puts you in the overweight category, while having a BMI of 30 or higher classifies you as having obesity.

Carrying excess weight may cause symptoms like joint or back pain, sleep apnea, or breathlessness. More importantly, overweight and obesity raise your risk of serious health problems. These include heart disease, blood clots, high blood pressure, stroke, and cancer.

Qsymia works to help with weight loss by reducing your appetite. The drug contains two active ingredients, which work in different ways in your brain to reduce feelings of hunger. This can help you consume fewer calories, which can lead to weight loss.

Limitations of use

Qsymia has certain limitations of use. Firstly, it’s not known if Qsymia can reduce your risk of heart disease because this hasn’t been studied. And secondly, it’s not known whether it’s safe or effective to use Qsymia with other weight loss medications.

Side effects of Qsymia

Like most drugs, Qsymia may cause mild to serious side effects. The following lists contain some of the more common side effects Qsymia may cause, but they don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

• your age
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Qsymia. They can also suggest ways to help reduce side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Qsymia and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here’s a list of some of the mild side effects that Qsymia can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Qsymia’s prescribing information.

Mild side effects of Qsymia that have been reported include:

• dizziness
• tingling or numbness in the hands, feet, or face
• trouble sleeping
• constipation
• metallic taste
• dry mouth
• nausea
• headache
• upper respiratory infections, such as the common cold or sinusitis (sinus infection)
• hair loss

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Qsymia can occur, but they aren’t common. If you have serious side effects from Qsymia, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Qsymia that have been reported include:

• depression or anxiety
• increased risk of suicidal thoughts and behavior
• eye problems, including closed-angle glaucoma (increased pressure in the eye)
• problems with thinking, concentration, memory, or speech
• kidney problems, such as reduced kidney function or kidney stones
• metabolic acidosis (high level of acid in the blood)
• hypokalemia (low level of potassium in the blood)
• increased heart rate
• serious skin reactions
• sleep problems
• reduced sweating and increased body temperature, especially in hot temperatures or when exercising
• slowed growth in children with long-term use of Qsymia

Side effects in children

Qsymia is used in children ages 12 years and older with obesity. The most common side effects reported in children taking Qsymia include:

• depression
• fever
• dizziness
• joint pain
• flu
• ligament sprain

Slowed growth has also been reported in children taking Qsymia for long periods of time. If your child takes Qsymia, their doctor will usually monitor their height and weight. If your child isn’t growing as expected, the child’s doctor may reduce their dosage of Qsymia or stop it completely.

If you have concerns about the risk of side effects in children taking Qsymia, talk with your child’s doctor.

Allergic reaction

For some people, Qsymia can cause an allergic reaction. But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Qsymia treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Qsymia, they may have you switch to a different treatment.

Qsymia dosage

The Qsymia dosage your doctor prescribes will depend on several factors. These include:

• your age
• how well your liver and kidneys work
• other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Form and strengths

Qsymia comes as an oral extended-release capsule. (Extended-release capsules release the medication into your body slowly over several hours.) It’s available in four strengths:

• 3.75 milligrams (mg) phentermine and 23 mg topiramate (3.75 mg/23 mg)
• 7.5 mg phentermine and 46 mg topiramate (7.5 mg/46 mg)
• 11.5 mg phentermine and 69 mg topiramate (11.5 mg/69 mg)
• 15 mg phentermine and 92 mg topiramate (15 mg/92 mg)

Recommended dosage

Your doctor will prescribe the dosage of Qsymia that’s right for you. Keep reading to learn more.

Dosage for weight loss

To help with weight loss in adults, the usual dosage for starting treatment is 3.75 mg/23 mg taken once per day for 14 days. After this, your doctor will usually increase your dosage to 7.5 mg/46 mg taken once per day.

After 12 weeks, your doctor will assess how much weight you have lost. In some cases, they may increase your dosage of Qsymia.

Children’s dosage

Qsymia is used to help with weight loss in children ages 12 years and older with obesity. To start treatment, the usual dosage is 3.75 mg/23 mg taken once per day for 14 days. After this, your child’s doctor will usually increase their dosage to 7.5 mg/46 mg taken once per day.

Your child’s doctor will monitor your child’s weight during their treatment. If they are losing weight too quickly, your child’s doctor may reduce their dosage.

After 12 weeks, your child’s doctor will usually assess how much weight the child has lost. In some cases, they may increase your child’s dosage of Qsymia.

About taking Qsymia

The following are some common questions about taking Qsymia.

• Can Qsymia be chewed, crushed, or split? No, you should not chew, crush, or split Qsymia capsules. You should swallow them whole. If you have trouble doing so, you can get tips on how to swallow pills, or ask your doctor or pharmacist for advice.
• Should I take Qsymia with food? Qsymia can be taken with or without food.
• Is there a best time of day to take Qsymia? Qsymia should be taken in the morning. Taking the medication later in the day can cause trouble sleeping at night.
• What if I miss a dose of Qsymia? If you miss a dose of Qsymia in the morning, skip the missed dose. Take your next dose at its usual time the following morning. You should not take two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
• Will I need to use Qsymia long term? Qsymia is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for you, you’ll likely take it long term.
• How long does Qsymia take to work? Qsymia begins to work after you take your first dose. But it may take a few weeks before you start losing weight. How quickly you lose weight during Qsymia treatment may depend on many factors, including your diet and how much exercise you do. Your doctor will monitor your weight throughout your treatment to check whether Qsymia is working for you.

