- Habits That Can Help You Lose Weight Slideshow
- Lose Weight Without Dieting Slideshow
- Surprising Sources of Hidden Sugar Slideshow
- What is phentermine and topiramate, and how does it work (mechanism of action)?
- What are the uses for phentermine and topiramate?
- What are the side effects of phentermine and topiramate?
- What is the dosage for phentermine and topiramate?
- Which drugs or supplements interact with phentermine and topiramate?
- Is phentermine and topiramate safe to take if I'm pregnant or breastfeeding?
- What else should I know about phentermine and topiramate?
What is phentermine and topiramate, and how does it work (mechanism of action)?
- Qsymia is a combination product that contains phentermine and topiramate in an extended release form. It helps some obese (body mass index [BMI] = 30 km/m2) adults or some overweight (BMI = 27 km/m2) adults with weight-related medical problems lose weight and keep the weight off.
- Phentermine is a sympathomimetic agent that has been used by itself for the treatment of obesity for quite some time. Although the exact mechanism by which phentermine works to promote weight loss is not understood, it is thought to stimulate the release of chemicals from the hypothalamus, the area of the brain known to have a major role in regulating hunger and food intake. Phentermine induced release of chemicals is thought to reduce appetite and decrease food intake, among other effects.
- Topiramate, the other medicine in Qsymia, is an anti-seizure medication that has been observed to be effective in causing weight loss. The precise mechanism by which topiramate works to stimulate weight loss is not yet understood. However, similar to the actions of phentermine, topiramate is also thought to suppress appetite and make a person feel full even after eating less food than usual.
- The effectiveness of Qsymia was proven by two placebo-controlled clinical studies. At the end of 1 year of treatment patients had an average weight loss of 7.8% compared to 1.2 to 1.6% for placebo treated patients. Furthermore, approximately 62 to 70% of patients lost = 5% of their body weight compared to about 17 to 21% of patients who received placebo.
- Qsymia was approved by the FDA in July 2012. Use and distribution of Qsymia is under stricter control by the federal government because it contains phentermine, a medicine that has a high potential for abuse and drug dependence. As such, Qsymia is classified as a schedule IV controlled substance.
What brand names are available for phentermine and topiramate?
Is phentermine and topiramate available as a generic drug?
Do I need a prescription for phentermine and topiramate?
What are the uses for phentermine and topiramate?
- Qsymia is an oral weight loss medicine that may help some obese adults (body mass index [BMI] = 30 km/m2) or some overweight adults (BMI = 27 km/m2) with weight-related medical problems such as high blood pressure, type 2 diabetes, or dyslipidemia lose weight and keep the weight off. To achieve maximum weight loss, Qsymia should be used with a reduced calorie diet and increased physical activity.
- The safety and effectiveness of Qsymia with other prescription, over-the-counter (OTC), or herbal weight loss medications has not been established. Therefore, use of Qsymia with such agents is not recommended.
- The safety and effectiveness of Qsymia has not been established in pediatric patients. Therefore, use of Qsymia in pediatrics is not recommended.
What are the side effects of phentermine and topiramate?
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 Qsymia 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.
Latest Diet & Weight Management News
Daily Health News
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 Qsymia if at least 5% weight loss is not achieved after an additional 12 weeks of treatment on the higher dose.
- To stop Qsymia, 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.
Which drugs or supplements interact with phentermine and topiramate?
- Qsymia should not be used during or within 14 days of treatment with a monoamine oxidase inhibitor (MAOIs), due to the risk of hypertensive crisis, a condition in which blood pressure becomes dangerously high and can cause organ damage or death.
- Qsymia can alter blood concentrations of certain birth control medicines. This may cause irregular bleeding, but does not seem to increase the risk of pregnancy. Patients are advised not to discontinue their birth control pills if spotting occurs. Instead, patients should speak to their doctor or pharmacist if the spotting is troubling to them.
- Taking Qsymia with alcohol or other CNS depressant drugs (for example, barbiturates, benzodiazepines or anti-anxiety agents, and sleep medications) increases the risk of drowsiness, confusion, loss of coordination, and other central nervous system (CNS) depression symptoms.
- Taking Qsymia with certain water pills (diuretics) such as hydrochlorothiazide (HCTZ) may cause a decrease in the level of potassium in the blood (hypokalemia).
- Qsymia decreases blood levels of carbamazepine (Tegretol) and valproic acid (Depakote).
