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Generic name: Phentermine and topiramate [FEN-ter-meen-and-toe-PIR-a-mate]
Classification of drugs: Anorexiants

What is Qsymia?

Qsymia includes a mix of phentermine and topiramate in an extended-release capsule. Phentermine is an appetite-suppressant like amphetamine. Topiramate is usually employed as a seizure medicine and is also known as an anticonvulsant.

Qsymia can be used in conjunction with exercises and diet to assist certain children and adults older than 12 years old with overweight or obese health issues related to weight, like diabetes, high cholesterol, and high blood pressure, to shed weight and keep it off.

Qsymia is not a treatment for any of these underlying issues. Continue to take any other medication that your doctor has prescribed to treat these ailments.


Do not take Qsymia while pregnant or if you are pregnant. This medicine may increase the risk of developing a birth defect known as cleft palate and lip in infants. It is not recommended to use Qsymia if you are sensitive to the chemicals phentermine (Adipex-P, Oby-Cap, Suprenza T-Diet, Zantryl) and topiramate (Topamax) or if you suffer from an overactive thyroid or glaucoma.

Before you start taking Qsymia, consult your physician about any conditions such as high blood pressure or diabetes, heart disease, liver or kidney disease, low levels of potassium in your blood, or having suffered a heart attack or stroke within the last six months.

Phentermine is a stimulant and should only be used by the person for the purpose for which it has been prescribed. Store the medicine in a safe area where other people are not able to access it. Don't stop using Qsymia abruptly, or you may experience seizures (convulsions). It is possible that you will need to take less and less until you completely stop taking the medication. Consult your doctor about how to prevent seizures after stopping using Qsymia. Topiramate can cause vision problems that can last for a long time if not treated promptly. Consult your physician immediately if you notice an abrupt decrease in your vision.

Certain people contemplate suicide when taking topiramate. Be aware of fluctuations in mood and their symptoms. Be sure to report any new or worsening symptoms to your doctor. Qsymia could raise the slow heartbeat. Consult your physician if you notice a rapid heart rate or high-pitched beat when you're resting.

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Before taking this medication

Avoid using Qsymia if you've used an MAO inhibitor in the last 14 days. A potentially dangerous interaction between drugs could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, rasagiline, and phenelzine, as well as tranylcypromine and others.

You shouldn't take Qsymia if you are intolerant to phentermine and topiramate or are suffering from:

  • Glaucoma;
  • Excessively active thyroid or
  • If you are expecting or are likely to be expecting.

It is possible that you will need to take a pregnancy test that is negative prior to commencing this treatment. Don't use Qsymia if you are expecting. Stop using this medication and notify your doctor immediately if you find yourself pregnant.

Topiramate can increase the likelihood of having cleft lips and palates during the birth of a baby. The birth defect can be seen during the early stages of pregnancy and can be present before you realize you're expecting. Loss of weight during pregnancy can cause harm to the unborn baby, regardless of whether you're obese. Make sure you are using effective birth control methods to stop pregnancy while using Qsymia.

Qsymia isn't FDA-approved for use by children younger than 12 years old.

To ensure that Qsymia is not harmful to you, consult your physician to determine whether you suffer from:

  • Heart conditions high blood pressure, heart problems
  • A heart attack or stroke
  • Diabetes (weight loss could cause the blood sugar to drop);
  • Metabolic acidosis (too much acid in your blood);
  • Soft or brittle bones (osteomalacia, osteopenia, and osteoporosis);
  • Renal disease, kidney stones, or dialysis;
  • Liver disease;
  • Mood disorders, depression, or suicidal ideas or actions
  • An allergy to aspirin or an allergy to yellow dye (tartrazine):
  • A seizure; or
  • Chronic diarrhea.

Topiramate may increase the amount of acid in the blood (metabolic acidosis). This can weaken bones, lead to kidney stones, trigger problems with growth in children, or harm an unborn baby. It is possible that you will need blood tests to confirm that you are not suffering from metabolic acidosis.

