What is Qsymia?
Qsymia contains a combination of phentermine and topiramate in an extended-release capsule. Phentermine is an appetite suppressant similar to an amphetamine. Topiramate is typically used as a seizure medication, also called an anticonvulsant.
Qsymia is used together with diet and exercise to treat obesity. This medicine is sometimes used to treat obesity that may be related to diabetes, high cholesterol, or high blood pressure.
Qsymia dosing information
Usual Adult Dose of Qsymia for Weight Loss:
-Initial dose: Take one capsule of the lowest dose (phentermine 3.75 mg/topiramate 23 mg extended-release) orally once a day in the morning for the first 14 days.
-Maintenance dose: After 14 days, take one capsule of the recommended dose (phentermine 7.5 mg/topiramate 46 mg extended-release) orally once a day in the morning.
-Weight loss should be evaluated after 12 weeks with phentermine 7.5 mg/topiramate 46 mg extended-release. If a patient has not lost at least 3% of baseline body weight, treatment discontinuation or dose escalation should be considered as it is unlikely the patient will achieve and sustain clinically meaningful weight loss at this dose.
Use: Adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese) OR 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia.
What are the side effects of Qsymia?
The most common side effects of Qsymia are:
- Paraesthesia (sensations of pricking, burning, tingling, or numbness of the skin)
- Blurred vision
- Urinary tract infections
- Back pain
- Taste disturbances
- Insomnia or trouble sleeping
- Dry mouth
Rare, but serious side effects associated with this drug therapy include mood changes, trouble sleeping, problems with concentration or memory, speech difficulties, an increase in acid levels in the blood, low blood sugar especially in patients with type 2 diabetes mellitus who are also taking medicines to treat their blood sugar, seizures, kidney stones, decreased sweating, and fever.
What is the dosage for phentermine and topiramate?
- The starting dose of Qsymia is 3.75/23 mg capsule by mouth once each morning for the first 14 days. Thereafter, the recommended dose is one Qsymia 7.5/46 mg capsule once each morning for 12 weeks. If weight loss of at least 3% of body weight does not occur, discontinue or the dose may be increased to one Qsymia 11.25/69 mg capsule once each morning for 14 days. Thereafter, take one Qsymia 15/92 mg capsule once each morning.
- Stop taking it if at least 5% weight loss is not achieved after an additional 12 weeks of treatment on the higher dose.
- To stop this drug, patients should take a dose (determined by your doctor) every other day for at least 1 week and then before stopping stop treatment altogether. Stopping Qsymia suddenly can cause serious medical problems such as seizures. Individuals should inform their doctor before stopping the medication.
- Patients with moderate (creatinine clearance 30 to <50 ml/min) to severe kidney disease (creatinine clearance <30 ml/min) should not exceed Qsymia dose of 7.5/46 mg per day.
- For patients with liver disease, do not exceed Qsymia 7.5/46 mg per day in patients with moderate (Child-Pugh Score= 7 to 9) liver disease.
- Although clinical trials are ongoing, the drug is not yet approved for use in the pediatric population.