What is Qsymia?
Qsymia has two drugs in it: phentermine and topiramate ER. Qsymia is a drug that can be addictive and misused.Qsymia comes as a pill that you swallow. It has four doses:
3.75 mg (phentermine)/23 mg (topiramate ER) 7.5 mg/46 mg 11.25 mg/69 mg 15 mg/92 mg When can you use Qsymia? Qsymia is a drug that the FDA says can help you lose weight if you are an adult and your BMI is 30 or more. You can also use it if your BMI is 27 or more and you have a health problem because of your weight. Some of these problems are high blood pressure, diabetes, and high cholesterol.
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In June 2022, the FDA said that Qsymia can also help teens who are 12 or older and have a BMI that is very high for their age and sex.
How does Qsymia help you lose weight?
Qsymia has two drugs that do different things.Phentermine is a drug that makes you feel more alert. We are not sure how it works. But we think it can make you less hungry and eat less food. You can also get phentermine (Adipex-P) by itself as a weight loss drug.
Topiramate ER is a drug that stops seizures. We are not sure how it helps you lose weight. But it seems to make you less hungry and feel full faster. You can also get topiramate (Topamax) by itself as a drug for epilepsy and headaches.
What is Contrave?
Contrave also has two drugs in it: naltrexone and bupropion. Contrave is not a drug that can be addictive.Contrave comes as a tablet that you swallow. It has one dose: 8 mg of naltrexone and 90 mg of bupropion.
When can you use Contrave? Contrave is also a drug that the FDA says can help you lose weight if you are an adult and your BMI is 30 or more. You can also use it if your BMI is 27 or more and you have a health problem because of your weight. But it is not for teens.
How does Contrave help you lose weight?
Qsymia, we don’t know how naltrexone or bupropion help you lose weight.
Naltrexone (Vivitrol) is a drug that you can use by itself, at higher doses, to stop using opioids or alcohol. It blocks parts of your brain that may make you gain weight when they are turned on. Blocking them seems to help you want less food.
Bupropion (Wellbutrin XL) is a drug that can make you feel happier. It can also help you quit smoking. Bupropion makes more of some chemicals in your brain. These chemicals may help you want less food."
"How well do Qsymia and Contrave work for losing weight?
Usually, Qsymia works better than Contrave. A study looked at many drugs for losing weight and Qsymia was the best. It showed that you have a better chance of losing 5% or more of your weight with Qsymia than with the other drugs, including Contrave.
Studies showed that after 56 weeks, about 7 out of 10 adults who took the highest dose of Qsymia lost 5% or more of their weight. And almost 5 out of 10 adults lost 10% or more of their weight. Teens who took Qsymia for 56 weeks had their BMI go down by 7% on average.
In studies, about 4 out of 10 adults who took Contrave lost 5% or more of their weight in 56 weeks. Only about 2 out of 10 adults lost 10% or more of their weight. When Contrave was used with group help and a set plan for eating and moving, these numbers got better. But they were still not as good as Qsymia."
What are the bad effects of Qsymia and Contrave?
In a study, more people quit Contrave than Qsymia because of bad effects.The bad effects that many people had with Qsymia and Contrave are shown in the table below.
Bad effect Qsymia* Contrave Feeling sick 7% 33% Feeling pins and needles 20% Not known Dry mouth 19% 8% Hard to poop 16% 19% Pain in the head 11% 18% Sick in the nose or throat 14% Not known Throwing up Not known 11% Feeling dizzy 9% 10%*Bad effect numbers change by dose. What are the very bad effects of Qsymia and Contrave? Qsymia has some very bad effects, but they are not common.
Babies with problems if taken when pregnant Heart beating fast Drug addiction or abuse Thinking of killing yourself or hurting yourself Trouble seeing, including eye disease Feeling sad or angry or having trouble sleeping Growing slowly in teens Too much acid in the blood Kidney problems The maker of Qsymia says you should check if you are pregnant before taking the drug and every month after that. This, and using birth control, can help stop babies with problems. They also say you should check your blood before taking Qsymia to see if you have too much acid or kidney problems.
