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Description
Qsymia (phentermine / topiramate ER) is a combination medication used to help you lose weight. It’s taken by mouth once daily, alongside a healthy diet and regular exercise routine. Qsymia (phentermine / topiramate ER) is only available through the Risk Evaluation and Mitigation Strategies (REMS) program it can raise the risk for birth defects if taken by people during pregnancy. Some common side effects of Qsymia (phentermine / topiramate ER) include feelings of a “pins-and-needles” sensation, dry mouth, and constipation.
Qsymia Doses
The starting Qsymia dosage for adults is 3.75 mg/23 mg once daily for 14 days. After that, the dosage is increased to 7.5 mg/46 mg once daily for 12 weeks (3 months). After 12 weeks, you and your healthcare provider should evaluate your weight loss and experience with Qsymia.
What are the side effects of Qsymia (phentermine / topiramate ER)?
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults
Feeling of pins and needles (4-20%)
Dry mouth (7-19%)
Constipation (8-16%)
Runny nose, sore throat, and other symptoms of an upper respiratory tract infection (12-16%)
Headache (7-11%)
Change in taste (1-9%)
Trouble sleeping (5-9%)
Dizziness (3-9%)
Children
Depression (2-4%)
Nausea (4%)
Fever (2-4%)
Dizziness (2-4%)
Joint stiffness (2-4%)
Other Side Effects
Adults
Sinus infection
Nausea
Back pain
Tiredness
Diarrhea
Blurry vision
Bronchitis
Cough
Urinary tract infection (UTI)
Serious Side Effects
- Suicidal thoughts or behaviors
- Seizures
- High levels of acid in your body (metabolic acidosis): fast shallow breathing, loss of appetite, feeling tired, and irregular heartbeat
- Dangerously low blood sugar: dizziness, drowsiness, feeling confused or anxious, hunger, shakiness, sweating, tingling sensation
- Severe allergic skin reactions: rash, blisters, peeling skin, fever, trouble breathing
- Serious allergic reactions: dizziness, flushing, trouble breathing, nausea, vomiting, fast heartbeat, rash, swelling in the face or tongue, difficulty swallowing
What are the risks and warnings for Qsymia (phentermine / topiramate ER)?
Harm to unborn baby
Risk factors: Currently pregnant | Females of childbearing age
Qsymia (phentermine / topiramate ER) can harm your unborn baby, so you shouldn’t use it during pregnancy. Studies show that taking topiramate, one of the medications in Qsymia (phentermine / topiramate ER), raises the risk of cleft lip during the first trimester.
Fast heart beat
Qsymia (phentermine / topiramate ER) can speed up your heart rate up to 20 beats per minute. There’s limited research regarding how this might affect people with certain heart conditions in the long run. Your provider will check your heart before you start this medication. You might not be able to start Qsymia (phentermine / topiramate ER) if your heart health isn’t stable. Contact your provider if your heart is beating really strong and hard while you’re at rest (meaning you’re sitting and haven’t done any physical activity recently) because your provider might ask you to stop taking Qsymia (phentermine / topiramate ER).
Suicidal thoughts or behavior, and mood problems
Risk factors: History of depression | History of attempted suicide
Qsymia (phentermine / topiramate ER) contains the antiseizure medication, topiramate. Many antiseizure medications, including topiramate, raise the risk of suicidal thoughts or behavior, depression, and anxiety. This can happen as early as within the first week of starting treatment. People with a history of attempted suicide need to avoid Qsymia (phentermine / topiramate ER). Watch for worsening depression or any unusual changes in your mood or behavior, especially during the first few months of treatment or when the dose changes. Make sure that you and your loved ones watch out for any changes in behavior that could lead to suicidal thoughts or depression, and report concerns to your provider right away. If you have depression or anxiety, your provider might need to lower your dose of Qsymia (phentermine / topiramate ER) or ask you to stop taking it all together.
Vision problems
Risk factors: First month of Qsymia (phentermine / topiramate ER) use
Qsymia (phentermine / topiramate ER) can cause eye problems and vision changes that can be serious and lead to blindness if not treated. Symptoms usually show up in the first month after you start Qsymia (phentermine / topiramate ER) and include eye pain and nearsightedness. Contact your provider if you experience any vision changes.
Problems concentrating
Risk factors: Raising the dose of Qsymia (phentermine / topiramate ER) too quickly | Drinking alcohol | Taking antidepressants or other medications that can affect your concentration
Qsymia (phentermine / topiramate ER) can cause problems with concentration, memory, and language. The risk for these problems is higher if your provider started you at a higher dose of Qsymia (phentermine / topiramate ER), or raised your dose too quickly. Try to avoid or limit how much alcohol you drink while taking Qsymia (phentermine / topiramate ER) because alcohol can also make these problems worse. Don’t drive or do anything that requires a lot of focus until you know how this medication affects you. Contact your provider if you have trouble with thinking or concentrating, or other symptoms such as dizziness, drowsiness, light-headedness, or feeling unsteady on your feet. Your provider might need to lower your dose of Qsymia (phentermine / topiramate ER) or stop your treatment altogether.
How much weight can I expect to lose with Qsymia (phentermine / topiramate ER)?
In clinical trials of adults, people who took the recommended dose of Qsymia (phentermine / topiramate ER) lost an average weight of 15 lbs after taking this medication for about 3 months, compared to 5 lbs lost by people who only managed their weight through diet and exercise (placebo group). After taking Qsymia (phentermine / topiramate ER) for about 1 year, people who took Qsymia (phentermine / topiramate ER) lost an average of 24 lbs, compared to 6 lbs lost by people in the placebo group. Keep in mind that different people might respond differently to Qsymia (phentermine / topiramate ER), so your results might not be the same. Let your provider know if you have more questions about how well this medication will work for you.
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