Overdose

Do not take more Qsymia than your doctor prescribes, as this can lead to harmful effects.

Symptoms caused by an overdose can include:

• restlessness
• tremor
• fast breathing
• nausea and vomiting
• confusion
• hallucinations
• irregular heartbeats
• high or low blood pressure
• irritability or aggression
• drowsiness
• blurred or double vision
• problems with speech or coordination
• psychosis
• seizures

In rare cases, overdose of Qsymia may cause death.

What to do in case of overdose

Call your doctor if you think you’ve taken too much Qsymia. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Qsymia interactions

Qsymia can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Before taking Qsymia, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, or supplements you use. Sharing this information can help you avoid potential interactions.

Interactions with medications, foods, and supplements

The following table highlights medications, supplements, and foods that can interact with Qsymia. This list does not contain all drugs that may interact with Qsymia. If you have questions about interactions that may affect you, ask your doctor or pharmacist.

Qsymia and alcohol

It may not be safe to consume alcohol while taking Qsymia. Drinking alcohol with Qsymia may raise your risk of certain Qsymia side effects or make them worse. Examples include dizziness, sleepiness, and problems with coordination, breathing, thinking, concentration, memory, or speech.

If you have questions about the safety of drinking alcohol while taking Qsymia, talk with your doctor or pharmacist.

Qsymia cost and savings

Whether you have health insurance or not, cost may be a factor when you’re considering Qsymia. What you’ll pay for Qsymia may depend on several things, such as your treatment plan and the pharmacy you use

Here are a few things to consider regarding cost:

• Cost information and savings coupons: You can visit Optum Perks for price estimates of Qsymia. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.
• Generic form: Qsymia is available as the generic drug phentermine/topiramate. Generics usually cost less than brand-name drugs. Talk with your doctor if you’d like to know whether generic phentermine/topiramate could be an option for you.
• Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Qsymia Engage may also be available. For more information, visit the program website or call 888-998-4887.

Factors to consider when taking Qsymia

The following is important information to consider and discuss with your doctor or pharmacist before taking Qsymia.

Pregnancy and Qsymia

Qsymia should not be taken during pregnancy. If you’re able to become pregnant, your doctor will likely want you to take a pregnancy test before starting Qysmia and every month during treatment.

If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this drug.

Birth control and Qsymia

Qsymia is not safe to take during pregnancy. So if you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control options while you’re taking Qsymia.

Qsymia and breastfeeding

Qsymia should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor about your options.

Qsymia precautions

Before taking Qsymia, discuss your health history with your doctor. Qsymia may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

• kidney problems
• liver problems
• history of mental health problems, such as depression or suicidal thoughts
• severe lung or breathing problems
• glaucoma
• hyperthyroidism (high thyroid hormone levels)
• diarrhea
• upcoming surgery
• previous allergic reaction to this or a similar drug
• allergy to aspirin
• pregnancy
• breastfeeding

Note: For more information about the potential negative effects of Qsymia, see the “Side effects of Qsymia” section.

Qsymia withdrawal and dependence

Qsymia can cause drug dependence. With drug dependence, your body relies on a drug to function as usual. So if you suddenly stop taking the drug, this may cause withdrawal symptoms.

Suddenly stopping Qsymia could cause extreme tiredness, depression, or seizures. So you should not suddenly stop taking Qsymia without talking with your doctor first.

If you and your doctor agree that you should stop taking Qsymia, your doctor may reduce your dosage slowly before you stop treatment completely.

Frequently asked questions about Qsymia

Here are answers to some commonly asked questions about Qsymia.

Is Qsymia the same as Ozempic?

No, Qsymia is not the same as Ozempic. They contain different active ingredients and work in different ways. Ozempic isn’t approved for weight loss, but it is sometimes prescribed off-label for this use.

Qysmia contains two active drugs called phentermine and topiramate. It works in your brain to reduce your appetite. Ozempic contains the active drug semaglutide. It works in both your digestive system and brain to help manage blood sugar levels and may also help reduce your appetite.

There are several other differences between these drugs. To learn more about how they compare, talk with your doctor or pharmacist.

Is Qsymia a controlled substance?

Yes, the Food and Drug Administration (FDA) has designated Qsymia as a Schedule IV controlled substance. This is because one of the active ingredients in Qsymia (phentermine) is related to amphetamine, which has a risk of misuse and dependence.

With misuse, a drug is used in a way that’s not prescribed by a doctor, usually for a pleasurable or rewarding effect. With dependence, you rely on a drug to function as usual, either physically or mentally.

If you’re concerned about the risk of misuse and dependence with Qsymia, talk with your doctor or pharmacist.

Is Qsymia better than phentermine?

It’s not known if Qysmia is better than phentermine. There haven’t been any studies comparing the effects of these medications on weight loss.

Phentermine is a weight loss medication that’s available as the brand name drugs Adipex-P and Lomaira. Qsymia contains phentermine with another medication called topiramate.

Qsymia and phentermine have both been found effective for helping with weight loss. However, phentermine is only suitable for short-term use (a few weeks), while Qsymia can be used long term. The amount of weight you may lose on either drug may vary depending on several factors, including your diet and the amount of exercise you do.

If you’d like to learn more about how Qysmia compares with phentermine, talk with your doctor. They can help you determine whether one of these medications is a better option for you.