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Qsymia: Diet Pill Information, Risks, Cost

Can the Diet Pill Work for You?


Updated April 22, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Qsymia: Diet Pill Information, Risks, Cost



If you are looking for a medical treatment for your weight, you have a few new options. The Food and Drug Administration (FDA) recently approved two new medications: Belviq (lorcaserin) and Qsymia (phentermine plus extended-release topiramate) in 2012. These two medications join Xenical (orlistat) as the only prescription medications available in the United States for weight loss.


What is Qsymia?

Qsymia is a combination of two medications: phentermine and topiramate. Phentermine was part of the popular phen-fen drug combination that was used years ago before it was removed from the market over concerns about the safety of fenfluramine. Topiramate is a drug that is used for the treatment of epilepsy and migraines. The two drugs work together to suppress appetite and reduce your food intake.

Qsymia can be prescribed for adults who have a BMI over 30 or who have a body mass index of 27 and higher, but who also have a weight-related condition such as type 2 diabetes or high blood pressure. Patients who take this diet medication should also follow a healthy eating and exercise program. The prescription, along with lifestyle modifications, is meant to be a lifelong treatment for obesity.

How Much Weight Can I Lose on Qsymia?

In clinical trials, patients who took a lower dose of the weight loss medication (3.75 mg phentermine/23 mg topiramate) lost an average of 6.7 percent of their weight. On the higher, recommended dose (7.5 mg/46 mg), patients lost an average of 8.9 percent of their total body weight. Higher doses of the diet medication, up to 15 mg phentermine/92 mg topiramate, are also available.

If you are thinking about taking Qsymia, you might estimate your potential weight loss in terms of a range. For example, based on clinical results, a patient who weighs 250 pounds could reasonably expect to lose 17 to 22 pounds of her original weight. But remember that while you are taking Qsymia, you should also be following a program of diet and exercise. Your success on the medication may depend on whether or not you stick to those lifestyle modifications.

Patients who take Qsymia are monitored by their physician. If they don't lose at least three percent of their weight in the first twelve weeks, they may choose to discontinue the drug, or take a higher dose. If after moving to a higher dose, the patient does not lose at least five percent of her weight, it's recommended that she discontinue taking the pill gradually, as it's not likely that she'll be able to lose a significant amount of weight.

What Are The Side Effects Of Taking Qsymia?

Patients who get pregnant while taking Qsymia have a “small yet increased risk of cleft lip and/or palate,” according to Craig Primack, MD, FAAP. Primack, the medical director of Scottsdale Weight Loss Center, explained the FDA recommendation that women of childbearing age take a monthly pregnancy test while on Qsymia. He says that, since the lip and cleft form at weeks 6-8 of pregnancy, women need to know immediately if they become pregnant. This allows them to stop taking the drug before a birth defect occurs.

Other possible side effects of the weight loss medication include depression, mood problems, trouble sleeping, and concentration and speech difficulties. The drug maker also recommends that patients receive regular heart-rate monitoring, and does not recommend the use of Qsymia in patients with recent or unstable cardiac issues or cerebrovascular disease, since its use in these patients has not been studied.

How Much Does Qsymia Cost?

Several pharmacies sell a month’s supply of Qsymia at prices ranging from $150-$160. Currently, most insurance plans do not cover the medication, but since plans vary, you should check with your provider to see if it might be covered for you. In addition, if you're a woman who can get pregnant, be sure to factor in the cost of a monthly pregnancy test as well.

If you do choose to invest in the medication, be aware that only certain pharmacies may dispense the drug. As part of an agreement with the FDA, drugmaker Vivus agreed to sell the medication only through pharmacies that take part in an educational program that ensures patients get risk reduction information along with their medication.

Should I take Qsymia?

Qsymia should not be taken by people who only have a few pounds to lose. But if you're significantly overweight and have tried other methods of weight loss without success, Qsymia may be able to help you slim down to improve your health. According to The New England Journal of Medicine, some patients who took the diet pill were able to improve their blood pressure and cholesterol levels in addition to losing weight.

But there are significant side effects and costs to consider as well, especially if you're a woman who's still planning to have children. You could choose to go off the medication in order to have a family, but without the medication, it's likely that your appetite will increase without the suppressant medication, and it's possible to regain the weight.

As with any medical decision, talk to your health care provider before making a decision. Talk to your doctor about the potential health benefits of losing weight and about which side effects may impact you based on your specific medical history.


Centers for Disease Control. Healthy Weight - it's not a diet, it's a lifestyle! Accessed: February 11, 2013. http://www.cdc.gov/healthyweight/losing_weight/index.html

Eric Colman, M.D., Julie Golden, M.D., Mary Roberts, M.D., Amy Egan, M.D., M.P.H., Joyce Weaver, Pharm.D., and Curtis Rosebraugh, M.D., M.P.H.. "The FDA's Assessment of Two Drugs for Chronic Weight Management." New England Journal of Medicine October 25, 2012.

Food and Drug Administration. Medications Target Long-Term Weight Control. Accessed: February 11, 2013. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm312380.htm

Craig Primack MD, FAAP. Interview. February 18, 2013.

Food and Drug Administration"Qsymia Medication Guide." February 23, 2013.

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