Generic Name: phentermine and topiramate extended-release (FEN ter meen and toe PIR a mate)
Brand Names: Qsymia
What is Qsymia?
Qsymia contains a combination of phentermine and topiramate in an extended-release capsule. Phentermine is an appetite suppressant similar to an amphetamine. Topiramate is a seizure medication, also called an anticonvulsant.
Qsymia is used together with diet and exercise to treat obesity. This medication is sometimes used to treat obesity that may be related to diabetes, high cholesterol, or high blood pressure.
Qsymia will not treat any underlying condition you have (such as heart disease, diabetes, high blood pressure). Keep taking any other medications your doctor has prescribed to treat these conditions.
Qsymia may also be used for purposes not listed in this medication guide.
Qsymia can harm an unborn baby or cause birth defects. Do not use Qsymia if you are pregnant. You should not take this medication if you are allergic to phentermine (Adipex-P, Oby-Cap, Suprenza, T-Diet, Zantryl) or topiramate (Topamax), or if you have glaucoma or overactive thyroid. Do not use Qsymia if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.
Before you take Qsymia, tell your doctor if you have high blood pressure, heart disease, diabetes, liver or kidney disease, low blood levels of potassium, or if you have had a heart attack or stroke in the past 6 months.
Phentermine may be habit-forming and should be used only by the person for whom it was prescribed. Keep the medication in a secure place where others cannot get to it. Do not stop taking Qsymia suddenly, or you could have a seizure (convulsions). You may need to use less and less before you stop the medication completely. Ask your doctor how to avoid seizures when you stop using Qsymia.
Before taking this medicine
Do not use Qsymia if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.
You should not take Qsymia if you are allergic to phentermine (Adipex-P, Oby-Cap, Suprenza, T-Diet, Zantryl) or topiramate (Topamax), or if you have:
To make sure you can safely take Qsymia, tell your doctor if you have any of these other conditions:
high blood pressure, heart disease (coronary artery disease, heart rhythm problems, congestive heart failure, pulmonary hypertension);
liver or kidney disease;
low levels of potassium in your blood; or
if you have had a heart attack or stroke in the past 6 months.
FDA pregnancy category X. Qsymia can harm an unborn baby or cause birth defects. Do not use if you are pregnant. Weight loss during pregnancy also can harm an unborn baby, even if you are overweight. Before receiving this medication, you may need a pregnancy test to make sure you are not pregnant. Use effective birth control while you are taking this medication. Qsymia can cause irregular vaginal bleeding while you are taking birth control pills. This should not make the pills less effective in preventing pregnancy. Phentermine and topiramate can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking Qsymia. Do not give this medication to a child younger than 18 years old.
See also: Pregnancy and breastfeeding warnings (in more detail)
Phentermine may be habit forming and should be used only by the person for whom it was prescribed. Never share Qsymia with another person, especially someone with a history of drug abuse or addiction.
How should I take Qsymia?
Take Qsymia xactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.
Drink plenty of liquids while you are taking Qsymia. This will lower your risk of having kidney stones. You can also easily become dehydrated while taking Qsymia, which can lead to severely low blood pressure or a serious electrolyte imbalance. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. You should lose at least 3% of your starting weight during the first 12 weeks of taking Qsymia and eating a low calorie diet. Tell your doctor if you do not lose at least 3% of your starting weight after taking the medication for 12 weeks.
Talk with your doctor if you have increased hunger or if you otherwise think the medication is not working properly. Taking more of this medication will not make it more effective and can cause serious, life-threatening side effects.
Do not stop taking Qsymia suddenly, or you could have a seizure (convulsions). You may need to use less and less before you stop the medication completely. Ask your doctor how to avoid seizures when you stop using Qsymia.
Store Qsymia at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Qsymia is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Qsymia can be fatal.
Overdose symptoms may include confusion, hallucinations, panic, feeling hostile or aggressive, nausea, vomiting, diarrhea, stomach cramps, irregular heartbeat, rapid breathing, overactive reflexes, or seizure (convulsions).
What should I avoid?
Do not take any other prescription or over-the-counter weight-loss products without your doctor's advice. Drinking alcohol can increase certain side effects of Qsymia. This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
Qsymia side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Qsymia: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking this medication and call your doctor at once if you have a serious side effect such as:
pounding heartbeats or fluttering in your chest;
depressed mood, thoughts of suicide or hurting yourself;
trouble concentrating, problems with thinking or speech, feeling like you might pass out;
blurred vision, eye pain, or seeing halos around lights;
low blood sugar (headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery);
severe pain in your lower back, red or pink urine;
feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or
dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, seizure).
Less serious Qsymia side effects may include:
mild dizziness, anxiety, feeling tired or irritable;
memory problems, sleep problems (insomnia);
numbness of tingly feeling; or
altered sense of taste, dry mouth, or an unpleasant taste in your mouth.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Qsymia?
Before using Qsymia, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety). They can add to sleepiness and other side effects caused by Qsymia.
Tell your doctor about all other medicines you use, especially:
digoxin (Lanoxin, Lanoxicaps);
lithium (Eskalith, LithoBid);
a diuretic (water pill);
glaucoma medications such as acetazolamide (Diamox) or methazolamide (Glauctabs, MZM, Neptazane);
insulin or oral diabetes medication; or
seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), divalproex sodium (Depakote), lamotrigine (Lamictal), phenytoin (Dilantin), valproic acid (Depakene, Stavzor), or zonisamide (Zonegran).
This list is not complete and other drugs may interact with Qsymia. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More about Qsymia (phentermine / topiramate)
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about Qsymia.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Qsymia only for the indication prescribed.
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
Copyright 1996-2014 Cerner Multum, Inc. Version: 1.01. Revision Date: 2012-08-15, 12:00:08 AM.