Contrave has a warning from the FDA about thinking of killing yourself or hurting yourself. Since bupropion can make you feel happier, it may also make you have this bad effect. Other very bad but not common Contrave effects are:
Feeling crazy or restless Shaking or twitching Blood pressure going up Heart beating fast Liver problems Eye problems
Qsymia (phentermine and topiramate ER) is a drug that has two parts: one that makes you less hungry and more alert, and one that stops seizures. It is used with eating less and moving more to help adults who are too heavy or fat stay healthy.
What are the bad effects of Qsymia? Qsymia can make you feel or act differently, such as:
feeling sad, having trouble sleeping, being confused, feeling dizzy, feeling worried, feeling tired, feeling angry, having trouble pooping, feeling pins and needles, tasting things differently, having a dry mouth, having a bad taste in your mouth, having a pain in your head, having a sick nose or throat, having a runny or blocked nose, having a sinus infection, having a pain in your back, having flu signs, having a chest infection, feeling weak, feeling sick, having loose stools, having a cough, having an infection in your pee, having trouble seeing, having pain in your arms or legs, having a rash, having a pain or upset in your stomach, having muscle twitches, having heartburn, feeling thirsty, having pain in your eyes, having dry eyes, having a fast heartbeat, losing hair, not wanting to eat, having different periods, having pain in your muscles, having pain in your neck, or having trouble thinking, paying attention, remembering or talking. Get help from a doctor or call 911 right away if you have these very bad effects:
Very bad eye signs such as losing your sight, seeing blurry, seeing a dark spot, having pain or swelling in your eyes, or seeing rings around lights; Very bad heart signs such as your heart beating fast, uneven, or hard; feeling a flutter in your chest; having trouble breathing; and feeling dizzy, faint, or falling down; Very bad head signs such as a bad pain in your head, being mixed up, talking funny, having a weak arm or leg, having trouble walking, losing your balance, feeling stiff, having a high fever, sweating a lot, or shaking. This paper does not have all the bad effects and there may be others. Ask your doctor for more information about the bad effects.
How much Qsymia should you take?
How much Qsymia you take depends on your BMI. Start with Qsymia 3.75 mg/23 mg (phentermine 3.75 mg/topiramate 23 mg ER) every day for 14 days; after 14 days take the suggested dose of Qsymia 7.5 mg/46 mg (phentermine 7.5 mg/topiramate 46 mg ER) once a day. Check how much weight you lose 12 weeks after you start.
What other things can change how Qsymia works? Other drugs can change how Qsymia works. Tell your doctor all the drugs you take.
Qsymia when you are pregnant or breastfeeding If you take this drug when you are pregnant, or if you get pregnant while taking this drug, stop taking it right away and tell your doctor. It can hurt your baby. We don’t know if Qsymia goes into breast milk. Ask your doctor before breastfeeding. You may feel bad if you stop taking this drug suddenly.
More information Our Qsymia Bad Effects Drug Center gives you a full view of the drug information on the bad effects when taking this drug.
"Drug Description /h4> DESCRIPTION Qsymia is a pill that you swallow. It has two parts: one that works right away and one that works slowly. Qsymia has phentermine hydrochloride, a drug that makes you less hungry and more alert, and topiramate, a drug that is like sugar and stops seizures.
Phentermine Hydrochloride The name of phentermine hydrochloride is α,α-dimethylphenethylamine hydrochloride. It is made of C10H15N • HCl and it weighs 185.7 (hydrochloride salt) or 149.2 (free base). Phentermine hydrochloride is a white, smell-less, wet, hard powder that can dissolve in water, methanol, and ethanol. It looks like this:
Phentermine Hydrochloride - Structural Formula Illustration Topiramate Topiramate is 2,3:4,5-di-O-isopropylidene-β-D-fructopyranose sulfamate. It is made of C12H21NO8S and it weighs 339.4. Topiramate is a white or almost white hard powder that tastes bad. It can dissolve in methanol and acetone, a little in pH 9 to pH 12 water solutions and very little in pH 1 to pH 8 water solutions. It looks like this:
Topiramate - Structural Formula Illustration Qsymia Qsymia comes in four doses:
Qsymia 3.75 mg/23 mg (phentermine 3.75 mg and topiramate 23 mg slow) capsules; Qsymia 7.5 mg/46 mg (phentermine 7.5 mg and topiramate 46 mg slow) capsules; Qsymia 11.25 mg/69 mg (phentermine 11.25 mg and topiramate 69 mg slow) capsules; Qsymia 15 mg/92 mg (phentermine 15 mg and topiramate 92 mg slow) capsules. Each capsule has these things that do not work: methylcellulose, sucrose, starch, microcrystalline cellulose, ethylcellulose, povidone, gelatin, talc, titanium dioxide, FD&C Blue #1, FD&C Red #3, FD&C Yellow #5 and #6, and black and white inks for drugs.
