The Obesity Made Simple Blog

Medication Highlight: Qysmia

Oct 14, 2022
Qsymia combines the weight loss drugs phentermine and topiramate in a time-release pill

What is Qsymia?

Qsymia combines the weight loss drugs phentermine and topiramate in a time-release pill. Similar to the effects of amphetamine, phentermine has an effect on appetite. As an anticonvulsant, topiramate is frequently recommended for the management of seizures. Together, these medications work to suppress appetite.

Qsymia can be used to assist in attaining and sustaining weight loss in addition to diet and exercise for some adults and children over the age of 12 who are obese, or for some overweight people who also have weight-related medical disorders, such as diabetes, high cholesterol, or high blood pressure.

How much expected weight loss can we expect when taking Qsymia?

Researchers found that after three months of treatment with Qsymia (phentermine/topiramate ER), study participants lost an average of 15 pounds at 12 weeks. After 56 weeks, or almost a year, of taking the medication, participants lost on average 24 pounds.

Who qualifies for Qsymia?

Adults with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 25 kg/m2 or larger (overweight) should use Qsymia in conjunction with a reduced-calorie diet and increased physical activity for long-term weight management.

Overweight is defined as a body mass index (BMI) of 27 or above in the presence of at least one weight-related medical disease, such as hypertension, diabetes mellitus type 2, or high cholesterol.

Pediatricians can also prescribe Qsymia for children 12 years of age and older whose initial body mass index was at or above the 95th percentile

How to Prescribe Qsymia:

  • For the first 14 days, take one Qsymia 3.75 mg/23 mg capsule once daily, preferably in the morning.
  • Following 14 days of taking one 3.75 mg/23 mg capsule, then can increase dose to 7.5 mg/46 mg capsule once daily.

After 12 weeks on Qsymia:

  • If your patients do not lose enough weight within the first 12 weeks of treatment at the prescribed dose, usually goal of at least 5% Body weight loss at 12 weeks, then can increase dose again to max dose of 15mg/92mg

Things to keep in mind:

  • This medication should be taken once daily, preferably in the morning, with or without breakfast.
  • While using Qsymia, it is important to drink lots of water daily to avoid dehydration and the formation of kidney stones.
  • For women of child bearing age, routine pregnancy tests recommended and birth control plan

Most common side effects:

Paraesthesia (numbness or tingling in the limbs or face), dizziness, altered or lost sense of taste (dysgeusia), difficulty sleeping (insomnia), constipation, and dry mouth are all possible side effects.

Most common side effects is children aged 12 years and older:

Depression, dizziness, joint pain, fever, flu, and ankle sprain.

Qsymia is contraindicated in patients:

  • Pregnant 
  • Patients with glaucoma 
  • Patients with With hyperthyroidism
  • Taking or within 14 days of stopping a monoamine oxidase inhibitors
  • With known hypersensitivity to phentermine, topiramate or other component of Qsymia, or idiosyncrasy to the sympathomimetic amines 
  • Patient with history of kidney stones 

If you're interested in learning more about obesity and how to help your patients lower their risk of acquiring fat-related disorders, then our obesity management course is for you. The Experts in the field of obesity medicine are Dr. Michelle and Jeffrey Shukhman who have put together an online course to teach you everything they know. Their obesity continuing medical education is a simplified and straightforward summary of the recommendations and details provided by experts in the field. Medical professionals who further their education by studying obesity and how to improve clinical management of the condition can receive continuing medical education (CME) credits for doing so. Join us now! For further correspondence, please email us at [email protected]