- Administration of topiramate, a component of Qsymia, with carbonic anhydrase inhibitors (for example, zonisamide [Zonegran], acetazolamide [Diamox]) may increase the levels of acid in the blood which consequently may increase the risk of kidney stone formation. Co-administration of such agents is not recommended.
Is phentermine and topiramate safe to take if I'm pregnant or breastfeeding?
- Qsymia may cause birth defects and should not be used during pregnancy. Use of topiramate, a component of Qsymia, during pregnancy has been associated with an increased risk of oral clefts. For this reason Qsymia has been classified as FDA pregnancy risk category X, and a program called Qsymia REMS was developed to help prevent fetal exposure to Qsymia. Patients, prescribers, and pharmacies must be registered in the Qsymia REMS programs to receive, prescribe, and dispense Qsymia. To prevent exposure to the unborn baby, females of reproductive age must have a negative pregnancy test before starting Qsymia and monthly thereafter while on Qsymia therapy. Additionally, females of reproductive age should use effective birth control methods during Qsymia therapy.
- Qsymia may be excreted into human milk because topiramate, a component of Qsymia, is known to enter breast milk. Due to the potential risk of causing serious side effects in the nursing infant, a decision should be made to either stop nursing or taking Qsymia.
What else should I know about phentermine and topiramate?
What preparations of phentermine and topiramate are available?
How should I keep phentermine and topiramate stored?
- Capsules should be stored at room temperature between 15 C to 30 C (59 F to 86 F).
- Qsymia is a schedule IV controlled substance because it contains phentermine. Due to the high potential for abuse and drug dependence, Qsymia should be kept in a safe place to protect it from theft.
Qsymia (phentermine and topiramate extended-release) is a combination of two drugs prescribed to treat individuals who are overweight or obese, in conjunction with diet and exercise. Side effects, drug interactions, dosing, storage, and pregnancy safety information should be reviewed prior to taking this medication.
Multimedia: Slideshows, Images & Quizzes
Fat and Fats Quiz: Fatty Food & Body Fat Percentage
Take this online Fat & Fats Quiz to learn if you really are what you eat!...
Food Portion Distortion Quiz: Correct Serving Size
Are your portions deceiving you? Take the Food Portion Distortion Quiz to find out how and why gigantic portions trick you into...
Sugar Quiz: Facts on Diet & Sugar
Sugar lurks in surprising places. Take the Sugar Quiz to learn of the many ways sugar sneaks into your diet and see what you know...
Protein Quiz: Foods High in Protein
Protein is a staple in our diets, but what happens if we get too much? Take this quiz to find out the truth about protein and...
Type 2 Diabetes: Test Your Medical IQ
What causes type 2 diabetes? Can it be prevented? Take this online quiz and challenge your knowledge of this common condition....
High Blood Pressure (Hypertension) Quiz: Symptoms, Signs & Causes
Take this quiz and test your IQ of high blood pressure (hypertension), the cardiovascular disease that causes most strokes and...
Superfoods Quiz: List of Top Superfoods
Take our Superfoods Quiz! Get to know how unprocessed, raw, organic foods and healthy drinks are rich in nutrients and dietary...
Salt Quiz: Test Your Diet IQ
Do you love salt? Take the online Salt Quiz to get the facts about dietary salts and sodium in fruits, vegetables, processed...
Diet and Nutrition Quiz: Plans & Facts
Even if you think you're getting enough fruits and vegetables per day, how can you be sure? Take the Diet & Nutrition Quiz to...
Diabetes Quiz: Test Your Medical IQ
Take the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do...
Vitamin D Quiz: Test Your IQ of Dietary Supplements
What happens to the body when there is a vitamin D deficiency? Take the Vitamin D Quiz to find out what you may be missing....
Top Diets: The Best Dieting Tips Ever for Weight Loss
What separates good diets from the best diets? These weight loss strategies--like drink more water, eat breakfast, sleep...
High Protein Diets: Good or Bad?
Low-carb, high-protein diets are quite popular. High protein diets let you snack on protein-rich foods you love, but what are the...
Foods to Boost Your Energy and Mood
Learn which foods may boost your energy level and have a positive impact on your mood. Foods such as salmon, Brazil nuts, and...
Vegetarian Diet: Tasty, Basic Choices in Pictures
Thinking about becoming a vegetarian? Compared to the general population, the typical vegetarian has a lower body mass index...
Type 2 Diabetes Diagnosis, Treatment, Medication
Learn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Read how diet and exercise can help manage...