"What you should know about Contrave, Qsymia, Saxenda and Xenical. Story by: Kelley M. McIntyre, M.D. on August 27, 2020
People who are too heavy or fat may get help from a drug that can help them stay healthy for a long time. Four drugs for losing weight — Contrave, Qsymia, Saxenda and Xenical — that were allowed since 2012 give doctors who help with weight more ways to help with fatness. Before 2012, we had less to use.
These drugs for losing weight are for people who have a BMI of 30 or more, or 27 or more with at least one health problem because of their weight, such as high blood pressure, diabetes, liver disease or breathing problems when sleeping. They are used with eating less and eating fewer carbs, and each works differently.
People have to follow some rules to use each of the drugs below, and not all of them are paid by insurance.
Qsymia has two parts: phentermine (Adipex-P, Lomaira), which makes you less hungry by making more norepinephrine, and topiramate (Topamax), which works with GABA in the brain and is used for headaches and seizures.
Qsymia is not for people with high blood pressure that is not controlled, many heart diseases and high blood pressure in the lungs.
Two big studies that lasted for a year found that people who took Qsymia lost more weight than people who took a fake pill. They lost from 6.7% (smallest dose) to 8.9% (suggested dose) of their weight.
Contrave Contrave has two parts: naltrexone, a drug that stops opioids, and bupropion, a drug that makes more dopamine and norepinephrine and is sold as a drug for sadness under names like Wellbutrin and Zyban.
A study showed that people who took Contrave lost 4% more weight than people who took a fake pill in one year, with 42% of people who took Contrave losing 5% or more of their weight compared with 17% of people who took a fake pill.
Qsymia and Contrave are not for women who are pregnant or breastfeeding. Women who take any of these drugs need to use a good birth control method.
"Saxenda (liraglutide) Saxenda is a drug that you inject. It makes you less hungry like the GLP-1 hormone that humans make naturally. After a year, a study showed 56% of people who got Saxenda lost 5% or more of their weight, compared with 25% for the fake group.
Saxenda makes thyroid C-cell lumps in rats and mice, so people who have family members with thyroid cancer or many hormone problems should not take it. It is also not for women who are pregnant or breastfeeding.
Xenical (orlistat) Xenical stops stomach and pancreas enzymes. This means that fats in the food go out instead of being taken in. After a year, a study showed people who took Xenical lost 10% of their weight on average, compared with 6% for the fake group.
Xenical is not for women who are pregnant or might get pregnant, and for people who have trouble absorbing food or have bile problems.
"In the contest of drugs for losing weight, we have a winner. All five drugs that the Food & Drug Administration said are good for weight loss do better than a fake pill in helping people lose weight, but a drug sold as Qsymia — a mix of the drugs phentermine and topiramate — made people who took it for a year lose a lot of their extra weight.
In the last four years, the FDA has, with a lot of care, said yes to four new drugs for losing weight. While some Americans are taking the new drugs — which are sold as Belviq, Qsymia, Contrave and Saxenda — many people still use Orlistat, a drug for losing weight that you can buy without a doctor’s note. The FDA first said yes to Orlistat in 1999 and it is sold as Alli.
The drug companies that make and sell the new drugs have paid a lot to make doctors give them to Americans who are too fat as the weight of most of the people in the country has gone up.
"Losing weight needs hard work, time, and sometimes, drugs. Adipex, Contrave, Wellbutrin, and Qsymia are some of the drugs that people talk about a lot for losing weight. In this article, we look closely at each of these drugs, and show how they are different and why you need a doctor to help you.
Knowing the Drugs There are many drugs for losing weight, and they work for different needs. Adipex, Wellbutrin, and Qsymia are some of the best drugs, and they have different benefits.
Adipex (Phentermine): A drug that makes you more alert and less hungry, like amphetamine. Adipex is used to make you eat less, and help you lose weight.
Wellbutrin (bupropion): A drug that was made to make you feel happier, but it can also help you lose weight. It works by changing chemicals in your brain, and affects your mood and hunger.
