This page was last updated/ edited on January 22, 2023.
Qsymia® is a medication containing a combination of sympathomimetic amine anorectic (phentermine) and an antiepileptic drug (topiramate extended-release).
On this page, we will provide basic information about this medication. Links to other articles on this website with more advanced information and tips related to this medication and related topics are provided below—under Related Pages below.
As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in:
1. Adults with an initial body mass index (BMI) of:
- 30 kg/m2 or greater (obese)
- 27 kg/m2 or greater (overweight) if at least one weight-related comorbidity is also present (for example, hypertension, type 2 diabetes mellitus, or dyslipidemia).
2. Pediatric patients (aged 12 years and older) with BMI in the 95th percentile or greater( standardized for age and sex).
Limitations of use
The Prescribing Information notes that: – The effect of Qsymia® on cardiovascular morbidity and mortality has not been established. – The safety and efficacy of Qsymia® with other weight loss products including prescription, over-the-counter drugs, and herbal preparations have not been established.
– Within 14 days of stopping a monoamine oxidase inhibitor (MAOI)
Dosage and Administration
Should be taken once daily in the morning with or without food. Avoid in the evening due to the possibility of insomnia.
Recommended starting dose: 3.75 mg/23 mg (phentermine/topiramate extended-release) daily for 14 days, then increase to 7.5 mg/46 mg once daily.
Increase the dose if 3% weight loss is not achieved after 12 weeks on 7.5 mg/46 mg dose once daily—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 the maximum daily dose of 15 mg/92 mg.
How to discontinue: 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 a possible seizure.
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
Important! This page does not provide all the information needed to prescribe this medication. Please refer to the full Prescribing Information (see link below) before prescribing this medication.
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