Diet Mistake Pictures: Crash Diets, High-Calorie Drinks, and More
Discover 10 common diet mistakes that may be preventing you from losing weight. Learn to avoid these diet blunders and watch the...
Pictures of Famous People With Diabetes
See pictures of celebrities that have been diagnosed with type 1 or type 2 diabetes including Mary Tyler Moore, Salma Hayek, and...
How to Lose Weight Without Dieting: 24 Fast Facts
Weight loss without dieting? No diet, no problem. Learn the best way to lose weight with these weight loss tips designed to help...
Portion Control Tips: Lose Weight and Stick to Your Diet
Portion control can help with weight loss and help you stick to a healthy diet. But how much is too much? This photo guide will...
Tips to Eat Healthy When You Dine Out in Pictures
Recognize the dangers of eating out and stay on your healthy diet at restaurants. Learn about healthy eating at restaurants,...
Diet-Wrecking Foods: Smoothies, Lattes, Popcorn, and More in Pictures
It may seem healthy, but is it really? Many food frauds masquerade as diet food. See 23 foods that seem healthy but can be...
10 Worst Fast-Food Sandwiches: Unhealthy Choices in Pictures
Want to know what the good and bad fast-food sandwiches choices are? Our experts explore the nutrition facts of major restaurant...
High Blood Pressure (Hypertension): Symptoms, Causes, Treatments
What causes high blood pressure (hypertension)? Know the warning signs and symptoms of high blood pressure. Read about high blood...
Bikini-Body Pictures: Workout & Beauty Tips for Swimsuit Season
Discover 25 ways to get ready for swimsuit season. See exercises, diet tips, and other healthy beauty fixes that will motivate...
Pictures of the Belly-Fattening Foods That Men Love
Belly-fattening foods such as chips, beer, doughnuts and fatty red meat can kill a diet. See which foods are tough to resist,...
Diabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Discover the best and worst meals for diabetes-savvy dining. See how to avoid carbs and control your blood sugar with healthier...
Healthy Dieting Myths and Facts
Learn about healthy dieting myths and facts. Can't tell fact from fiction about weight loss and healthy eating? Discover the...
Food Cravings Slideshow: Chocolate, Carbs, Salt, Sugar
Learn which food cravings can wreck your diet. Whether your craving something creamy or crunchy, sweet or salty, food cravings...
Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels
Learn to better control your glucose levels by preventing blood sugar swings. Beware of caffeine, sugary foods, spices, exercise,...
Diabetes Management Tips and Preventing Complications
Learn 10 simple ways to better manage your diabetes. See tips for controlling blood sugar, diet and exercise and other helpful...
Pictures of 10 Muscle-Building Exercises for Diabetes
Watch this slideshow on Diabetes and Exercise. If you have diabetes, see how strengthening your muscles with these 10 weight...
13 Easy Ways to Eat More Greens
Learn 13 easy ways to add more greens to your diet. Discover how to add kale, spinach, broccoli rabe and more into your diet....
Low-Carb Snacks in Pictures
Interested in low-carb snacking? Here are some ideas about smart snacks that are filling and low in carbohydrates....
12 Reasons to Love the Mediterranean Diet in Pictures
The Mediterranean diet is a delicious way to eat healthy. We show you how to get the most from this diet with foods like olive...
Travel Tips for Better Diabetes Control
Traveling with diabetes can be intimidating, but it shouldn't stop you! Learn tips for packing your diabetic supplies, how to...
Diabetes Diet: 11 Low-Sugar Drink Ideas
Searching for low-sugar drink ideas? This pictures slideshow has eleven beverages ideal for people with diabetes and those...
Related Disease Conditions
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are...
High Blood Pressure (Hypertension) Signs, Causes, Diet, and Treatment
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million...
Obesity is the state of being well above one's normal weight. A person has traditionally been considered to be obese if they are...
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the...
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body....
Type 2 Diabetes Medications (Side Effects, Differences)
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and...
Preventing Diabetes Naturally (Type 2, Diet, Causes, Symptoms)
Prediabetes is a condition in which a person has early symptoms of diabetes, but have not yet fully developed the condition. If...
Diabetes Treatment (Type 1 and Type 2 Medications and Diet)
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar....
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include...
Diabetes: Caring for Your Diabetes at Special Times
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in...
Fast-food consumption and lack of exercise are just a couple of causes of childhood obesity. Health effects of childhood obesity...
Diabetes Diet for Type 2 Diabetes, List of Foods
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to...
Treatment & Diagnosis
Medications & Supplements
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.