Many people contemplate suicide when they take topiramate. Your doctor must monitor your progress on a regular basis during checkups. Family members or other caregivers should be on the lookout for changes in your symptoms or mood.

Breastfeeding is not recommended when using Qsymia.

How to take Qsymia?

You should take Qsymia exactly as directed by your physician. Follow all instructions on your prescription label, and go through all the medication guides or instructions on the label. Your physician should place you on a diet and workout program once you start taking Qsymia. Keep this program in place throughout the course of your treatment. Use this medicine every morning, whether or not you eat. Drink plenty of fluids every day to avoid the effects of dehydration and kidney stones when you take Qsymia.

To begin the treatment process with Qsymia:

  • Consume one Qsymia 3.75 mg/23 mg capsule every 14 days.
  • After having taken 3.75 mg/23 mg capsules for 14 days, you should take the 7.5 mg/46 mg capsule every morning.

After taking Qsymia for 12 weeks:

  • Your doctor may advise you to take a higher dosage if you don't lose some weight or don't notice a significant decrease in BMI for children aged 12 years or older in your first twelve weeks at the dosage recommended.

If your doctor will increase the dosage of Qsymia,

  • You should take 1 11.25 mg or 69 mg pill once a day throughout the day for 14 days.
  • After 14 days of taking the 11.25 mg/69 mg capsule, you should take a 15 mg/92 mg capsule every morning.

Stopping Qsymia treatment:

Your physician should inform you to quit taking Qsymia in the event that you haven't lost a specific amount of weight or see a reduction in BMI for children aged 12 years old and over following another 12-week treatment with the higher dosage. Stop taking Qsymia before consulting your doctor. Stopping Qsymia abruptly can result in serious issues, like seizures. Your doctor will instruct you on how to stop Qsymia gradually. Place it in a cool, dry place far from heat and moisture.Phentermine can be habit-forming. Usage can trigger addiction, overdose, or even death. Keep the medication in a safe place so that others can't access it. The act of selling or giving away the medication is a violation of the law.

Details on dosage

Usual Adult Dose of Qsymia for Weight Loss:

Initial dosage Start by taking one capsule of the smallest dose (phentermine 3.75 mg/topiramate extended release 23 mg) every day orally at the beginning of the day for the initial 14 days.

Maintenance dose: after 14 days, you should take 1 capsule from the suggested dosage (phentermine 7.5 mg/topiramate 46 mg long-release) daily, orally in the early morning.

Weight loss should be assessed after 12 weeks of the use of phentermine 7.5 mg and topiramate 46 mg extended release. If the patient hasn't lost at least 3% of their body weight at baseline, increase the dosage to 11.25 mg/topiramate (69 mg) every day for 14 days, after which an increase in dosage to be phentermine 15 mg/topiramate mg taken orally every day. The weight loss must be assessed after 12 weeks using phentermine (15 mg) and topiramate (92 mg). If a patient hasn't lost at least 5% of their body weight before treatment, cease treatment, as it is highly unlikely that a patient will attain and sustain clinically significant weight loss with this dosage. Reduce the phentermine 15 mg/topiramate dose slowly by taking it once a day for at most one week prior to discontinuing treatment completely.

Use: As an adjunct to a diet that is low in calories and to increased physical activity to aid in chronic weight control in patients suffering from an initial body mass index (BMI) of 30 kg/m2 or higher (obese) or 27 kg/m2 or more (overweight) with at least one comorbidity related to weight like hypertension, Type 2 diabetes mellitus, or dyslipidemia.

Usual Pediatric Dose of Qsymia for Weight Loss:

Initial dosage: Take one capsule of the dose that is lowest (phentermine 3.75 mg/topiramate 23,5 mg long-release) daily at the beginning of the day for the initial 14 days.

Maintenance dose: After 14 days, you should take just one pill of your recommended dosage (phentermine 7.5 mg and topiramate 46 mg long-release) daily, orally in the early morning.

