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What Is Qsymia?

Qsymia is a prescription extended-release combination medication containing phentermine and topiramate. It is approved for long-term weight management in adults and adolescents aged 12 years and older with obesity, and adults with overweight who have at least one weight-related medical condition. Qsymia is used alongside a reduced-calorie diet and increased physical activity. Phentermine acts as an appetite suppressant, while topiramate contributes to weight reduction through mechanisms that are not fully established. Qsymia is a Schedule IV controlled substance and can cause serious fetal harm if taken during pregnancy.

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What Is Qsymia?

Qsymia is a prescription extended-release combination medication containing phentermine and topiramate. It is approved for long-term weight management in adults and adolescents aged 12 years and older with obesity, and adults with overweight who have at least one weight-related medical condition. Qsymia is used alongside a reduced-calorie diet and increased physical activity. Phentermine acts as an appetite suppressant, while topiramate contributes to weight reduction through mechanisms that are not fully established. Qsymia is a Schedule IV controlled substance and can cause serious fetal harm if taken during pregnancy.

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How Does Qsymia Work?

Qsymia combines phentermine, a sympathomimetic appetite suppressant, with extended-release topiramate, an anticonvulsant that also affects appetite and weight regulation. Phentermine influences neurotransmitters involved in hunger, particularly norepinephrine. Topiramate has several neurological actions, including effects on ion channels and neurotransmitter signaling, although its precise contribution to weight reduction remains uncertain. Together, the ingredients can reduce food intake and support weight loss alongside dietary and activity changes. Qsymia does not directly block dietary fat absorption. Its effects and tolerability depend on the prescribed dose and individual response.

Who Can Receive Qsymia for Weight Management?

Qsymia is approved for adults and adolescents aged 12 years and older with obesity. It is also approved for adults who have overweight with at least one weight-related condition, such as hypertension or type 2 diabetes. A clinician assesses body weight, medical history, kidney function, cardiovascular factors, and other medications before prescribing it. Qsymia must not be used during pregnancy or in patients with glaucoma, hyperthyroidism, or certain medication interactions. It is not approved for children younger than 12 years. Treatment response is evaluated periodically to determine whether continued therapy is appropriate.

How Should Qsymia Be Taken?

Qsymia is taken orally once daily in the morning, with or without food. Treatment begins with 3.75 mg phentermine and 23 mg topiramate daily for 14 days, followed by 7.5 mg/46 mg once daily. Further dose escalation depends on weight reduction and treatment response, with a maximum approved dose of 15 mg/92 mg daily. Patients with moderate or severe kidney impairment or moderate liver impairment have lower maximum dose limits. Patients who can become pregnant should have a negative pregnancy test before treatment and monthly thereafter and use effective contraception. The highest dose must be tapered gradually when discontinued to reduce seizure risk.

What Are the Side Effects and Warnings of Qsymia?

Common adverse effects include tingling sensations, dizziness, altered taste, insomnia, constipation, and dry mouth. Qsymia can cause serious fetal harm, including an increased risk of oral clefts, and is available through a restricted REMS program. Other serious risks include acute myopia and secondary angle-closure glaucoma, mood changes, suicidal thoughts, metabolic acidosis, kidney stones, and increased heart rate. Pediatric patients require growth monitoring because treatment can slow height gain. Sudden eye pain, blurred vision, significant mood changes, or symptoms of pregnancy require prompt medical assessment. Qsymia must be discontinued immediately when pregnancy is recognized.

Common Questions About Qsymia

Is Qsymia the same as phentermine?

Qsymia contains phentermine together with extended-release topiramate. It is not the same as phentermine-only weight management medication.

Can adolescents take Qsymia?

Yes. Qsymia is approved for weight management in adolescents aged 12 years and older with obesity, alongside dietary changes and increased physical activity.

Is Qsymia safe during pregnancy?

No. Qsymia is contraindicated during pregnancy because topiramate exposure can increase the risk of birth defects, including oral clefts.

Can Qsymia affect eyesight?

Yes. Qsymia can cause acute myopia and secondary angle-closure glaucoma. Sudden blurred vision or eye pain requires immediate medical attention.

References

DailyMed - QSYMIA (phentermine and topiramate) capsule, extended release. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=40dd5602-53da-45ac-bb4b-15789aba40f9. Date Accessed November 2, 2026.

Phentermine and Topiramate. MedlinePlus. https://medlineplus.gov/druginfo/meds/a612037.html. Date Accessed November 2, 2026.

Phentermine. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK547916/. Date Accessed November 2, 2026.

Risk Evaluation and Mitigation Strategy (REMS). Qsymia REMS. https://qsymiarems.com/. Date Accessed November 2, 2026.

Topiramate. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK548632/. Date Accessed November 2, 2026.