What Is Qsymia (Phentermine and Topiramate)?
Qsymia is the brand name for a prescription drug that combines the drugs phentermine and topiramate, both of which are used to help people lose weight.
Phentermine belongs to a class of drugs called psychostimulants, while topiramate belongs to a class of drugs called antiepileptics that are used to treat epilepsy.
However, because topiramate also causes weight loss, it's been combined with phentermine.
Qsymia is prescribed to help adults with obesity lose weight (combined with exercising and cutting calories) when one of two conditions applies:
The Food and Drug Administration (FDA) originally approved Qsymia in 2012. It's manufactured by Vivus.
Qsymia is a schedule IV controlled substance because it has potential for abuse.
You should not take Qsymia if:
- You are allergic to the active ingredients in Qsymia or any of its inactive ingredients
- You have very serious kidney problems
- You are pregnant
- You have glaucoma
- You either have or are prone to kidney stones
- You have an overactive thyroid
- You are sensitive or allergic to certain chemicals called sympathomimetic amines which could raise your blood pressure
- You have taken a drug called a monoamine oxidase inhibitor (MAOI) within the last 14 days
Additionally, people with the following conditions should be very careful when taking Qsymia:
- Sleep or mood disorders
- Memory and attention span problems
- Mild liver problems (may require a lower dose or dose change)
Pregnancy and Qsymia
Qsymia should not be taken during pregnancy because it can cause severe birth defects.
Tell your doctor if you are pregnant or might become pregnant before taking this medication.
You should also alert your doctor if you are breastfeeding or plan to breastfeed, because Qsymia is not recommended for women who are breastfeeding.
Qsymia Side Effects
Common Side Effects of Qsymia
- Abnormal movements or sensations in the legs, arms, fingers, and/or toes
- Dry mouth and blurry vision
- Constipation, nausea, and diarrhea
- Upper respiratory infections including bronchitis
- Tiredness or inability to sleep (insomnia)
- Urinary tract infections (UTIs)
- Decreased appetite or unpleasant taste in the mouth
- Throat pain, heartburn, stomach discomfort, or upset stomach
- Muscle pain or back pain
- Hair loss
- Potassium levels that stay low continuously while taking Qsymia
- Depression or anxiety
- Changes or abnormalities in your menstrual cycle
- Racing heart beat
Serious Side Effects of Qsymia
- Kidney stones
- Decreased sweating and increase in body temperature
It's always important to share with your doctor and pharmacist all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking.
You should not take Qsymia if you are taking the following drugs:
- Marplan (isocarboxazid)
- Zyvox (linezolid)
- Nardil (phenelzine)
- Matulane (procarbazine)
- Emsam, Eldepryl, or Zelepar (selegeline)
- Parnate (tranylcypromine)
You should also avoid taking Qsymia if you are about to undergo a procedure requiring a contrast dye that contains lobenguane.
If you are taking any of the following, talk to your doctor about drug options other than Qsymia:
Qsymia and Seizure Drugs
Certain drugs for epileptic seizures like phenytoin and carbamazepine were found to decrease levels of topiramate by nearly 50 percent, making Qsymia less effective.
Qsymia and Birth Control
If you are taking birth control while using Qsymia, it's a good idea to use a back-up form of contraception.
Qsymia was also found to make birth control less effective by decreasing estrogen levels by nearly 20 percent.
Qsymia and Alcohol
Currently, there are no available studies demonstrating the effects of drinking alcohol while taking Qsymia.
However, it is possible that alcohol consumption may worsen some of the drug's side effects, so talk to your doctor before drinking alcohol while taking Qsymia.
Additionally, drinking alcohol does not help with weight loss, which, of course, is the whole point of using Qsymia.
Qsymia and Grapefruit Juice
It's unknown whether phentermine is processed by the liver the same way as grapefruit juice.
Topiramate is broken down by the liver the same way as grapefruit, however, so it's best to avoid drinking or eating grapefruit products while taking Qsymia.
For best results, Qsymia should be taken in the morning, with or without food.
Avoid taking Qsymia in the evening and close to your bedtime, because it could make falling asleep very difficult.
Your doctor may prescribe a dose of 3.75 mg/23 mg phentermine and topiramate once a day for the first 14 days of treatment.
After that time, your doctor may increase your dose up to 7.5 mg/46 mg a day for 12 weeks. Expect to have follow-up visits with your doctor to assess your weight loss.
Your doctor may increase your dose if you haven't achieved your weight-loss goal after 12 weeks.
If you suspect an overdose, contact a poison control center or emergency room immediately.
You can get in touch with a poison control center at (800) 222-1222.
Missed Dose of Qsymia
If you miss a dose of Qsymia, take it as soon as you remember, as long as it's not too close to your bedtime or to the time you would normally take your next dose.
If it's almost time for the next dose, skip the missed dose and resume your regular dosing schedule.
Don't double up to make up for missed doses.
Video: Is the new diet drug Qsymia Safe to take? What about the side effects of Qsymia?
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