Endocrinology Book

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Phentermine and Topiramate

Aka: Phentermine and Topiramate, Qsymia, Qnexa
  1. See Also
    1. Medications Associated with Weight Gain
    2. Orlistat (Xenical)
    3. Lorcaserin (Belviq)
    4. Phentermine (Ionamin, Fastin)
    5. Obesity
    6. Obesity in Children
    7. Obesity Evaluation
    8. Obesity Measurement (or Obesity Screening)
    9. Obesity Risk (or Obesity Comorbid Conditions)
    10. Obesity Management
    11. Obesity Medication
    12. Dietary Supplements in Obesity
    13. Exercise in Obesity
    14. Obesity Resources
  2. Indications
    1. BMI >30 or
    2. BMI >27 and one comorbid condition
  3. Dosing
    1. Phentermine/Topiramate
      1. Start: 3.75 mg/23 mg for the first 2 weeks
      2. Titrate to maximum of 15 mg/92 mg
    2. Discontinuation
      1. Discontinue if 5% weight loss not achieved at maximum dose at 12 weeks
      2. Taper off gradually (risk of Seizure)
  4. Efficacy
    1. Weight loss is promising at 24 pounds in one year or 10% of body weight
    2. Weight loss of at least 5% in up to 70% of patients at one year
  5. Adverse effects
    1. Teratogenic (Topiramate)
      1. Precautions to avoid pregnancy (reliable Contraception) while on Qsymia are paramount
      2. REMS training program (Risk Management) has been developed
      3. Pregnancy Test when initiating medication and then monthly
    2. Tachycardia, Hypertension and Insomnia (Phentermine)
    3. Impaired memory or concentration (Topiramate)
    4. Dizziness
    5. Paresthesias in distal extremities
    6. Altered Taste Sensation
  6. References
    1. (2013) Presc Lett 20(7): 37
    2. Erlandson (2016) Am Fam Physician 94(5): 361-8 [PubMed]
    3. Garvery (2012) Am J Clin Nutr 95:297–308 [PubMed]
Medication Costs
qsymia (on 12/21/2016 at Medicaid.Gov Pharmacy Drug pricing)
QSYMIA 11.25 MG-69 MG CAPSULE $6.38 each
QSYMIA 15 MG-92 MG CAPSULE $6.40 each
QSYMIA 3.75 MG-23 MG CAPSULE $5.78 each
QSYMIA 7.5 MG-46 MG CAPSULE $5.96 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Phentermine / topiramate (C3475162)

Concepts Pharmacologic Substance (T121)
English Phentermine / topiramate, phentermine-topiramate, PHENTERMINE/TOPIRAMATE
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Qsymia (C3497630)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C576188
English Qsymia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Qnexa (C3530195)

Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH C577572
English Qnexa
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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