The weight loss needs to be assessed after 12 weeks of the use of phentermine 7.5 mg and topiramate 46 mg extended release. If a child does not lose at least 3% of their BMI at baseline, increase the dose up to 11.25 mg (topiramate, 69 mg) daily, orally, for 14 days. This is after which you increase the amount to be phentermine (15 mg) or topiramate (92 mg) once a day. It is recommended to evaluate weight loss after 12 weeks of the dose of 15 mg/topiramate at 92 mg. If a patient in the pediatric age group does not lose at least 5% of their BMI at baseline, cease treatment since it is highly unlikely for the child to experience or sustain a meaningful clinical weight loss with this dosage. Reduce the phentermine 15 mg/topiramate dose in a gradual manner by taking it once a day on alternate days for a minimum of one week prior to discontinuing treatment completely.

Use as an adjunct to a diet that is low in calories and more physical activity to help manage weight in chronically overweight children aged 12 years and over with a BMI within the 95th percentile or higher standardized for gender and age.

What happens if I miss a dose?

Don't miss the dose you missed; take the next dose at your regular time. Don't take two doses at the same time.

What happens if I overdose?

For medical emergencies, seek emergency treatment or contact the Poison Help line toll-free at 1-800-222-1222. A high dose of topiramate and phentermine can cause death.

The signs of an overdose could include hallucinations, confusion, mood changes, panic, tremors, a disorienting feeling that is followed by extreme fatigue, nausea, vomiting, diarrhea, stomach cramps, an unsteady heartbeat, and rapid breathing. It could also be a sign of a seizure or coma.

Avoid this

Do not use any other weight-loss products without consulting your physician. "Ketogenic" (also known as "ketosis") diets that are heavy in fat and low in carbohydrates could cause an increase in the likelihood of developing metabolic acidosis. Avoid using such diets when you are taking this medication. Consuming alcohol while taking this medication may cause unwanted side effects.

Avoid driving or engaging in hazardous activities until you are aware of the effects of this medication on your body. Your reaction could be affected. Beware of becoming dehydrated or overheated during the summer heat. Topiramate can reduce sweating and raise body temperature, which can lead to dangerous dehydration.

Side effects Of Qsymia

Take immediate medical care. If you are experiencing symptoms that indicate an allergy Qsymia (itching and breathing difficulties or swelling of your throat or face) or a severe skin reaction (fever or burning eyes, sore throat, and skin irritation, as well as an ailment that is purple or red with peeling and blisters),

Inform your doctor about any new or worsening symptoms, including changes in your mood or behavior, anxiety, panic attacks, trouble sleeping, or if you are feeling uncontrollably angry, irritable, or aggressive. active, restless (mentally as well as physically), depressed, or think about suicide or harming yourself.

See your doctor right away. If you suffer from:

  • Unexpected changes in behavior or mood;
  • Difficulty concentrating, confusion issues with speech, or memory
  • Beats that are fast or rapid while you're sleeping
  • A seizure;
  • Indications of a kidney stone a severe pain in your lower back, side pain, difficulty urinating
  • Indicators of high levels of acidity in the lood: appetite loss, fatigue, mental problems, and tiredness irregular heartbeats.

Common Qsymia adverse effects could include:

  • Joint pain and ankle sprains;
  • Flu-like symptoms;
  • Dizziness;
  • Constipation;
  • Tingling sensation or numbness
  • Sleep problems (insomnia);
  • Dry mouth; changes to your sense of taste; or
  • Mood swings, mood swings, low self-esteem mood changes, feelings of low self-esteem, a loss of interest in activities that you used to love, and feelings of guilt about causing harm to yourself.

This isn't a complete list of possible side effects, and other side effects could occur. Contact your physician to seek medical advice on the effects. You can report any symptoms to the FDA at 1-800-FDA-1088.

Interaction with other drugs

Qsymia could cause vaginal bleeding that is irregular, even when you're taking birth pills to control your birth. This shouldn't render pills less effective in the prevention of pregnancy.




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