Phentermine and Topiramate

Phentermine and Topiramate are two drugs approved by FDA (Food and Drug Administration) in the U.S. The combination of these medications has resulted in the rise of a new weight loss pill that now stands second to Lorcaserin – the first anti-obesity drug that has been used since 1999. The frequently asked questions and answers on this newly approved drug are given below.

What is Phentermine?

It is a prescription appetite-suppressant drug that functions as an effective weight loss pill to treat obesity on a short-term basis. It is normally beneficial to those obese patients who are at a greater risk of developing serious health complications.

What is Topiramate?

It is an anticonvulsant drug used to prevent seizures in epileptic patients. It is generally used alone or in combination with other medications. The drug is also effective in preventing migraine headaches.

Can Phentermine be combined with Topiramate?

An extended-release preparation of Phentermine and Topiramate is being widely used by many obese patients. This is known as Qsymia and is available in the form of capsule. It is indicated as an adjunct to a low- calorie diet and vigorous physical exercise for chronic weight management. It has been found to treat other obesity-associated disorders like Type 2 diabetes, hypertension and high cholesterol.

Who can use Qsymia?

The combination drug can be taken by patients with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater
  • 27 kg/m2 or greater in the presence of at least one obesity-related co-morbidity such as diabetes, high cholesterol or high blood pressure

Who is the manufacturer of Qsymia?

Vivus Inc., a California-based pharmaceutical company is the sole manufacturer of the combination drug.

What are the recommended doses of Qsymia?

During research, various doses of Phentermine instant release (IR) and topiramate controlled-release (CR) were used in the late-stage clinical trials to check the effectiveness as well as safety of the combination drug.

Full-strength formula

It consisted of 15 mg of Phentermine IR and 92 mg of Topiramate CR.

Mid-strength formula

Its active ingredients comprised of 7.5 mg of Phentermine IR and 46 mg of Topiramate CR.

Low-strength formula

The low dose of Qsymia comprised of 3.75 mg of phentermine IR and 23 mg of topiramate CR.

The clinical trial results showed that the affected patients must start on a middle dose of the drug for approximately 12 weeks as it helps them in losing an average 8.4% of their current weight. Higher doses are administered to those patients who do not lose 3% of their body weight after 12 weeks of use.

What are the side effects of Qsymia?

The presence of topiramate may increase the risk of suicidal thoughts or behavior in patients. Behavioral changes, mood swings, poor concentration and memory loss are frequently observed in patients who are on Qsymia. Some of the most common side effects of this combination drug include:

  • Dizziness
  • Tingling in hands and feet
  • Dry mouth
  • Insomnia
  • Modification in taste
  • Constipation

What are the limitations of Qsymia treatment?

The drug is not recommended to pregnant women as it may put the growing fetus at a higher risk of developing various congenital abnormalities, such as cleft lip or cleft palate. A negative pregnancy test is advisable for women who are planning to start this combination drug therapy. Women who become pregnant while consuming the drug must immediately stop taking it and consult a healthcare provider for quick remedial action. Qsymia causes rapid heartbeat that may increase the risk of developing various cardiac disorders. Individuals who are on monoamine oxidase inhibitors, a class of anti-depressants, are strictly prohibited from having the drug. The drug is not recommended to patients who are highly allergic to Phentermine, Topiramate, or its other ingredients. It should not be used by patients suffering from Hyperthyroidism or Glaucoma.

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