Qsymia: A drug that has two parts: Phentermine and Topiramate. Qsymia helps you lose weight in two ways. Phentermine makes you less hungry, and Topiramate makes you feel full faster. This is why Qsymia is a good choice for losing weight.
Contrave: A drug that has two parts: bupropion, a drug for sadness, and naltrexone, a drug that stops opioids. Together, they help you control your hunger and cravings, and help you with your mood and weight.
Dealing with Weight Loss Drugs Every drug, while it can help you, can also have bad effects. Knowing this helps you make good choices and be ready for any problems. Some bad effects of weight loss drugs can be dry mouth, trouble sleeping, hard to poop, or high heart rate or blood pressure. You need to know the bad effects of the drug you want to take.
The Need for a Doctor Using drugs for losing weight is not a simple decision. Our bodies are different, and drugs can work differently for us. You need a doctor who knows a lot about fatness to help you.
Health Problems: Some problems like heart diseases, mood problems, or hormone problems, can change how safe and good the weight loss drugs are for you.
Different Reactions: People can react differently to drugs. A doctor can watch you and help you if you have any bad reactions.
Knowing the Bad Effects: Drugs can have bad effects. You need to know what they are and what they mean for your safety and health.
Complete Plan for Losing Weight Losing weight and keeping it off is not just about taking a pill; it is a big journey. Drugs can help you a lot with your weight, but they work better with eating well, moving more, and thinking positively. These things together make a complete plan for losing weight. You can get help from experts – doctors, food experts, exercise experts, and talk experts – who can give you advice and a plan. This plan can help you lose weight and be healthy and happy.
Do you want to start a journey to lose weight with these drugs? Contact the Weight Loss Center of the North Shore (WLCNS) and find out how we can help you lose weight. We can guide you to your health goals. Start today.
References:
American Medical Association. (2021). The Role of Prescription Drugs in Weight Management. Link
"All five drugs for losing weight that you can buy in the U.S. can help people lose enough weight to be healthier, researchers said on Tuesday.
The drugs, which work differently to help people lose weight, have been allowed over the last 17 years.
The drug that made people lose the most weight? One called Qsymia — a mix of an old drug that makes you less hungry called phentermine and a drug that stops seizures called topiramate.
They work together in ways that we don’t know well to make you eat less and 75 percent of people who used the drug lost 5 percent or more of their weight, the study found.
“All drugs that work were linked to more weight loss than a fake pill after one year."
People who used Qsymia lost more than 19 pounds on average after a year. People who used liraglutide, a drug for diabetes sold as Victoza, lost almost 12 pounds on average, the researchers found, and 63 percent of those who used it lost 5 percent or more of their weight — the amount that can make diabetes and heart problems less likely.
Victoza, which you have to inject, helps the stomach get rid of food faster and changes how well the body uses insulin, which changes food into sugar.
What can change how Qsymia and Contrave work?
Qsymia can make you bleed more when you use birth control pills. It can also make you more likely to feel dizzy and confused when you use other drugs that make you less alert like alcohol. If you use a drug that makes you pee more, Qsymia can make you have less potassium in your body. And you should not use MAO (monoamine oxidase) inhibitors with Qsymia.
Contrave has a drug that makes you happier, so using it with other drugs that make you happier or MAO inhibitors can make you have too much serotonin. Contrave can make you have more digoxin in your blood if you use them together. And Contrave also changes how other drugs that affect dopamine and those that cause seizures work.
Contrave is broken down by liver enzymes. And it can stop other drugs from being broken down by the liver. This can make more interactions possible.
With both Qsymia and Contrave, it’s important for your doctor and pharmacist to check your current drugs for any interactions.Indications & Dosage INDICATIONS QSYMIA is a drug that can help you lose weight for a long time when you eat less and move more. It is for:
Adults who have a BMI of: 30 kg/m² or more (too fat), or 27 kg/m² or more (too heavy) and have at least one health problem because of their weight such as high blood pressure, diabetes, or high cholesterol Teens who are 12 years or older and have a BMI that is very high for their age and sex. Limitations Of Use We don’t know how QSYMIA affects heart problems and death. We don’t know how safe and good QSYMIA is when you use it with other things for losing weight, including drugs that you need a doctor’s note for, drugs that you can buy without a doctor’s note, and herbs.