Phentermine-topiramate (Qsymia)

Approved for adults who are:

  • obese with a body mass index of 30 or more, or
  • adults who are overweight with a body mass index of 27 or more with at least one weight related condition such as high blood pressure, diabetes, sleep apnea etc.

How does Qsymia work?

A mix of two medications: phentermine, which lessens your appetite, and topiramate, which is used to to teat seizures or migraine headaches. May make you less hungry or feel full sooner.

Brand names of combination products

  • Qsymia® (containing Phentermine, Topiramate)

Side effects of Phentermine and Topiramate

Side effects of of Qsymia

  • constipation
  • dizziness
  • dry mouth
  • taste changes, especially with carbonated beverages
  • tingling of your hands and feet
  • trouble sleeping


Things to know about Phentermine and Topiramate

How should this medicine be used?

  • Phentermine and topiramate is available as Qsymia which is an extended release
  • Many doctors also prescribe the components separately
  • Phentermine and topiramate is usually taken with or without food once a day in the morning.
  • Phentermine and topiramate may cause difficulty falling asleep or staying asleep if it is taken in the evening.
  • Take phentermine and topiramate at around the same time every day.
  • Follow the directions for taking Phentermine and topiramate
  • Take phentermine and topiramate as directed.



  • The dose is usually titrated up gradually by most doctors
  • Phentermine and topiramate may be habit forming as it is a controlled substance although true withdrawal is rare.
  • Phentermine and topiramate will help control your weight only as long as you continue to take the medication

What special precautions should I follow?

Before taking phentermine and topiramate:

  • tell your doctor any and all medications you take including any medications for depression
  • tell your doctor about any vitamins, nutritional supplements, and herbal products you are taking or plan to take
  • follow instructions on how to take the medicine properly
  • tell your doctor if you have glaucoma
  • tell your doctor if you have had a heart attack or a stroke in the past 6 months
  • if you have ever thought about killing yourself or tried to do so,
  • tell your doctor if you are pregnant or plan to become pregnant
  • If you are woman of child bearing age, you need a secure form of contra-ception as you cannot get pregnant on this medication, it can lead to birth defects such as neural tube defects, talk to your doctor about it
  • tell your doctor if you are breast-feeding.

Birth control options

contraceptive-options-qsymiaDue to the risk of cleft lip in the fetus, woman who can potentially become pregnant need secure form of contraception while on Phentermine Topiramate.
Here are the acceptable options
Acceptable Contraception Methods
For Females of Reproductive Potential
OPTION 1 – Highly Effective Methods To Use Alone
These options include
Intrauterine device (IUD) or intrauterine system (IUS)
 – Copper IUD
 – Levonorgestrel­releasing IUS
Progestin implant
 Tubal sterilization 
Male partner’s vasectomy
OPTION 2 – Acceptable Methods To Use In Combination
Two methods of contraception in this
choose one from each – see the diagram
Option 3 – see the diagram


  • Can phentermine and topiramate be taken together?
  • How much weight did you lose on Phentermine and Topamax?
  • How long does it take for phentermine and topiramate to start working?
  • How much weight can you lose with topiramate?
  • What is the average weight loss on phentermine?
  • Can you lose weight on Topamax?
  • Should I take Topamax at night or in the morning?
  • Can you drink caffeine while taking phentermine?
  • Can you take more than 37.5 mg phentermine per day?
  • Is topiramate an appetite suppressant?
  • How long does it take to lose weight on topiramate?
  • Can you take 60 mg of phentermine?
  • Is hair loss a side effect of topiramate?
  • How does topamax make you feel?
  • Does topiramate help you sleep?

Qsymia FAQS

  • How long should you take qsymia?
  • What happens when you stop taking Qsymia?
  • What are the side effects of Qsymia?
  • Does qsymia work immediately?
  • What are the 4 worst blood pressure drugs?
  • How long does it take for qsymia to leave your system?
  • Do you lose weight on topiramate?
  • What time of day should you take qsymia?
  • Can you drink coffee while taking Qsymia?
  • How much weight do you lose with qsymia?
  • What’s the best prescribed weight loss pill?
  • Is qsymia effective for weight loss?

W8MD physician medical weight loss program offers Phentemine and Topiramate or other prescription weight loss options for patients interested in losing weight after consultation with one of our weight loss doctors



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