Qsymia® is a medication containing a combination of sympathomimetic amine anorectic (phentermine) and an antiepileptic drug (topiramate extended-release). Here is basic information about this medication.
FDA-approved indications
As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:
- 30 kg/m2 or greater (obese)
- 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.
Limitations of use
Effect of Qsymia® on cardiovascular morbidity and mortality has not been established.
Safety and efficacy of Qsymia® with other weight loss products including prescription, over-the-counter drugs, and herbal preparations have not been established.
Contraindicated in pregnancy
For complete discussion of all warnings, precautions, and contraindications, etc., please refer to Prescribing Information (see link below)
Dosage
Recommended: 3.75 mg/23 mg (phentermine/topiramate extended-release) daily for 14 days, then increase to 7.5 mg/46 mg once daily. Should be taken once daily in the morning with or without food. Avoid in the evening due to possibility of insomnia.
Discontinue or escalate dose (as described) if 3% weight loss is not achieved after 12 weeks on 7.5 mg/46 mg dose once daily.
To escalate the dose: Increase to 11.25 mg/69 mg daily for 14 days followed by 15 mg/92 mg once daily.
Discontinue, if 5% weight loss is not achieved after 12 weeks on maximum daily dose of 15 mg/92 mg.
Discontinue 15 mg/92 mg gradually by taking a dose every other day for at least 1 week prior to stopping treatment altogether, to prevent possible seizure.
Special cases
Renal Impairment
Moderate (Creatinine Clearance 30-49 mL/min) and severe (Creatinine Clearance < 30 mL/min) renal impairment: Do not exceed 7.5 mg/46 mg once daily
Hepatic impairment
Moderate hepatic impairment: Do not exceed 7.5 mg/46 mg once daily
Severe hepatic impairment: Avoid in this patient population
Dosage forms and strengths
Capsules:
3.75 mg phentermine and 23 mg topiramate
7.5 mg phentermine and 46 mg topiramate
11.25 mg phentermine and 69 mg topiramate
15 mg phentermine and 92 mg topiramate
Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.
Related Pages
Naltrexone and bupropion (Contrave®): Basic Information
Orlistat (Xenical®): Basic Information
Miscellaneous topics in psychopharmacology: Index and Links
References
Prescribing Information for phentermine and topiramate extended-release (Qsymia®)
Copyright 2016, Rajnish Mago, MD. All rights reserved. May not be reproduced in any form without express written permission.
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